Hospitals prepare for influx of coronavirus patients; officials worry it won’t be enough

Bracing for a surge of COVID-19 patients in Long Beach and across the county, officials are in a life-and-death race to create hundreds of new intensive-care beds through a variety of conventional and creative tactics.

The immediate goal: To amass enough beds in public and private hospitals to simultaneously confront a massive influx of coronavirus patients while continuing to care for other patients who must be hospitalized.

Long Beach Mayor Robert Garcia has warned that, should current social distancing efforts fall short, coronavirus patients could outstrip hospital capacity to handle them, even though the numbers in Long Beach now are relatively small.

“In the next two to three weeks,” Garcia said at a Monday press conference, “we are either going to stay home, try our best to stay healthy and social distance, or we are going to fail at that and fill our hospitals to an emergency [level] where we will not have enough beds to be able to treat everyone that needs support.”

To avoid that possibility, government officials here and in Washington, along with hospital executives, already are undertaking a series of measures to prepare for a crush of coronavirus patients.

On Friday, for example, one of the Navy’s floating hospitals, the USNS Mercy, is expected to arrive in the Port of Los Angeles, providing more than 1,000 beds and 800 medical personnel to treat non-COVID-19 patients.

The Department of Defense ordered the ship to Southern California after receiving requests from Gov. Gavin Newsom and Los Angeles County Supervisor Janice Hahn, who noted that of the county’s 2,200 intensive care beds, only 220 are available. As of noon Wednesday, there were over 800 confirmed coronavirus cases and 12 deaths in Los Angeles County.

Hahn, whose 4th District includes Long Beach and the waterfront, said the Mercy will instantly become Los Angeles County’s “largest hospital,” freeing up space in other facilities for incoming coronavirus patients.

“This is going to save lives,” she told the Post, adding that 90% of the county’s ICU beds are currently occupied by non-COVID-19 patients.

To further expand the number of beds for coronavirus patients, Hahn said the county is creating new acute care facilities in non-traditional settings. One idea has been to convert hotels and motels into hospitals.

The 158-bed Community Hospital in Long Beach also is being reopened in the days ahead for non-COVID-19 patients. It was shuttered in 2018 because of seismic issues the operator deemed too expensive to fix.

In all, Long Beach will have more than 1,350 hospital beds, including: 453 at Long Beach Medical Center, 357 at Miller Children’s & Women’s Hospital Long Beach, and 389 at Dignity Health – St. Mary Medical Center. On the Lakewood-Long Beach border, Lakewood Regional Medical Center has another 172 beds.

In addition, temporary mobile field hospitals are being deployed by Long Beach Health and Human Services to the MemorialCare campus, St. Mary and College Medical Center Long Beach. Once in place, each hospital will determine the best use for its 30-by-42-foot tent, which can accommodate up to 20 medical cots, or serve as a triage or emergency centers.

A temporary triage facility has been erected outside of the Dignity Health – St. Mary Medical Center emergency room. Photo By Brandon Richardson

In 2017, the city of Long Beach procured six tents from the California Emergency Medical Services Authority. This is the first time they will be deployed for medical use, according to Sandy Wedgeworth, director of public health emergency management in Long Beach. She added that the remaining three tents may be deployed to areas away from hospitals at a later time if necessary.

Should all these facilities still be unable to handle a patient surge, the Veterans Administration healthcare system in Long Beach with its 291 beds could step in to help, according to Richard Beach, chief of public affairs for the VA.

Beyond these measures, hospital space for coronavirus patients is being created through other means as well, including the discharge of patients who no longer need acute care and the cancellation of elective procedures.

According to the county, which has a total of 22,000 beds, these measures alone could potentially free up 20% more beds without additional space or resources.

MemorialCare’s chief medical officer, James Leo, said emergency operations plans at his facility have already been “activated” in anticipation of a patient surge.

Among other things, the Long Beach medical campus is: assessing and improving staffing levels and creating a labor pool to deploy to specific areas; activating emergency credentialing and privileging, which streamlines the process of bringing in volunteer physicians and physicians; and working with the city of Long Beach and the California hospital association to regularly evaluate and coordinate its surge capacity.

If necessary, Leo said, MemorialCare could also double occupancy in private rooms, use operating and recovery rooms for critical care and relocate the emergency room, using that space for critical care rooms.

Leo said that MemorialCare is also exploring partnerships with other facilities around the city—such as urgent care centers—where recuperating patients could be moved to free up critical beds.

“Although we hope we don’t have to take these measures,” Leo said, “our hospitals are poised to take them to continue to provide medical care to our community.”

At St. Mary Medical Center, officials have identified unoccupied space to use for isolating patients, a spokesperson said. Already, the hospital has erected a triage tent in front of its emergency room entrance to identify critically ill patients who require a higher level of care.

“The safety of our patients, visitors, employees, volunteers and physicians remains our highest priority,” the spokesperson said.

The creation of more beds is not the only issue that hospitals worry could impact patient care and healthcare worker safety: hospitals across the country are reporting shortages of critical protective equipment, such as masks, gloves, gowns and hand sanitizer, for their staff and volunteers.

L.A. County says it currently has “adequate” protective equipment at its hospital facilities and that orders have been placed with state and national stockpiles for providers.

On Feb. 28, the Centers for Disease Control announced that some critical medical equipment in U.S. stockpiles, such as filtering facepiece respirators, have passed the manufacturer-recommended shelf life—some dating back to the 2009 H1N1 pandemic. Although expired respirators have an increased chance of failing, the equipment is still being sent to hospitals across the country due to the high demand and the urgent circumstances.

A MemorialCare spokesperson said the Long Beach campus currently has enough protective equipment. However, the hospitals have set up a page detailing items the community can donate to better prepare the facilities for a surge of patients. Necessary items listed on the donation page include face masks (disposable or handmade), respirator masks, eye protection, disposable gowns, gloves, surgical caps and foot covers, antimicrobial wipes and hand sanitizer.

The hospital is still assessing the number of ventilators on site.

Still, officials say the best thing the public can do to help hospitals weather the coronavirus and “flatten the curve” is to follow the rules.

“Stay home,” Supervisor Hahn said. “Unless you are considered an essential worker, you should not be leaving your home aside from picking up food.”

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