Surge planning already in the works for some California counties

As Gov. Gavin Newsom is considering an expanded stay-at-home order if COVID-19 overwhelms hospitals in December, surge planning has been in the works for many months. 

"If our local hospitals should reach capacity, then we will activate an overflow site," said Laine Hendricks, public information officer for the County of Marin.

For example, normally the Marin Center is an entertainment venue at the county fairgrounds. But the popular auditorium is now occupied by a 48-bed Alternate Care Site, one of many across California.

It's not a COVID ward, but a place to transfer regular hospital patients in, if a hospital needs more space for COVID cases.

"So it's good to have a facility like this staged and ready to go, so that even if we need to entertain that idea of surge, we are equipped to care for those who need that hospitalization," said Hendricks.  

On Monday, Newsom did not downplay the threat.

"This is a dynamic week, an incredibly important week in the history of this pandemic," said Newsom. "Red flags are flying, not yellow flags, red flags."

December is expected to be critical as COVID-19 hospitalizations are expected to double or triple, depending on the location.

More than 60 percent of the state's hospital beds are already in use.  

"Roughly 12 percent of our new cases likely will be hospitalizations," said Newsom, " and of those hospitalized, 10 to 30 percent will likely need respiratory care and ICU support."

Health officials note there is a lag between infection and hospitalization.

"The high case numbers that we've seen in the last week to ten days have not even begun to impact hospitals yet, " said Dr. Mark Ghaly, the state's Secretary of Health and Human Services.

Newsom hinted that a stronger stay-at-home directive could come within days, aimed at counties in the most restrictive purple tier where transmission is widespread.

Instead of the existing overnight curfew, daytime hours could be added.    

"If these trends continue we're going to have to take much more dramatic - arguably drastic- action," warned Newsom.

Ghaly did clarify that new orders would not be as broad or open-ended as those first imposed in the Spring.

"We can be not only more surgical in what we do, we can prescribe it for a shorter or different amount of time," said Ghaly.

Hospitals are required to have a surge plan.

"Collectively our local hospitals in Marin are able to increase their capacity up to 67 percent if needed," said Hendricks.

Only after those strategies are employed would patients be transferred out to the Alternate Care Site.

As December promises to break records,  Ghaly expressed frustration that people want him to identify vectors, activities that are spreading COVID19: "The truth is it's just all around our communities and everyone is somewhat vulnerable to having an encounter with someone who's infected."