California hospitals near breaking point as Covid cases soar

Hospitals across California are reaching a breaking point amid a shortage of ICU beds and healthcare workers, as the state faces its worst surge in Covid cases since the pandemic began.

Millions of Californians are back under the nation’s strictest lockdown, but hospitalisations are already at record levels. The state has seen a roughly 70% increase in ICU admissions in just two weeks, leaving just 1,700 of its 7,800 ICU beds available.

Fatigued Californians are back in lockdown. Will it work?

Read more

The situation has prompted California’s governor, Gavin Newsom, to bring in hospital staff from outside the state, and to restart emergency hospitals that were created but hardly used when the coronavirus surged last spring.

This week saw the state begin to activate the first two of 11 alternative care sites that have a total capacity of 1,862 beds.

A site in hard-hit Imperial county, on the border with Mexico, already has 19 of its 25 available beds in use, though it can expand to handle 115 patients. The second site is at the former home of the Sacramento Kings professional basketball team.

Elsewhere, southern California’s Riverside University health system medical center opened an ICU in a storage room.

California officials paint a dire picture of overwhelmed hospitals and exhausted health workers as the state records an average of 22,000 new cases a day. After nine months of the pandemic, they recognize about 12% of people who test positive will end up in the hospital two to three weeks later. At the current rate, that means 2,640 hospitalizations from each day’s new case total.

“As we see the distressing surge in cases, we know that we can expect in the upcoming weeks alarming increases in hospitalizations and deaths,“ said Barbara Ferrer, health director for Los Angeles county.

Several hospitals in Los Angeles county and others in San Diego, Imperial and Fresno counties are close to running out of intensive care beds, leaving the state scrambling to create more space and staffing.

And in the Bay Area’s Santa Clara county, home to more than 2 million people, health officials warned only 50 ICU beds remained.

California has requested nearly 600 healthcare workers to help in ICUs through a contracting agency and the federal government. It is starting a two-day program to train registered nurses to care for ICU patients and setting up links for doctors to consult remotely on ICU patients.

The goal is to avoid a nightmare scenario: people lined up outside hospital emergency rooms, patients struggling to breathe alongside those seeking care for non-life-threatening ailments, and not enough staff to take care of them. With that scene in mind, Newsom recently imposed an overnight curfew and a ban on nonessential travel and issued stay-home orders in regions where open ICU beds have dipped below 15%.

Similar concerns about patient overload and staffing shortages faded during the initial months of the pandemic, leaving most of the state’s auxiliary surge hospitals barely used. But now capacity is dwindling, and the impact of the Thanksgiving weekend has yet to be fully felt.

County health officials point to two troubling trends: a surge in healthcare workers themselves becoming infected, and a dearth of traveling nurses who are busy in other states dealing with their own unprecedented surges.

Fresno county has been pleading for state help to staff three area hospitals for several weeks, but it was sent just one or two workers for each amid the nationwide shortage, said Daniel Lynch, the county emergency medical services director.

Fresno officials urged the state to open 123 alternative care beds ready for use in Tulare county, but Lynch said they were told the state’s priority was the Sacramento arena. Now county officials are considering putting overflow beds in the Fresno Convention Center.

Brian Ferguson, a spokesman for the governor’s office of emergency services, defended the state’s approach of having “flexible” alternative care sites that could serve residents displaced from nursing homes or skilled nursing facilities, or absorb some of hospitals’ less serious patients.

“This is kind of what the next stage of this looks like, if things go back to really bad,” Ferguson said.