Critically Low ICU Capacity Across Swath Of California Triggers State’s Emergency Surge Protocols

In mid-August California’s Health Officer, Dr. Tomás J. Aragón, issued a new order meant to ensure rapidly-filling hospitals and ICUs had the support and flexibility they needed.

At the time, Aragón announced: “California is currently experiencing the fastest increase in Covid-19 cases during the entire pandemic with 23.8 new cases per 100,000 people per day, with case rates increasing eleven-fold within two months…Hospitalizations have increased over 700% in the past two months and are projected to continue to increase.” That they have.

Since mid-August, cases have plateaued but the 7-day average of new cases of per 100,000 has grown then dropped a bit 27.9 per 100,000 today. Hospitalizations and ICU demands — which are lagging indicators generally rising weeks after spikes in cases — have continued to increase.

In mid-August, there were 7,166 people with Covid-19 hospitalized in the state. Today, there are 8,630 such patents, with the number of available staffed ICU beds statewide down from 1,861 then to 1,533 today. Those changes are more acute in some areas than others.

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In the San Joaquin Valley the number of available staffed ICU beds dropped to just 8.6%. The drop below 10% triggered Aragón’s health officer order. That makes the San Joaquin Valley the first region in the state to implement the provisions the new Public Health Order and the first time since the winter surge that such provisions taken effect.

Intended to ensure ICU capacity remains available, the health officer surge protocols help shift capacity throughout the region and the state

According to the order, for at least the next seven days, San Joaquin Valley Region hospitals must adhere to the following:

1. “All general acute care hospitals in the county who do have ICU bed capacity must accept transfer patients when clinically appropriate and directed by the Medical and Health Operational Area Coordinator.”

2. “All general acute care hospitals in the region who do have ICU bed capacity must accept transfer patients when clinically appropriate and directed by the Regional Disaster Medical Health Specialist.

3. “If there is no ICU bed capacity within the region, then all general acute care hospital(s) in the State of California must accept transfer patients when clinically appropriate and directed by the California Emergency Medical Services Authority Director or designee.”

The San Joaquin Valley Region includes the counties of Calaveras, Fresno, Kern, Kings, Madera, Mariposa, Merced, San Benito, San Joaquin, Stanislaus, Tulare and Tuolumne. It has a population of 4.3 million people which encompasses 11% of the state’s population, according to the Public Policy Institute of California.

Fresno County, for instance, which has a population of over 1 million, has just 6 staffed ICU beds left, according to the state data dashboard. See image below.

Fresno County’s vaccination rate is also low. Statewide, about 56% of all residents are fully vaccinated. In the Fresno area, just 44% of residents have been fully inoculated.

Officials will reevaluate the San Joaquin Valley Region’s ICU capacity on September 9.

State administrators have divided California into five regions for the purposes of characterizing local Covid spread and restrictions. In addition to the San Joaquin Valley, there are the Bay Area, Greater Sacramento, Southern California and Northern California.

Two of those regions, Greater Sacramento and Northern California, are not far from the 10% threshold, either. Greater Sacramento’s extant ICU capacity sits at 12.9%. Northern California’s is 15.3%. The state as a whole has 18.3% of its staffed ICU beds available. To see ICU stats for each region, click here.

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