The large hospital systems of Southern California are preparing to create more space for coronavirus patients as cases continue to rise in the region and across the state.
An emergency doctor said hospital CEOs “are eager” for their facility’s ability to handle the influx, and some are developing phased plans to ensure they can do so.
From Riverside and San Bernardino counties to Los Angeles and Orange counties, the number of patients infected with COVID-19 has increased dramatically in recent weeks.
In Orange County, health officials reported on Friday that COVID-related hospitalizations rose 17.6% in the past three days, well above the 10% state threshold. The spread has been so pronounced that the county may soon be on the state’s watch list for possible renewed blockade orders.
In Los Angeles County, the seven-day average of daily new coronavirus cases was 1,979 on Friday, an increase from the average of 1,379 two weeks ago, authorities said.
And in San Bernardino County, the number of new cases per week is growing rapidly, particularly among patients ages 18 to 49, authorities said. The county averaged about 160 new cases a week earlier in the month, mid-200 to mid-month, and has averaged more than 300 in the past seven days.
San bernardino county
Health officials in San Bernardino are preparing with plans to use additional beds and temporary hospital sites in the county if the increase in coronavirus cases continues.
“This is the first time that, when we have conversations with hospital CEOs regarding the hospital’s capacity, that our CEOs are getting anxious,” Dr. Troy Pennington, an emergency physician at Arrowhead Regional Medical Center, said Friday, during a press conference on Friday. June 26th.
Hospitals are close to having to use their “surge capacity” beds, which are installed in addition to traditionally licensed beds to cater for the influx of coronavirus patients, he said. If the hospitals fill up, the county could use alternative sites like the National Orange Show in San Bernardino and the county fairgrounds in Victorville.
“We could be moving towards alternative care sites in a matter of weeks,” Pennington said. “That is the very real reality of where we might be heading if we continue on the same slope of the curve that we have been seeing recently.”
Surgical beds are still available and there is still intensive care capacity, he said, adding that using fewer ventilators for treatment these days is a silver lining.
In preparation for a possible influx of patients with COVID-19, Loma Linda University Medical Center and Children’s Hospital have designated isolation units to mitigate the spread of infection in adult and pediatric patients who tested positive for COVID- 19, said spokeswoman Briana Pastorino.
In addition, the hospital has three emergency medical tents outside the emergency department, which could serve as an adequate isolation space for the detection of patients showing symptoms, he said.
Los angeles county
UCLA Health carefully monitors COVID-19 tests and hospitalization data, maintains regular contact with public health officials and Los Angeles County hospitals throughout the region, and is well prepared for the possibility of additional patients, Spokesman Phil Hampton said.
As of Thursday, system hospitals had 31 patients with COVID-19 positive and have treated 304 patients with coronavirus since March 12. The Ronald Reagan UCLA Medical Center in Westwood has 446 beds and the UCLA Medical Center in Santa Monica has 281 beds. That includes 133 intensive care unit beds in Westwood and 22 in Santa Monica.
Hampton said UCLA has a “comprehensive, multi-stage” surge plan and could gradually increase the number of beds to 1,100 by adding beds to individual inpatient rooms and converting other rooms to provide ICU-level care.
Riverside County hospital systems say they are preparing for a surge by ensuring they have the capacity to expand the number of beds in both their hospitals and intensive care units.
The 17 riverside county hospitals have 3,560 licensed hospital beds, of which 2,500 are currently in use, said county spokeswoman Brooke Federico. But only 311 of those beds are occupied by COVID-19 patients, he said. However, intensive care units are almost entirely occupied by patients with COVID-19. Of the ICU’s 385 beds, 90% are in use and 95% of them are occupied by patients with COVID-19, Federico said. Additionally, across the county, there are 680 fans available, of which 166 are in use, she said.
Under a five-phase growth plan drafted last week, county hospitals are in phase three, where patient volumes continue to rise but have not had to expand to hospital areas that are not licensed for a specific use, such as intensive care. said Dr. Michael Mesisca, medical director of the Department of Emergency Medicine and the University of Riverside Health System Disaster Medicine Team.
“We are moving towards phase four, when we will start using other spaces within the hospital,” he said. “Phase five is when we move from treatment areas to spaces like conference centers.”
The health system also hired travel nurses, plus nurses on staff, worked to maximize telehealth options, and invested in supplies, from IV fans and pumps to monitors and cots.
This is not the time to panic, Mesisca said, but county residents need to be vigilant by wearing face covers and practicing physical distancing to help ensure that local hospital systems are not overwhelmed.
Over the past week, the ICU Medical Center in Orange averaged approximately 50 coronavirus positive hospitalized patients per day and nearly 880 patients with the virus have been admitted and treated since mid-March, spokesman John Murray said.
“These patients are admitted to dedicated units (coronaviruses), including ICUs. We will expand the number of beds available as needed, ”he said. Murray said that while the supply lines for some personal protective equipment continue to expand, UC medical centers across the system are busy securing the supplies necessary to handle an additional surge of patients.
At Hoag Presbyterian Hospital in Orange County, only 5% of hospital beds are in use for coronavirus patients because most coronavirus patients are not hospitalized, said Dr. Philip Robinson, director of infection prevention . Less than 2% of its fans are currently in use, he said.
“Many of our coronavirus patients are seen at the offices of Hoag Urgent Care and / or Hoag Medical Group,” he said. “We classify and treat them in an outpatient setting, and patients are convalescent at home in isolation. Telehealth options also support that. ”
Robinson said one of the challenges healthcare professionals continue to face is having to remind the community not to delay care when experiencing life-threatening medical conditions such as strokes and heart attacks.
“We have seen patients so cautious with the involvement of the health care system that they let these symptoms go unchecked during the height of the crisis, resulting in permanent damage and, in some cases, death,” he said, and He added that people should not delay essential surgeries and major medical tests simply out of fear.
Robinson said he also reminded the community that it has a responsibility to slow the spread of the virus so that health systems are not overwhelmed.
“It is up to the community to continue to practice hand hygiene, social distancing, and the use of face covers in public to help curb the spread and allow hospitals to care for those in need.”
Kaiser Permanente System
Kaiser Permanente, which has medical centers throughout Southern California, does not disclose its bed or ICU capacity, or the number of COVID-19 patients receiving treatment at its facilities.
However, Nancy E. Gin, regional chief medical officer for quality and clinical analysis, said the system has enough beds and ventilators to treat any increases in coronavirus patients.
The health system has the ability to “take advantage of expanded treatment capabilities, including the ability to increase treatment space, staff and supplies to control surges, even when we reopen the health care system with new measures of social distancing “Gin said.
“Given the emphasis on testing, monitoring, and contact tracing, we hope to be in a better position than at the start of the pandemic to identify and predict potential hotspots and waves of patients seeking high-level care for the coronavirus. This will allow us to tailor surge planning to meet local needs rather than planning a surge in coronavirus patients system-wide. “
Writers Sandra Emerson, Hayley Munguia, and Ian Wheeler contributed to this report.