The autumn COVID-19 surge has now spread not only through major urban areas like Los Angeles but across California and even to the far northern rural reaches of the state, a troubling sign as the state faces its greatest challenge from the pandemic yet.

A Times data analysis found that most California counties are now suffering their worst coronavirus daily case rates of the entire COVID-19 pandemic, surpassing even the summer surge that had forced officials to roll back the state’s first reopening in the late spring.

The data suggest California will face new problems in December if the unprecedented rise in cases continues. In earlier phases of the pandemic, different parts of California could help harder-hit areas, like San Diego County and San Francisco taking in patients from Imperial County. But that could be difficult in this wave, with the pandemic worsening in most places across California simultaneously.

“We can’t depend on our counties next to us because they are under the same stress and strain,” said Dr. Marty Fenstersheib, the Santa Clara County COVID-19 testing officer. “They can’t provide us with beds in their counties. So we are on our own. And our hospitals are hurting at this point.”

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