SACRAMENTO, Calif. (AP) — Thirteen counties in Northern California will be placed under the state's most restrictive coronavirus rules this week because capacity in intensive care units has fallen below 15%, and officials warned Wednesday that hospitals across the state are filling up with COVID-19 patients.

The greater Sacramento region, encompassing the state capital, has an ICU capacity of 14.3% and will face a regional stay-at-home order starting at 11:59 p.m. Thursday, according to the state Department of Public Health.

The region includes Lake Tahoe, the popular ski destination where vacation travel is now banned for the second time this year.

“If we can get things under control in the next three weeks, we can reopen just in time for New Year’s,” said Chris Fiore, communications manager for the city of South Lake Tahoe.

Under the restrictions, restaurants must stop outdoor dining, personal care businesses such as barbers must close and the number of people allowed inside stores is reduced. Residents are asked to stay home except for essential activities.

The huge Southern California and San Joaquin Valley regions are already in the strictest category, and several counties in the San Francisco Bay Area chose to implement their own voluntary orders independent of the state. Monterey County joined that group Wednesday, implementing its own lockdown through Jan. 11, the latest end date for any current order.

San Francisco Mayor London Breed said the city is experiencing its worst surge of new cases and hospitalizations since the start of the pandemic, and she pleaded with residents to stay home and curb holiday activities. Dr. Grant Colfax, San Francisco’s health director, said the city may hit the 15% threshold for available intensive care unit beds “as early as sometime this week” and could run out of ICU beds by Dec. 27.

“And that’s if things don’t get even worse, but they very well may,” Colfax said.

In Los Angeles County, the usually stoic health director, Barbara Ferrer, became emotional as she described “a devastating increase in deaths,” with the total hitting 8,075 on Wednesday. This week, the county recorded an average of 43 daily deaths — up from about 12 a day in mid-November, she said.

“Over 8,000 people who were beloved members of their families are not coming back,” Ferrer said, fighting back tears. She called the deaths “an incalculable loss to their friends and their family and the community.”

LA County hospitals are dealing with a surge in COVID-19 patients: new admissions near 500 a day. Officials anticipate that number will increase to 700 a day by next week.

While rules tightened in many places, California is now allowing outdoor playgrounds to stay open in regions under the toughest restrictions, apparently swayed by criticism that closing them would harm children who have few options to safely play outside.

On its website, the state said playgrounds could stay open to “facilitate physically distanced personal health and wellness through outdoor exercise."

Ali Bay, a spokesperson for California's Department of Public Health, said in an email that the change was new and the department was working to share the news more broadly.

Democratic Gov. Gavin Newsom came under heavy criticism for closing children's playgrounds when his administration has repeatedly said being outdoors is safer than being indoors and there is little evidence of the virus spreading on playground structures.

Playground advocates have said children need fresh air and exercise for their emotional and physical health, and many don't have access to private backyards. Fraught parents also need a place to take their cooped-up kids, advocates said.

“We understand that many parents were desperate to find a place where their child could go,” Ferrer said. The LA County health director urged parents to take precautions at playgrounds and avoid them altogether if the spaces are too crowded.

The voluntary order for San Francisco, Santa Clara, Marin, Contra Costa and Alameda counties also had shuttered playgrounds.

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Weber reported from Los Angeles. Associated Press writers Janie Har and Daisy Nguyen in San Francisco and John Antczak in Los Angeles contributed to this report.