COVID-19: Riverside County nears 0% ICU capacity Monday; Southern California at 2.7%
Riverside County's intensive care unit capacity fell to almost zero on Monday, the public health department said, while the larger Southern California region designated by the state under COVID-19 protocols fell to 2.7% ICU capacity.
In total, Riverside County reported 930 people hospitalized with COVID-19 on Monday, with 184 in ICU, across 21 hospitals. That was up from Friday's record-breaking 809 hospitalized across the county, with 170 in ICU units.
Although the county put the capacity at 0%, county spokesman Jose Arballo said during a 4 p.m. news conference: "We're not at zero — we're close."
Lee Rice, a spokesperson for Eisenhower Health, said Monday afternoon: "Currently we have two staffed ICU beds available."
"Our capacity has reached full capacity," Arballo said, "however, each hospital has its own surge plan." Hospitals can make modifications to increase their capacity including stopping elective surgeries. "Even though the capacity is pretty close to the max, there are beds available."
Zero percent capacity refers to the number of licensed staffed beds, said Shane Reichardt with Riverside County's Emergency Management Department.
When hospitals are reaching the point where those beds are full, they implement their surge plans — canceling elective surgeries, moving ICU patients no longer in need of those intensive care services to other areas of the hospital. They may also repurpose beds in other hospital units into ICU beds where possible, Reichardt said.
The challenge, however, is in staffing, Reichardt said.
“Every neighboring county and jurisdiction is dealing with the same thing that we’re dealing with, so this is not like a localized emergency where we might be able to call our neighbors and say, ‘Hey, can you spare some staff or assist us?’ Because all of our neighbors are unfortunately dealing with the same thing,” Reichardt said.
“And, it’s not just our neighbors here in Southern California, it’s up and down the state and across the nation,” he said.
At the same time, he urged people experiencing an emergency, such as a heart attack, to not put off going to the nearest emergency room, because they will be treated.
In a bit of welcome news, the first shipment of the recently approved Pfizer vaccine for COVID-19 could arrive in Riverside County on Friday, county officials said.
The vaccine is expected to arrive at pre-selected hospitals and at Riverside University Health System where doses will be stored until they are transported to other medical facilities. The total number of vaccine doses coming to the county is between 14,000 and 15,000, according to a statement from the county Monday afternoon.
The first group of people to be vaccinated — what's known as the Phase 1-A Tier — includes healthcare workers at acute care hospitals with "direct patient contact who have potential for direct or indirect exposure."
“Receiving the first doses of vaccine for our front-line healthcare workers is a day we’ve been looking forward to,” County Supervisor Vice Chair Karen Spiegel said in the statement. “As we receive more vaccine in the coming weeks and months, we’ll be able to offer vaccinations to more of our workforce and start to see big movement in recovering from this terrible pandemic.”
Riverside adds 6,741 cases since Friday
As of Monday, Riverside County had recorded 119,691 total positive cases and 1,586 deaths. That was an increase of 6,741 cases and 13 deaths since Friday.
There were 2,379 new cases and five deaths tallied Saturday; 3,006 new cases and one death reported Sunday; and 1,356 cases and seven deaths reported Monday.
“With so much grim news lately with the pandemic, it is great that we can give the public something so positive that we believe can turn this around,” Kim Saruwatari, director of Public Health, said in the statement. “This is a turning point in the pandemic and we are looking forward to a time in the not-to-distant future when we can vaccinate tens of thousands of our neighbors against this virus.”
As hospitals across the county are seeking additional staffing amid a surge in COVID-19 patients, county supervisors last week called for immediate action at the local and state level.
Nurses could strike as soon as Christmas Eve
Riverside County is bracing for a possible strike of health care workers, with nurses and licensed medical professionals in the SEIU Local 121RN who work at three Hospital Corporation of America facilities voting last week to authorize an unfair labor practice strike. They cited unsafe working conditions including lack of clean supplies, insufficient testing and insufficient support staff.
The facilities include Riverside Community Hospital in Riverside, West Hills Hospital and Medical Center in Los Angeles, and Los Robles Regional Medical Center in Thousand Oaks.
Public officials say a strike would have a domino effect, as other hospitals in the region would need to take in more patients.
The vote doesn't necessarily mean that these workers will strike, but they can if the bargaining team for the union deems it necessary while continuing negotiations with the hospital.
The nurses plan to strike before Christmas unless negotiations can be finalized in the next 10 days. SEIU Local 121RN delivered a strike notice on Monday morning, according to union representative Terry Carter.
