Tag Archives: Intensive Care Units (ICUs)

Why the sudden improvement in our ICU bed numbers?

By Roger Straw, January 25, 2021

The surge hasn’t slowed in Solano and some other California locations, but more ICU beds don’t get us out of the “purple tier”

B.C. clears more acute hospital beds as COVID-19 case growth slows – Surrey Now-Leader

Something changed dramatically and suddenly in Solano County on Thursday, January 14, and the State seems to have followed suit lately.

Solano County reported the following percentage of ICU beds available during January.  Note the remarkable jump on January 14:

Date Total Confirmed Cases Daily or Weekend Δ ICU Beds Available
Monday, January 4, 2021 20,953 90 17.0%
Tuesday, January 5, 2021 21,223 270 20.0%
Wednesday, January 6, 2021 21,520 297 15.0%
Thursday, January 7, 2021 21,855 335 12.0%
Friday, January 8, 2021 22,232 377 4.0%
Monday, January 11, 2021 23,314 1,082 20.0%
Tuesday, January 12, 2021 23,554 240 5.0%
Wednesday, January 13, 2021 23,889 335 1.0%
Thursday, January 14, 2021 24,291 402 23.0%
Friday, January 15, 2021 24,654 363 23.0%
Tuesday, January 19, 2021 25,806 1,152 24.0%
Wednesday, January 20, 2021 25,983 177 28.0%
Thursday, January 21, 2021 26,191 208 20.0%
Friday, January 22, 2021 26,494 303 26.0%

According to the Fairfield Daily Republic on 1/14/21, Solano County Public Health Officer Dr. Bela Matyas said in a phone interview, “‘NorthBay has opened up additional ICU space and Kaiser and Sutter plan to.’”

My worst fear is that the COVID surge will rage on here in Solano County, and with more ICU beds now available, we will only fill them with those who become seriously ill with the virus.  It seems the State of California could do the same.  We may be lifting the strict stay-at-home order, but the purple tier restrictions are incredibly important.  We don’t want to fill those additional ICU beds!

What Is Happening With the Virus in California? For Now, Many Mixed Signals

Monday: Hospital capacity is increasing in some areas. The vaccine rollout is still chaotic.

People waiting in line at a super vaccination station set up in an empty department store in Chula Vista.
People waiting in line at a super vaccination station set up in an empty department store in Chula Vista. Mike Blake/Mike Blake

New York Times, By Jill Cowan, 1/25/21, 9:07 a.m. ET  (This article is part of the California Today newsletter. Sign up to get it delivered to your inbox.)

Good morning.

If you’re confused about the state of the virus in California, you’re not alone.

While California’s overall case numbers have been on the decline, hospitals in Southern California are still overwhelmed and experts worry that new variants of the virus — including one that researchers recently found in more than half of samples collected in Los Angeles — could threaten progress curbing Covid-19’s rampant spread.

[Compare coronavirus case numbers, hospitalizations and deaths across California with this map.]

In the Bay Area, intensive care unit capacity has risen to 23.4 percent, according to the state as of Sunday — well above the 15 percent threshold that triggered the stay-at-home order for the region. Yet the Sacramento area has just 11.9 percent intensive care unit capacity, and was allowed to exit the strict order more than a week ago.

Although The San Francisco Chronicle reported on Saturday that officials in the region were feeling hopeful that the order would be lifted soon, the state’s department of public health reported on Sunday that the Bay Area wasn’t eligible to have restrictions loosened based on its projections.

[See how full hospital intensive care units are near you.]

Gov. Gavin Newsom is expected to make an announcement about lifting some restrictions in the state on Monday.

The Associated Press reported that Mr. Newsom’s administration has refused to disclose key data that would help explain the difference in approaches between the Bay Area and Sacramento.

In any case, the state hinted in a news release on Sunday that Sacramento may be required to re-enter the stay-at-home order, which would force many businesses to shut back down. (We can expect to get an update from state officials in coming days.)

And even after President Biden unveiled what experts have long said is a desperately needed national strategy for finally controlling the pandemic, there are still major hurdles in the vaccine rollout, which in California has contributed to continuing chaos, in which vaccine eligibility rules have been implemented differently county by county.

As CalMatters reported, the state quietly rolled out a promised clearinghouse website to help people find vaccination appointments. But it’s still a work in progress.

[Track the vaccine rollout in California and other states.]

