SACRAMENTO, Calif. (AP) — A staggering rise in coronavirus cases could overwhelm California’s health system within weeks and “drastic” action such as a widespread stay-at-home order may be needed to combat the threat, Gov. Gavin Newsom warned.

Hospitalizations from COVID-19 have increased nearly 90% and could triple by Christmas, officials said Monday.

“The red flags are flying in terms of the trajectory in our projections of growth,” Newsom said.

The number of COVID-19 cases reported each day in California has been setting records, with the average daily case rate over the last week topping 14,000.

The levels are far above those recorded during a summer peak or even in March, when a state public health order restricted people from going outside except for the most essential reasons. That order was later eased.

Currently, 51 of 58 counties are in the “purple” tier of the state’s COVID-19 system, meaning they are under the strictest business restrictions. Those counties account for most of the state’s population. A recently imposed curfew in those counties bars most nonessential work, movement, and gatherings but only overnight.

Although he supplied few details, Newsom said that unless the current trends slow, the rise in COVID-19 cases creates the potential for an order that could place further restrictions on businesses and keep the majority of people indoors in the most seriously-affected counties.

Hospitalizations in California have increased 89% over the past 14 days and nearly 7,800 coronavirus patients were hospitalized as of Monday. Public health officials warned that people ignoring distance and mask guidelines and gathering for Thanksgiving with non-household relatives could lead to a massive increase in coronavirus cases by Christmas.

About 12% of Californians testing positive are likely to need hospital care within the next two to three weeks.

The biggest concern is intensive care cases, which have increased 67% in the past two weeks. The state has around 7,700 ICU beds, and currently, 75% are occupied. More than 1,800 ICU patients have COVID-19.

If the trend continues, ICU beds would reach 112% of capacity by mid-December.

“It’s brutal. It’s astoundingly bad. … They’re seriously, seriously bad numbers,” Dr. George Rutherford, epidemiologist and infectious-diseases control expert at UC San Francisco, told the Los Angeles Times.

California can’t even ship patients to ICU beds out of state “because stuff that’s just as bad is going on in Oregon and Nevada and Arizona,” Rutherford said. “We are here on our own, and this is a natural disaster.”

Los Angeles County, the nation’s most populous and home to 10 million residents, already imposed its own stay-home order that took effect Monday. It banned most gatherings but stopped short of a full shutdown on retail stores and other nonessential businesses. Santa Clara County is requiring anyone traveling there from more than 150 miles away to quarantine for 14 days.

The county is the largest in the San Francisco Bay Area with about 2 million people, and COVID-19 hospitalizations there have soared to levels not seen since the beginning of the pandemic.

Meanwhile, California on Monday announced help for small businesses suffering financially because of COVID-19 restrictions and lower sales.

With more shutdowns on the horizon and no imminent help from Congress, Newsom and state legislative leaders announced several steps aimed at helping small business owners survive until the federal and state governments can act more broadly early next year.

They include an automatic three-month extension for those reporting less than $1 million in sales tax; interest-free payments for companies with up to $5 million in sales tax; and $500 million in grants of up to $25,000 each available to small businesses.

Associated Press writer Amy Taxin contributed to this story from Orange County.