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SACRAMENTO, Calif. — Anthony Fauci said Monday he advised California officials that they “really don’t have any choice” but to impose stay-at-home orders that more than 33 million residents are now living under.

California’s stay-home rules are some of the strictest in the nation, limiting most nonessential activities, banning restaurant dining and prohibiting private gatherings. Gov. Gavin Newsom last week assigned counties to one of five geographic regions that would have to lock down if their intensive care unit capacity dropped below 15 percent.

Fauci spoke Monday with CNN on the same morning that President-elect Joe Biden named him as chief medical adviser on Covid-19 in addition to director of the National Institute of Allergy and Infectious Diseases. He said he was consulted by California officials before they moved forward on their stay-home order and that he “absolutely” agreed with the state’s approach.

“In fact, I have been in discussion with the health authorities from the state of California who called me and asked,” Fauci said. “You know, they said, ‘We feel we need to do this, what do you think?’ And I said, ‘You know, you really don’t have any choice. When you have the challenge to the health care system, you’ve got to do something like that.'”

Southern California and the San Joaquin Valley had to lock down Sunday, while five Bay Area counties preemptively issued stay-home orders this weekend. Only about 15 percent of residents living in the Sacramento region, parts of the greater Bay Area and the northern reaches toward the Oregon border do not yet have to follow the lockdown restrictions.

California residents have generally abided by stricter rules over the course of the year, starting with the nation’s first stay-home order in the Bay Area in March through mask mandates and business restrictions that have been installed in different iterations. But the current round has sparked anger among restaurateurs in particular, many of whom invested in heat lamps and other outdoor dining equipment to survive the winter. A lawsuit against Los Angeles County’s stay-home order is winding through court there, and a judge has asked the county to return Tuesday with data supporting a ban on outdoor dining.

Newsom has framed the state’s stay-at-home order as necessary to ensure hospitals can handle an expected surge in hospitalizations in coming weeks. ICU capacity had dropped to 6.6 percent in the San Joaquin Valley — the nation’s biggest agricultural producer — and 10.3 percent in Southern California, the state reported Sunday.

California also surpassed 30,000 coronavirus cases in one day for the first time over the weekend; the state reported 30,075 new cases on Saturday. While the state has dramatically increased Covid-19 testing, the seven-day positive test rate has soared to 10.3 percent, higher than during the summer surge.