World News – UK – Surging Virus Reveals California’s Vulnerability: Lack of Hospital Beds and Staff

Many of the state hospitals sometimes have fewer beds in order to limit the length of patient stays and shorten costs. But this approach is now being tested.

SAN FRANCISCO â ???? Despite its size and economic power, California long had few hospital beds relative to its population, a shortage that state officials could now describe as disastrous.

California has an average of almost 15. 000 new cases per day, the largest increase in coronavirus cases. This corresponds to an increase of 50 percent compared to the previous record in the summer.

Although the state has taken some of the most restrictive measures in the country to prevent the virus from spreading, an influx of people with severe cases of Covid-19 may force overwhelmed hospitals to turn away patients until Christmas, Gov. . Gavin Newsom warned this week.

Hospital bed shortages have been a global problem throughout the pandemic, but California has a particularly acute shortage of 40 million people. The richest state in the richest country has 1. 8 hospital beds per 1. 000 residents, a level that, according to the Kaiser Family Foundation in 2018, exceeds just two states, Washington and Oregon. California has a third of the number of beds per capita as Poland.

Many California hospitals have fewer beds in some cases to limit patient stays and reduce costs. But this approach is now being tested.

In addition to beds, a shortage of nurses will make managing the rise in virus cases extraordinarily difficult for us in California. said Carmela Coyle, director of the California Hospital Association, which represents 400 hospitals across the state.

??????????????????????????????????????????????? ?????????????????????????????????????????????????? ?????????????????????????????????????????????????? Mrs. Coyle said. It is what made this pandemic unique and different from other disasters. â ????

Even unlike other disasters, California cannot rely on other states for help. Mutual aid was a cornerstone in disaster planning and, for example, called on thousands of firefighters from neighboring countries to help put out the mega-fires of recent years.

With so many parts of the country grappling with the coronavirus at the same time, few traveling nurses or nearby hospital beds are available.

« You have to think of this as a natural disaster, like an earthquake » There is a great need for hospitalization. said dr. . George Rutherford, Professor of Epidemiology at the University of California at San Francisco. But the difference here is that it happens across the country. We can’t send people to Reno, Phoenix, or Tucson. We’re stuck. â ????

The state government says it has 11 surge protection systems or alternative facilities, including mothballed medical buildings and at least one sports arena, ready when hospitals become overloaded.

Beyond California, hospitals have been struggling in the past few weeks to handle a new onslaught of patients, particularly in parts of the Sun Belt and New England that had largely avoided coronavirus spikes in the spring and summer. The country is likely to set a record of 100 this week. 000 hospital admissions.

As hospitals are exceeding or near exceeding capacity for coronavirus patients, state and local officials have opened hospitals in parking lots or in unoccupied buildings.

In Rhode Island, where infections have risen rapidly in recent weeks, a field hospital opened in Cranston, the state’s second largest city, on Monday. For $ 8 million, a former Citizens Bank call center was converted into a 335-bed field hospital. In New Mexico, an empty medical center in Albuquerque has been used to recover coronavirus patients. « We’re seeing the worst rates we’ve seen since the pandemic broke out, » Mayor Tim Keller said in a recent interview.

Nancy Foster, vice president of the American Hospital Association for Quality and Patient Safety Policy, said hospital systems that are busy during the pandemic haven’t fully explored how to better prepare them. But she said the shortage of hospital beds in many states reflected the pre-Covid era.

« At a time when you are focused on cutting health care costs and having overcapacity » that you heat and light and clean and all that stuff ???? is just in contrast to your efforts to be as lean as possible and as cost effective as possible. Mrs. Said Foster. So we’re going to think critically about what the right balance is between low cost and disaster preparedness. â ????

The number of hospital beds in California has declined over time, in part because of the trend towards more outpatient care, said Kristof Stremikis, an expert on the state hospital system at the California Health Care Foundation. But more acute than the lack of beds, sir. Stremikis says there is a shortage of staff, especially in regions with high concentrations of black patients, Latin America and Native American people.

« The system flashes red when it comes to the workforce » Mr.. Said Stremikis. « It’s Nurses, Doctors, Allied Healthcare Professionals » We don’t have enough of many different types of clinicians in California and they are not in the right places. It’s a big problem. â ????

Mr. . Newsom said California will draw from a register of retired or non-practicing health care workers and use them in hospitals.

But woman. Coyle, director of the California Hospital Association, says she doesn’t think volunteers can fill the void.

« We are limited to a very, very small part ready to serve, » she said. These volunteers have not been trained to be as helpful in a hospital. â ????

At the county level, health officials are counting down the days until their hospitals are full. According to a New York Times database, California became the first state to exceed 100 on Sunday. 000 cases per week. The state government estimates that around 12 percent of cases end up in a hospital.

Dr. . Sara Cody, the chief health officer of Santa Clara County, which also includes a large part of Silicon Valley, expects the county’s hospitals to reach capacity by mid-December.

« This is the most difficult phase of the pandemic yet » DR. Said Cody. Everyone is tired. â ????

She expects an increase in Thanksgiving gathering cases, which could speed up the timeline, she said.

Few states have battled the pandemic as aggressively as California, which now has a stash of half a billion face masks on hand. Los Angeles last week announced a ban on gatherings with other households. In Santa Clara County, hotels are reserved for essential travel only, and a contact sports ban is forcing the San Francisco 49ers to play home games in Arizona.

« We have done everything we can as local leaders and health officials, » said Dr. . Cody, who led efforts in March to set up the country’s first emergency shelter. We worked as hard as we can work. We tried everything we can. But without bold action at the state or federal level, we will not be able to slow this down. We are not an island. â ????

In Los Angeles, local officials came under fire after hundreds of tests scheduled for Tuesday at Union Station were canceled because of a movie, a remake of the 1990s romantic comedy « She’s All That ». one???? People who had scheduled tests were informed of the cancellation Monday afternoon, and it wasn’t until after midnight that Mayor Eric Garcetti announced that testing had resumed.

Filming was still on Tuesday morning when Wendy Ambriz wiped her mouth at the station’s test kiosk.

woman. Ambriz didn’t think the county’s outdoor dining restriction, which came into effect last week, was necessary as kitchen staff were keeping it clean. But she didn’t blame government officials for the runaway coronavirus in Southern California.

Sheila Kuehl, who sits on the district’s governing body, was discovered at an Italian restaurant in Santa Monica after publicly describing outdoor dining as « an extremely dangerous situation ». and vote to ban it. In a statement on Monday, Mrs.. Kuehl’s office found that the ban had not come into effect at the time of dinner. Their meal was reminiscent of another moment of apparent hypocrisy that Mr.. . Newsom and a group of lobbyists at the luxurious French laundry restaurant in Napa Valley just as the governor was advising residents not to meet with large groups.

Picnic tables were cordoned off outside the Broad Street Oyster Company in Malibu last week and the restaurant did not have seating for customers. But didn’t that stop people from eating there? They just ducked under the ribbon.

Thomas Fuller reported from San Francisco and Manny Fernandez from Houston. Louis Keene contributed to coverage from Los Angeles.

Gavin Newsom, Calif., Coronavirus