California could see 100,000 hospitalizations within a month

SACRAMENTO, California (AP) - California has recorded half a million coronavirus cases in the past two weeks. The overwhelming emergency rooms in urban centers and rural areas, including along the Mexican border, where a small hospital system warns that patient beds are fast running out of beds.
The state could face an unthinkable number of nearly 100,000 hospitalizations in a month, Governor Gavin Newsom said Monday.
Conditions at El Centro Regional Medical Center in the southeast corner of the state are desperate, even worse than during a summer flood that caught the governor's attention, hospital officials said.
"We don't have a place for anyone. We've been holding patients for days because we can't refer them or get beds for them," said Lenz, an emergency doctor at the Imperial County medical center, home to 180,000 people.
Of the 175 patients who were hospitalized on Monday, 131 had COVID-19. The facility, approved for 161 beds, has set up a tent with 50 beds in its parking lot and converted three operating theaters to virus care.
Newsom, who has himself been quarantined for the second time in two months, said a state projection model is showing previously unfathomable hospital stay rates and that he will likely extend his home stay order for much of the state next week.
Dr. California minister of health and human services, Mark Ghaly, said he feared entire areas of the state, even in their makeshift "surge" capacity units, "may run out of space" by the end of the month and early January. In response, the state is updating its planning guide on how hospitals would ration supplies if everyone couldn't get the treatment they need, he said.
"Our goal is to make sure these plans are in place but to work hard to ensure that no one has to implement them anywhere in California," said Ghaly.
She hopes to do this by building up temporary workers, opening makeshift hospitals in places like gyms, tents, and a vacant NBA arena, and sending patients to regions of the state that may still have valuable beds.
California is experiencing by far the worst increases in cases and hospitalizations. In all of Southern California and in the San Joaquin Valley with 12 counties in the north, regular intensive capacities have not been available for days.
California has an average of nearly 44,000 newly confirmed cases per day and has recorded 525,000 in the past two weeks. It is estimated that 12% of those who test positive end up in the hospital. That means 63,000 hospital stays in the last 14 days. The current number is 17,190.
The state health department released crisis planning guidelines for hospitals and other care facilities during the pandemic in June. It provides detailed instructions for managing care decisions when resources are scarce.
The goal is the best possible result for most people, the document says.
The guidelines emphasize the importance of planning crisis scenarios and ensuring that decisions are not made on the basis of discriminatory factors such as age, race, disability, gender, socio-economic status or insurance status.
The document describes best practices for “proactive triage” that must occur when a hospital has used up its resources. A basic graph shows that the first consideration should be whether a patient is actively dying or will die safely. In this case, he should only receive palliative care.
For patients outside of this category, care providers are generally asked to assess an individual's prognosis for survival compared to others when determining how limited resources should be allocated.
Los Angeles is among the hardest hit areas in the state, but its hospitals aren't there yet, said Dr. Christina Ghaly, director of the LA County Department of Health, on Monday. You are in the emergency phase, which means that staff and equipment need to be replaced.
Los Angeles Mayor Eric Garcetti said experts had "drawn a straight line" between current spikes in cases and Thanksgiving gatherings, warning people to stay home for the coming weeks.
"If you gather for the holidays, our hospitals will be overcrowded," Garcetti said. "This is not a good sign and a recipe for a Christmas and New Years burst."
Newsom gave the briefing from home on Monday when it began a 10-day quarantine Sunday for the second time in two months after an employee tested positive for the virus. The governor was tested and his result was negative.
In a rare bright message, Newsom said federal aid and more vaccines are on the way. The first 110,000 doses of the newly approved Moderna vaccine arrived a week after the first 70,258 doses of the Pfizer vaccine were administered by California hospitals.
The explosion in cases over the past six weeks has increased the death toll in California. Another 83 deaths reported on Sunday brought the total to 22,676, though Newsom warned the daily number was likely to be low due to a normal delay in reporting over the weekend.
The state has recorded an average of 233 deaths per day for the past 14 days.
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Associate press reporters John Antczak and Christopher Weber in Los Angeles, Elliot Spagat in San Diego and Kathleen Ronayne in Sacramento contributed to this report.
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