Read more:

  • One of the biggest contributors to Los Angeles County’s surge is its overcrowded housing. [The New York Times]

  • Mandatory masking for interstate travel. Ramped up manufacturing. Here’s more of what’s in President Biden’s pandemic executive orders. [The New York Times]

  • Experts believe as many as thousands of coronavirus deaths have not been counted in San Bernardino County, giving a false sense of the disease’s deadliness. [The Riverside Press-Enterprise]

  • Fear over testing positive for Covid-19 and not being able to return to work, as well as worries over the vaccines, are hurting the eastern Coachella Valley. [The Desert Sun]

  • A coalition of more than 50 Bay Area restaurants and wineries sued Governor Newsom over the state’s outdoor dining ban. [The San Francisco Chronicle]

  • Getting millions of people vaccinated will help reduce infections. But vaccines alone won’t end the pandemic. [The New York Times]

  • The governor’s $2 billion school reopening fund could actually cost districts money. [CalMatters]


Newsom reopens California, with most counties going to ‘purple’ tier. Here’s what it means

Elias Gambaccini brings in a propane heater as he shuts down his restaurant's outdoor seating at Pizzeria Trattoria in North Beach in San Francisco. Across California, some counties will begin allowing some business activities to resume, including outdoor dining, after Gov. Gavin Newsom rescinded regional stay-home orders.
Elias Gambaccini brings in a propane heater as he shuts down his restaurant’s outdoor seating at Pizzeria Trattoria in North Beach in San Francisco. Across California, some counties will begin allowing some business activities to resume, including outdoor dining, after Gov. Gavin Newsom rescinded regional stay-home orders. Photo: Carlos Avila Gonzalez / The Chronicle
Vanessa Arredondo and Michael Williams Jan. 25, 2021 Updated: Jan. 25, 2021 9:18 a.m.

Gov. Gavin Newsom lifted mandatory stay-home orders across California Monday as the surge of coronavirus cases that followed the holiday season begins receding.

The move will shift counties back into the color-coded reopening system and reopening will no longer be tied strictly to the number of available beds in intensive care units.

Now, with most counties statewide poised to reenter the purple tier, some activities like outdoor dining and personal-service businesses like nail salons will be allowed to resume. Individual counties can still impose stricter requirements, despite the relaxed mandate from the state.

“California is slowly starting to emerge from the most dangerous surge of this pandemic yet, which is the light at the end of the tunnel we’ve been hoping for,” said California Health and Human Services Secretary Dr. Mark Ghaly.

“Seven weeks ago, our hospitals and front-line medical workers were stretched to their limits, but Californians heard the urgent message to stay home when possible and our surge after the December holidays did not overwhelm the health care system to the degree we had feared,” he said.

Mayor London Breed tweeted Monday morning that she expects San Francisco to return to the state’s purple tier. “We will be moving forward with some limited re-openings, including outdoor dining and personal services,” she said. More details on San Francisco’s reopening plans were expected to emerge during a news conference Monday afternoon.

Following a post-holiday surge, coronavrirus cases and hospitalizations have been decreasing across the state. ICU capacity in regions that remained under the stay-at-home orders as of Sunday — including the Bay Area and Southern California — are projected to rise above the 15% threshold that triggered the lockdown measures.

The decision comes more than six weeks after the Bay Area and nearly all of the state was placed under stringent stay-at-home orders due to the explosive spread of the virus in late November and early December.

Though the Dec. 3 stay-at-home order was statewide, it was not triggered unless ICU projections fell below 15%. Because of this, the state’s northernmost counties were never affected. Most Bay Area counties voluntarily moved into the lockdown condition on Dec. 6. But as of Saturday’s report from the state, the Bay Area’s ICU capacity was 23.4%.

News of the change first began circulating Sunday evening after the California Restaurant Association sent a letter to members saying it had received word from Newsom’s administration that the stay-at-home orders would be lifted. Several members passed the letter along to media outlets including The Chronicle.

Vanessa Arredondo and Michael Williams are San Francisco Chronicle staff writers.

Surge: Some ambulances forced to wait hours as Bay Area ICU availability plunges

California, Bay Area hospitals strain amid crush of ICU patients

San Francisco Chronicle, By Jill Tucker, January 2, 2021
A COVID-19 patient who has had a stroke is prepared to be flown from one hospital to another on Dec. 22. Hospitals across California are straining to keep up with the surge.
A COVID-19 patient who has had a stroke is prepared to be flown from one hospital to another on Dec. 22. Hospitals across California are straining to keep up with the surge. Photo: Francine Orr / Los Angeles Times

The Bay Area’s intensive care unit availability dipped to 5.1% — its lowest figure yet — on the second day of the new year, even as the state braces for a further surge from Christmas and New Year’s celebrations.

