Southern California’s ICU capacity falls to 0%, an alarming sign amid deepening coronavirus surge

Southern California’s intensive-care unit bed capacity fell to 0% on Thursday, Dec. 17, an alarming nadir for the region’s healthcare system — though one that had seemed like an inevitability for more than a week as the worsening coronavirus surge sapped available ICU beds daily.

Thursday’s decline from 0.5% the day before was the 10th consecutive day available ICU bed capacity dropped.

The metric, which state officials update daily, has become the critical marker in the fight against the coronavirus pandemic, with new cases, hospitalizations and deaths rising rapidly. Health officials have long said that ensuring hospitals don’t become overrun was paramount to controlling the renewed surge.

Yet, on Thursday, state officials reported that there were 15,431 coronavirus patients in hospitals across California and 3,280 in ICUs, the latter representing a nearly 3% increase. The Southern California region — which includes 11 counties, including Los Angeles, Orange, Riverside and San Bernardino — is under a statewide stay-at-home order that was triggered when ICU capacity fell below 15%.

The shutdown required mass closures, including all in-person dining and salons, and will last until at least Dec. 27. But it’s become increasingly likely that the shutdown order will remain in effect well beyond that. The order won’t get lifted until projections show ICU capacity climbing to 15% or above.

But the region has seen its coronavirus numbers worsen daily, despite vaccines rolling out throughout Southern California this week.

Los Angeles County, for example, reported 138 coronavirus-related deaths on Wednesday, with its new daily cases surpassing 11,000 for the past week.

The 11 counties that comprise the Southern California region had 2,310 confirmed COVID-19 patients on Wednesday, according to the state’s latest hospital survey. That’s a 4% increase from the day before. And the number of coronavirus patients in ICUs across the region has increased 27% over the last week — and 64% from two weeks ago.

The recent surge, health experts have said, was catalyzed further because of large gatherings during Thanksgiving. And with the specter of Christmas a week away, and the new year looming as well, those officials have urged folks to stay home.

“The virus is rampant in all neighborhoods,” LA County Public Health Director Barbara Ferrer said Wednesday. “We have the most difficult road yet in front of us.”

It’s unclear how much more the healthcare system can take.

State officials haven’t disclosed why they chose 15% as the threshold for triggering the regional stay-at-home. And hospitals, despite the region having 0% ICU bed capacity according to the state, can always add more intensive-care beds if they need.

But more beds means more patients per every doctor and nurse.

The state, in fact, announced last week that it would allow hospitals to submit expedited waivers to increase staffing ratios further; the state will also temporarily stop enforcing other regulations, including those laying out how much space medical facilities need.

The increase in staffing ratios has met resistance from the state nurses union.

“At a time when nurses are already overwhelmed and at their breaking points, and COVID patients need much more intensive care than typical patients,” the California Nurses Association said in a statement earlier this week, “overloading nurses with patient assignments will put countless lives at risk.”

State officials, for their part, have said controlling the current coronavirus surge and stabilizing ICU capacity is also about ensuring hospital staffers don’t get overrun.

Ferrer has said the state wants no more than 30% of patients in ICUs to have COVID-19. But the California Department of Public Health, on Thursday, said more than 50% of ICU patients statewide have tested positive for the coronavirus.

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