SACRAMENTO, Calif. (AP) — California had a near-record number of daily coronavirus deaths as pandemic cases strained hospitals and reduced normal intensive care space to a record low, Gov. Gavin Newsom said Wednesday, yet there were faint hints that residents may be heeding medical officials’ increasingly desperate calls for caution during the holidays.

The transmission rate — the number of people that one infected person will in turn infect — also has been slowing for nearly two weeks. The rate of positive cases reached a new high of 12.3% over a two-week period but was starting to trend down over the last seven days from a peak of 13.3% to 12.6%.

The number of new positive cases dropped to a relatively modest 39,069, given that California has been averaging nearly 44,000 newly confirmed cases a day.

“We are experiencing a modest decline in the rate of the growth,” Newsom said. A three-day decline “doesn’t necessarily make a trend…but it’s a modest indication of a possible sign of some good news.”

Yet the state’s worst surge is taking a horrendous toll that threatens to only worsen if people gather during the holidays.

California recorded the second-highest number of deaths, at 361. The number of coronavirus patients in intensive care units nearly doubled in just three weeks, to 3,827 cases, while the state’s overall ICU capacity fell to 1.1%, down from 2.5% just two days ago. The number of hospitalizations jumped to 18,828 patients, more than double since Dec. 1, with 605 new patients in one day.

Santa Clara County near San Francisco was down to 35 ICU beds, putting hospitals dangerously close to rationing care, said Dr. Ahmad Kamal, the county’s 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.

Any Christmas surge in cases would push the county over the edge, warned its top health officer, Dr. Sara Cody.

“If we have a surge on top of a surge, we will definitely break,” she said. “We cannot afford that.”

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The out-of-control increases are reminders of how “dynamic and virulent this disease is,” Newsom said.

The statewide total of positive cases is now 1.96 million, with Los Angeles County accounting for one-third of the cases and nearly 40% of deaths.

Los Angeles County Public Health Director Barbara Ferrer reported 145 new deaths Wednesday, the county’s highest one-day total, pushing the death toll there to 9,153.

“More than half a million people in LA County have tested positive and tragically we’re on our way to witnessing 10,000 deaths from COVID-19 as our hospitals are overwhelmed with COVID-19,” Ferrer said. Currently, 6,155 people are hospitalized, with 20% in ICUs and 16% on ventilators.

She warned that cases will climb for at least the next two weeks, and will continue to spike into the new year unless people take precautions.

County Health Services Director Dr. Christina Ghaly said residents “must accept that our collective behaviors as a community of Los Angeles County in the days around Thanksgiving directly led to our rising rates of hospitalization and the rising deaths that we are now experiencing.”

Medical workers are discouraged and outraged over scenes of crowded outdoor malls, packed parking lots, and parents and children walking around without masks, she said.

The Archdiocese of Los Angeles announced that the latest guidelines from the Los Angeles Department of Public Health allow parishes to resume indoor religious services with precautions including masks, social distancing and sanitation. But Archbishop José Gomez said in a letter to priests and pastors that it is safer to keep celebrating Masses outdoors.

Statewide, a third of all hospital patients have tested positive for the disease, rising to 70% in some hospitals. All of Southern California and the 12-county San Joaquin Valley to the north have been out of regular ICU capacity for days.

Health workers in the San Joaquin Valley’s Fresno County on Tuesday described operating rooms and regular hospital floors turned into ICUs and patients being treated in auditoriums and offices.

“If people don’t stay home for Christmas this year, we’re going to see something that’s, it’s hard for me to even imagine,” said Dr. Patrick Macmillan. “I think it will break the health care system if people don’t stay home.”

“There’s no backup,” added Dr. Anneli von Reinhart, an emergency physician at Community Regional Medical Center in downtown Fresno. “There’s no one coming to save us because the whole country is in this boat.”

In partial response, the state has 951 health workers assisting at 91 facilities in 25 of the state’s 58 counties, and is opening a fifth alternative care site in San Diego County.

The California National Guard was setting up about 200 beds on vacant floors of the Palomar Health Center near San Diego, within the existing hospital complex, said Brian Ferguson, a spokesman for the Governor’s Office of Emergency Services. It could begin accepting patients Christmas Day, relieving overburdened hospitals particularly in nearby Imperial County.

California expects more federal medical workers to arrive by the weekend, and Newsom said he expects more of the 3,000 contract health care workers the state is seeking to arrive after the holidays.

Newsom said 128,210 doses of vaccines had been administered as of Tuesday, in another encouraging sign beyond the modest decline in the transmission rate.

“I think the regional stay-at-home (order) has had an impact,” he said, referring to lockdowns affecting 98% of the state that mean many businesses must remain closed, restaurants can only serve takeout and virtually all retail is limited to 20% capacity.

But he warned that could dissipate quickly, leading to the nearly 100,000 hospitalizations some models project in one month if people don’t heed calls to avoid holiday gatherings, particularly indoors.

“This virus loves social events,” Newsom said. “This virus thrives in that atmosphere.”