The highest-ever Covid-19 case counts were reported in Marin over the past two weeks, signaling more trouble is on the way for local hospitals—even before Christmastime transmission has been detected. The stress on Marin’s hospitals lessened this week, but the dip in admissions is likely short-term. On Tuesday, 24 patients with Covid-19 were hospitalized, down from a peak of 35 two weeks ago, while 26 of 29 beds in intensive care units were occupied, an improvement from the maxed-out capacity on Dec. 15. Dr. Matt Willis, the public health officer for Marin, said when hospitals reach capacity, fatal outcomes become more likely. Kaiser Permanente has already canceled elective surgeries through Jan. 4 at all of its Northern California hospitals; Novato Community Hospital and the MarinHealth Medical Center have not yet announced a change, but medical directors have said they would reduce worker-to-patient ratios and reassign staff as necessary. Marin’s metrics are better than those of the state, which is seeing the worst surge in the nation and about 10 Covid-related deaths every hour; 12.6 percent of tests are returned positive, triple Marin’s rate. In West Marin this week, five new cases were reported—three in Point Reyes Station and one each in Inverness and Stinson Beach. The Inverness Park Market reopened last Monday after a weeklong closure; owner Dan Thompson said he directed all of his staff to be tested after an employee showed symptoms. He shut the doors after a test came back positive, resulting in lost wages that he hopes to make up to staff later on. “Safety first. Commerce comes later, right?” he said. Indoor gatherings are driving transmission countywide, and outbreaks continue at Marin’s 13 skilled nursing facilities, where 92 of the county’s 111 deaths have originated. The vast majority of medical workers at these facilities received their first dose of the vaccine two weeks ago, and residents will be visited by CVS Pharmacy and Walgreens this week for their turn. The vaccine offers some level of protection 10 days after inoculation and is 95 percent effective after the second dose, which comes three or four weeks after the first one. The county launched a new awareness campaign with videos from emergency department staff pleading with the public to do their part. “We are not the front line—we are the last line,” said Dr. Laura Eberhard, a physician at Kaiser for 22 years. “As an I.C.U. doctor I’m not scared by much, but I find the prospect of having a hospital and an I.C.U. overflowing and not being able to take good care of our residents of Marin, I find that scary.” Governor Gavin Newsom said on Monday that stay-at-home orders on 98 percent of the population are likely to be extended. The state issued an order for the entire Bay Area on Dec. 17 when I.C.U. capacity fell below 15 percent. The order is set to expire on Jan. 8, but current Regional I.C.U. capacity is at 11 percent and decisions are based on four-week projections. “Things, unfortunately, will get worse before they get better,” Gov. Newsom said. To receive a test, contact your medical provider, visit curative.com, or go to the Coastal Health Alliance from 10 to 11 a.m. on Thursdays starting next week.