The availability of intensive care sank again in the Bay Area on Tuesday and there were virtually no vacant ICU beds in most of the state for the 19th day, as California was looking for a way out of the long winter rush.
The situation in intensive care has become so dire worldwide that the state on Tuesday night issued a new health order requiring provinces with reasonable availability of ICUs, which will include several in the Bay Area, to transport patients from hospitals in crisis is and can no longer. provide adequate care.
Hospitals in Southern California and the San Joaquin Valley have been flooded with COVID-19 patients for weeks and may soon be forced to transfer to the ration. The new health order also requires most provinces in those regions to cancel almost all electives. The order takes effect immediately.
“This order helps ensure that patients continue to receive appropriate medical services by distributing available resources across the state to prevent overwhelmingly specific hospitals, provinces and regions,” said Dr. Tomás Aragón, director of the California Department of Public Health and State Health said. officer, in a statement. The order was the first of Aragon’s since taking office this month; he was previously the health officer in San Francisco.
“If hospitals are overwhelmed and overflowing, they can no longer provide the traditional standards of care we expect,” he said, “but if health care resources are available elsewhere, we need to ensure that Californians can get the care they need.”
The state has been struggling for more than two months with its current boom, and although there are signs it could flatten out, the next few weeks still look grim, public health officials said.
At the same time, vaccines rolled out much more slowly than hoped or expected. Further aggravation of a bad situation, a new, more contagious strain of the coronavirus is circulating – another 28 cases were announced in San Diego County on Tuesday, for a total of 34 nationwide – which could slow down efforts to spread the disease complicate.
“December has been really difficult, and January is not going to be any easier,” London Mayor London Breed told a news conference on Tuesday.
It is too early to say how much more pressure will be put on hospitals due to the expected increase in cases due to the end of the year holiday. Several provinces in the Bay Area report the first hints of a rise after Christmas. But public health officials say they still do not know if they are facing a small bump or the start of a new ‘bump on top of a boom’.
On Monday, the state reported 74,135 cases, a record of a one-day with a significant margin, although it contained a backlog in cases of the long holiday weekend for some provinces.
The availability of intensive care fell to 5.9% for the Bay on Tuesday, but the number varies dramatically in the provinces. San Francisco reported that 35% of its ICU beds were available and that four patients from other provinces were transferred to city hospitals.
In Southern California and the San Joaquin Valley, the two regions hardest hit, ICU availability has been at 0% since mid-December.
San Francisco public health officials could not immediately say what effect the new health order would have on local hospitals. In a newsletter earlier in the day, dr. Grant Colfax, director of the Department of Public Health in San Francisco, noted that the tremendous ICU tensions in other parts of the state could also affect the Bay.
“Although we have care available and people need care, it is the moral and ethical and right thing to do to provide the care when asked,” Colfax said, referring to the patients currently living in the city in the hospitalized. ‘We are monitoring our capacity very closely, because because the central and southern part of the state is still experiencing a catastrophic situation, and because the region has fewer ICU beds, we would expect our local ICU bed capacity to decrease as well. ”
Matters and deaths
The seven-day average in daily cases has recorded in some provinces of the Bay Area and remains flat for the region as a whole. Some provinces report in case cases, although it is difficult to say whether this is due to holiday wear in testing and reporting or a real decrease in the spread of diseases.
‘I would be reluctant to make radical policy changes based on holiday data so far. A lot of things in COVID take place over weeks, and we’re only ten days away from Christmas, ” said Dr. Nicholas Moss, the health officer of Alameda County, said.
He said an increase in business after Christmas and New Year would definitely come. “The question is: will this be the worst case scenario where we will resume day-to-day increases?” Moss said. ‘Or is it a blip? Things are rising, but they are falling again, and the dynamics are just not there to cause a boom. ”
The state reported 503 deaths on Tuesday, higher than the previous week’s daily average. The Bay Area reported 73 deaths, which has also increased over the past few days. Both were the second highest for the state and region since the pandemic began.
Hospitals and intensive care
Cases have picked up in Contra Costa County since Christmas, but officials said they do not yet know how big the boom after holidays will be, and that they are worried about the extra pressure on hospitals. In the last few days, a single figure has been available in the country for intensive care.
“So, we’re already at the highest we’ve ever been, and it’s worrying to have these cases in the pike,” said dr. Ori Tzvieli, the deputy health officer, said. “We are holding our breath and hoping that our peak will not be as big as Southern California, because they are really struggling down there.”
As of Monday, 269 COVID-19 patients had been hospitalized in the Contra Costa province, including 69 in intensive care – both peaks for the pandemic. In the Bay Area, the number of intensive care units dropped slightly from a weekend high, with 495 people in the ICU as of Monday; 2,134 COVID-19 patients were hospitalized in the region.
Across the country, 21,597 people were hospitalized with COVID-19 and 4,623 were in the ICU – both new peaks for the pandemic.
Usually, provinces will back each other up if a hospital is overwhelmed by patients, which can happen during a bad flu season. But Tzvieli said it is not as viable now, with hospitals in California. The state has opened six “alternative care sites” to deal with the floods.
Tzvieli said hospitals in his country are dealing with their current patient load, but he is concerned that one major outbreak – for example in a nursing home or as a result of a widespread event – could be disastrous.
“At the moment they are close to the edge,” Tzvieli said.
Virus variant
San Diego County officials said Tuesday they have identified another 28 cases of people likely to be infected with the new coronavirus variant that is sounding the alarm worldwide. The province reported a total of 32 confirmed or probable cases, and two other cases were identified in San Bernardino County over the weekend.
The San Diego County cases include 28 cases confirmed by genomic sequence, and four cases directly linked to one of the confirmed infections. The samples were collected from 27 December to 31 December. One of the 32 patients was temporarily admitted to the hospital, but the other remained at home.
None of the patients had traveled recently, so they did not pick up the tension in the UK, where the variant was first identified, or anywhere else outside of California. The patients come from 19 different households in four cities.
“The fact that these cases have been identified in several parts of the region shows that this virus strain can spread rapidly,” said Dr. Wilma Wooten, the San Diego County health officer, said in a statement. “People need to be extra careful to prevent and spread COVID-19, especially this variant which according to research is more contagious.”
The variant has been identified in at least four other states. Bay public health officials said they suspect it is also spreading in this region, although they have not yet identified any cases.
Erin Allday is a staff writer for the San Francisco Chronicle. Email: [email protected] Twitter: @erinallday