By Betty Yu

SAN FRANCISCO (KPIX) — The CDC has a grim prediction: the U.S. death toll from COVID-19 could hit 321,000 by mid-December and hospitals might be overflowing with patients in many parts of the country.

California hit 18,350 daily coronavirus cases on Wednesday.

In Los Angeles, health officials expect shortages in nurse-staffed ICU beds over the next two weeks.

“We have a full ICU of people with COVID who are fighting for their lives so this is real,” said Dr. Jim Keany, an emergency room physician at Mission Hospital in Mission Viejo.

The numbers aren’t as bad in the Bay Area. Still, Santa Clara county saw its highest daily number of hospitalizations on Wednesday with 197 patients. San Francisco did not move into the most restrictive purple tier as expected earlier this week but that could soon change.

“San Francisco is like that last bit of sanctuary, it’s like the safe house in Walking Dead,” said UCSF infectious disease specialist Dr. Peter Chin-Hong. “But you’re being boxed in by all that purple so it’s only a matter of time because of people moving back and forth.”

Dr. Chin-Hong said the rate of increase in cases and the number of hospitalizations are breathtaking. For example, UCSF recently doubled its admissions and that number has not changed this week.

“We’re seeing more of a variety of cases, so there’s essential workers, there’s people who might’ve had pandemic fatigue, they might’ve been really good at staying away from high-risk environments for months and months and months and then they went to that meal outdoors,” he said.

Because community transmission is so high, Dr. Chin-Hong says people are getting the virus in indoor and outdoor settings.

The CDC is stressing the importance of wearing a mask. It recently took a look at Kansas’ mask mandate, saying it is proof that face coverings work. Counties that implemented a mask mandate saw a 6 percent drop in cases. Counties that didn’t saw cases rise 100%.

Canada also celebrated its Thanksgiving six weeks ago. Since then, the number of coronavirus cases diagnosed per day has more than doubled. The surge in the U.S. is expected to be worse.