The situation has gotten so difficult in Santa Clara County that some ambulances are sitting outside emergency rooms for up to seven hours waiting for a bed to open up for the patients they are carrying, county health officials said.

The delays — which mean the waiting ambulances cannot respond to other calls — have caused the San Jose Fire Department to transport people to emergency rooms at least a half-dozen times in the past week, the county officials said.

It’s a problem that’s already well known to the hard-hit Los Angeles area, where ambulances have waited for up to eight hours outside a hospital before patients could be moved inside, according to the Associated Press. In some cases, doctors started treating cases inside the vehicles.

Across the state, the outlook remained bleak, with a record 4,531 coronavirus patients in California intensive care units on Friday and the number of cases continuing to rise. The state recorded 53,341 new coronavirus cases on Friday, the second highest single-day figure, and another 386 deaths.

Available intensive care unit capacity in the Greater Sacramento region dropped sharply on Saturday, from 11.5% on Friday to 6.9%. The region, which includes the California side of Lake Tahoe, remains under a stay-home order, as do the Bay Area, the San Joaquin Valley and Southern California. The latter two regions are drawing heavily on hospital surge capacity, since their regular ICUs have zero availability.

Experts fear it’s unlikely to get better anytime soon, because it’s still too early for hospitals to see the effects from a Christmas surge.

“Admission to the ICU is often 10 to 12 days after exposure,” said Dr. Robert Siegel, a Stanford virologist. “The number of deaths may continue to increase for another week or more.”

Siegel also expects spikes from Christmas gatherings “will merge with, and contribute to surges” from New Year’s gatherings.

The ambulance wait times in Santa Clara County could be an alarming sign of things to come. The county saw a record number of COVID-19 deaths Friday — 38.

Santa Clara County Supervisor Joe Simitian, who co-chairs the Health and Hospital Committee at the Board of Supervisors, said wait times for ambulances are not uncommon during busy times of the week or during holidays. But they typically last no more than an hour — not seven.

“Whatever the period of time is, it’s always a concern because by definition you have folks you want to have admitted as soon as possible, and you want to have an ambulance crew on the road as quickly as possible,” Simitian said.

The combination of New Year’s Eve and COVID may have added stress on the county’s emergency system, he said.

“When you put together New Year’s Eve compounded by the COVID crisis, there are going to be some outliers that are troubling,” he said. “My understanding is they were relatively few in number — but obviously that’s cold comfort if you’re the one waiting for an ambulance.”

James Williams, the Santa Clara County counsel, said the county’s hospital system has been “teetering on the edge,” since a post-Thanksgiving surge in virus hospitalizations. He fears that another, similar surge, would greatly exacerbate what is already a problem with wait times at hospitals.

“If we have another surge now, anything like what we had after Thanksgiving — it’s going to cause collapse,” Williams said. Unlike March, the county cannot just make room by transporting patients to other facilities in California or another state. Santa Clara County has contingency plans for how to provide “some level of support” to those who may need it during a potential surge. But, Williams warned, those contingency plans would not be “providing everyone with the level of medical care that we take for granted in the United States.”

The virus continued its indiscriminate path through the population, infecting the young, old, famous and infamous. Talk show host Larry King, 87, was hospitalized with the virus, according to reports Saturday, while Dawn Wells, who played Mary Ann on “Gilligan’s Island,” died Wednesday. And at least one person was hospitalized after a New York Republican club’s Christmas party featuring an unmasked conga line.

Between pandemic fatigue and the holidays, the current surge will probably continue well into January, with hospitals, funeral homes and nursing homes continuing to see the fallout. State prisons also continued to see a surge, with 6,510 reported cases in the last two weeks — a sizable portion of the 40,985 incarcerated people who have had COVID-19 at some point.

Across Southern California, where the virus has hit the hardest, mortuaries have had to turn away families due to lack of space for all the bodies — and with funeral homes filling up, there’s a backup of bodies at hospitals, Los Angeles County Director of Health and Human Services Dr. Christina Ghaly told the Associated Press. The county medical examiner is looking for alternatives to store the bodies, she said.

Although thousands of California front-line workers have received vaccines, there is no impact yet on case counts. But the idea of a vaccine may be having something of behavioral impact, for good or for bad, according to Stanford’s Siegel.

“Some people have increased their precautions with the realization that it would be tragic to be infected when their turn to be vaccinated may be just around the corner,” he said. “Other people have increased their risk behavior knowing they will soon be protected or knowing that other people around them are vaccinated.”

Chronicle staff writer Michael Williams contributed to this report.  Jill Tucker is a San Francisco Chronicle staff writer.