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COVID-19 hospitalizations have essentially doubled across much of California over the last two weeks — a troubling trend officials say illustrates the pandemic’s continued potency amid an ongoing surge in infections.

Increases of that magnitude have been seen in Los Angeles, San Diego, Orange, Riverside and San Bernardino counties, state data show, straining healthcare systems to an extent not seen in months.

Those counties — California’s five most populous — both reflect and drive the wider trends playing out across the state. California as a whole has seen its total number of hospitalized coronavirus-positive patients swell from 2,981 on July 25 to 5,973 as of Sunday.

“The significant increase in hospitalizations is of great concern,” L.A. County Public Health Director Barbara Ferrer said in a statement. “With the effectiveness of the COVID-19 vaccines, we are hopeful that more people will get vaccinated during this time of very high transmission.”

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