California ICU availability plummets as SLO County leaders warn of ‘dire consequences’
The Southern California region, which includes San Luis Obispo County, has hit a critical point in coronavirus hospitalizations.
The California Department of Public Health reported that 0.0% of intensive care unit beds were available as of Thursday afternoon.
In addition to San Luis Obispo County, the Southern California region includes Imperial, Inyo, Los Angeles, Mono, Orange, San Bernardino, San Diego, Santa Barbara and Ventura counties.
ICU bed availability from the state is calculated using information that individual hospitals report about the total number of available staffed ICU beds each day, according to the CDPH.
Both staffed ICU beds and staffed ICU surge beds are counted in the calculation, but neonatal and pediatric ICU beds are not included, the state says. The CDPH standardizes the number of staffed ICU beds for adults for a percentage.
The 0% availability, however, does not mean there are no available ICU beds.
“You hear we’re at 0%. That doesn’t mean we have no ICU beds or staff available at all. It means we’re into a surge,” Gov. Gavin Newsom said Monday.
While the percentage of available ICU beds in San Luis Obispo County is closer to around 40%, according to the county Public Health Department, health leaders still raised concerns about local capacity.
San Luis Obispo County Public Health Officer Dr. Penny Borenstein touched on some concern about hospital capacity and shared that some hospital staff and first responders have tested positive for COVID-19.
“We need our community to preserve that capacity,” Borenstein said. “Not just of the beds we’ve been talking about, but of our healthcare workers and our front-line first responders.”
Local hospital leaders have also spoken out saying that the need for concern has been understated.
Top SLO County physicians warn of hospital strain
The Southern California region hit 0% capacity the same day a group of San Luis Obispo County’s top physicians released a plea for help in slowing the spread of COVID-19.
The letter was co-signed by Dr. Andrea Tackett, Dr. Eric Salinger and Dr. Aiga Charles — the chiefs of staff at French Hospital Medical Center in San Luis Obispo, Sierra Vista Regional Medical Center in San Luis Obispo and Twin Cities Community Hospital in Templeton, respectively — as well as by Arroyo Grande Community Hospital emergency department director Dr. Margaux Snider and French Hospital ICU director Dr. Mark Soll.
The letter warned of “dire consequences” and stressed that local hospitals are greatly feeling the effects of the surge already.
“Recent messaging from community leaders has gravely underestimated our local crisis,” the letter read. “We want to be clear — the dramatic increase in coronavirus hospitalizations and ICU admissions is straining your local hospitals. Some ICUs have had no available beds this week.”
San Luis Obispo County’s COVID-19 case count has increased 28% so far in December, while local coronavirus hospitalizations have reached all-time highs. A total of 16 people have died due to COVID-19 this month.
No ICU beds were available at one of the two San Luis Obispo hospitals on Wednesday, and only three ICU beds were available at Arroyo Grande Medical Center, according to the CDPH dashboard.
“Elective services are being canceled or postponed. Twenty residential care facilities have outbreaks. This threatens to exceed hospital capacity and lead to dire consequences,” the letter continued.
The concerns raised by hospital leaders are grim compared to the messages from official hospital statements.
Dignity Health spokesperson Sara San Juan wrote in an email to The Tribune that both Arroyo Grande Community Hospital and French Hospital Medical Center, operated by Dignity Health, are adequately staffed amid the rising cases.
“We are seeing a moderate surge in cases, as is consistent with other parts of the country,” she wrote. “Our facilities are prepared and have the ability to care for our community during this and future surges.”
At this time, Dignity Health is not anticipating the need to bring in traveling nurses, according to San Juan.
Tenet Health Central Coast, which operates Twin Cities Community Hospital and Sierra Vista Regional Medical Center, wrote in a statement that they have been preparing for a surge in hospitalizations and will continue to do so.
“We are closely monitoring the census in our hospitals and make rapid adjustments as needed,” the statement read.
“As a normal part of operations, we continually analyze the use of ‘traveling’ nurses and our staffing includes them in some capacity throughout the year. Since the beginning of the pandemic, we have included surge mitigation as a part of operational planning,” the statement continued.
Meanwhile, San Luis Obispo County officials have pushed for the county to break a part from the Southern California stay-at-home region.
A letter was jointly signed by San Luis Obispo, Santa Barbara and Ventura county leaders to form a Central Coast region.
San Luis Obispo County officials said in a news release that breaking away from the larger region would allow the county to potentially move forward from the stay-at-home order, which applies to regions with less than 15% ICU bed availability.
Soll said he doesn’t think that distinction would even make a difference.
“I don’t understand these politicians raising a stink about the Central Coast being a part of the Southern California region, as if we’re in so much better shape,” he said.
What is ICU availability like in SLO County?
The latest data for beds available in San Luis Obispo County was released Wednesday.
According to Wednesday’s data, 19 out of 53 total ICU beds were available.
Dignity Health’s two San Luis Obispo County hospitals account for 19 of the ICU beds in San Luis Obispo County. A Tenet Health spokesperson said he could not disclose how many ICU beds were at the company’s local hospitals.
Soll, who is in charge of staffing ICU beds in San Luis Obispo County, said while there may be more physical ICU beds in the county, there are only enough nurses to adequately staff around 35 to 38 beds before local hospitals need to go into emergency staffing mode.
“There’s been a bit of a disconnect of how serious this is,” Soll said. “It’s not like we can snap our fingers and say, ’Get us six nurses.’ ”
In addition, Soll said, coronavirus patients come with unique challenges.
“The problem with all the COVID cases is once they’re in the hospital, they stay,” Soll said. That in turn backs up ICU availability, making it challenging to help more and more incoming patients.
How can SLO County open up ICU capacity, increase staffing?
Borenstein, the county public health officer, said Newsom recently changed the standard ICU staffing ratio from two patients per ICU nurse to three in response to the surge in COVID-19 cases.
In addition, elective, non-emergency surgeries have been postponed or canceled to account for incoming coronavirus patients.
In their letter, top San Luis Obispo physicians pleaded with community members to wash their hands and stay home as much as possible, even throughout the holiday season.
“The message to the community can’t be ‘We’re all hunky dory,’ ” Soll said. “That’s not true.”
Update: This story has been updated to include a Tenet Health Central Coast statement.
This story was originally published December 17, 2020 at 5:17 PM.
