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Posted: 2020-12-24T17:48:16Z | Updated: 2020-12-24T17:48:16Z

LOS ANGELES (AP) California became the first state to record 2 million confirmed coronavirus cases, reaching the milestone on Christmas Eve as close to the entire state was under a strict stay-at-home order and hospitals were flooded with the largest crush of cases since the pandemic began.

A tally by Johns Hopkins University showed the nations most populated state has recorded 2,010,157 infections since January. More than 23,000 people have died from the virus.

Californias infection rate in terms of the number of cases per 100,000 people is lower than the U.S. average but its nearly 40 million residents mean the outbreak outpaces other states in sheer numbers.

The grim milestone comes as a COVID-19 crisis that health officials say stems from Thanksgiving gatherings strains the states medical system. More than 18,000 people are hospitalized and many of the states intensive care units are filled.

The state has seen its number of cases climb exponentially in recent weeks, fueled largely by people who ignored warnings and held traditional Thanksgiving gatherings, health officials say. Soaring rates of hospitalizations and deaths have overwhelmed intensive care units and prompted hospitals to put emergency room patients in tents and treat others in offices and auditoriums.

Nearly the entire state is under a stay-home order that imposed an overnight curfew, shuttered many businesses, and restricted most retail to 20% capacity. Restaurants may only serve takeout.

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The pleas to avoid social gatherings for Christmas and New Years rang with special desperation in Southern California. Los Angeles County is leading the surge, accounting for one-third of the states COVID-19 cases and nearly 40% of deaths.

We know that this emergency is our darkest day, maybe the darkest day in our citys history, Los Angeles Mayor Eric Garcetti said Wednesday when the county reported its highest death toll and hospitalizations in a single day since the pandemic began 145 deaths and more than 6,000 people in hospitals.

More than 9,000 people have died from the coronavirus in the county.

If LA County continues to see the same growth in COVID-19 infections in the next two weeks, hospitals may find themselves having to ration care because of a lack of medical staff, Garcetti said.

That means the doctors will be forced to determine who lives and who dies, he said.

Medical workers are discouraged and outraged over scenes of crowded outdoor malls, packed parking lots, and parents and children walking around without masks, county Health Services Director Dr. Christina Ghaly said.

Santa Clara County near San Francisco was down to 35 ICU beds, putting hospitals dangerously close to rationing care, said Dr. Ahmad Kamal, the countys director of health care preparedness.

We are talking about people in gurneys without a bed to go to. We are talking about people not getting hospital care; we are talking about rationing what scarce resources our exhausted health system has left to those who would benefit the most, he said.