“The bargaining team is pleading to continue negotiations,” Carter told The Desert Sun on Monday morning. “The Hospital Corporation of America has said it is walking away from the bargaining table at this time.”
But by 10 a.m., the HCA returned to the table and negotiations were set to continue Tuesday or Wednesday, said Kerry Cavazos, labor and delivery nurse and president of the Riverside chapter. "We are close to a contract," she said.
Carter said the strike notice gives the hospital 10 days to find temporary replacement staff. “The nurses are still asking the employer to remain in negotiations for these 10 days,” she said.
If a strike does happen, Carter said, the first day would be Christmas Eve.
"We’re not asking for you to pay me more," Cavazos told The Desert Sun. "We want you to give me a mask (and) give me the proper equipment."
Riverside Community Hospital did not respond to a request for comment.
George Greene, President & CEO of the Hospital Association of Southern California, a regional trade association representing hospitals and health systems, said Monday: “Now is the time for everyone who touches health care to come together with a common goal: preventing workforce stoppages that could reduce the ability to care for people in need of critical services.”
Although Greene noted that the “association does not normally speak publicly about hospital-labor negotiations," it felt "compelled to engage.”
“It’s clear that these are extraordinary and dangerous times, and no one should harbor any illusions about what’s at stake: a strike during an unprecedented pandemic puts people’s lives in danger," he said.
“In no way are we questioning any union’s right to engage in negotiations, including their right to strike, but now is simply not the time,” Greene added, calling upon all involved to “set their differences aside to keep every possible hospital bed open and ready – not just for COVID patients, but for every Californian needing care.”
Expanding capacity at hospitals
On Sunday, the California Department of Public Health approved a temporary waiver of nurse-to-patient ratios for intensive care units, "step-down" units, emergency medical services and medical and surgical units.
Arballo, the county spokesman, said there are currently no plans to open up the county's two federal medical facilities in Indio and the city of Riverside, although he said the equipment remains stored at the sites if needed.
"We are confident that the hospitals have the ability when they get to this point to be able to add more capability to their facilities,'' he said.
Eisenhower Health, in Rancho Mirage, has additional areas in the hospital designated to manage ICU patients as part of its surge plan, said Dr. Alan Williamson, Eisenhower's Chief Medical Officer. The hospital continues to add staff, he said, in order to care for additional patients. The hospital also received some additional nursing from the state, which will help, he added.
Todd Burke, director of communications for Tenet Healthcare, which operates Desert Regional Medical Center in Palm Springs and John F. Kennedy Memorial Hospital in Indio, said Monday: “Desert Regional has reached its licensed adult ICU bed capacity, but we have enacted our surge plan, and we are currently able to provide ICU care for patients requiring it in other units within the hospital. We continue to flex our ICU bed capacity as needed."
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ICU capacity at or near zero in several regions
The state has divided California's 58 counties into five regions for assessing COVID-19 spread and hospital availability. The Southern California region includes Imperial, Inyo, Los Angeles, Mono, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara and Ventura counties.
As of Monday, the intensive care unit capacity by region was as follows:
- Southern California: 2.7%
- Bay Area: 17.8%
- Greater Sacramento Region: 14.8%
- Northern California: 29.0%
- San Joaquin Valley: 0.0%
The Southern California, San Joaquin and Greater Sacramento regions are all under the state's stay-at-home orders — which mandate closures of certain businesses and reduced capacity or services at others — because their ICU capacity has dropped below 15%.
Regions are subject to the stay-at-home orders for at least three weeks. The earliest possible dates for those orders to be lifted are Dec. 28 for Southern California and San Joaquin, and Greater Sacramento Jan. 1.
California as of Monday had repoted 1,585,044 cases, up 33,278 from Sunday, and 21,046 deaths, up 77 from Sunday.
Monday's numbers: Riverside County
Positivity rate: Riverside County reported a virus positivity rate of 14.8% Monday, up from 10.1% the week prior.
Case rate: The county's adjusted case rate is 47.8 new cases per day per 100,000 residents — a sharp increase from 38.9 new cases the week prior. Under its system, the state health department adjusts counties' case rates based on whether they're conducting more or fewer than the state's average number of tests per capita.
Active cases: The number of known, active cases countywide was 47,291 on Monday. The active count is derived by subtracting deaths and recoveries from the current case total, according to the county's executive office.
Recoveries: According to the county, 70,814 people have recovered, which is about 59% of its overall cases.
Tests: A total of 1,335,227 coronavirus tests have been administered in Riverside County, according to officials. There were 53,050 additional tests administered since Friday.
The county did not break down its cases and deaths among age groups and ZIP codes Monday due to technical issues, said county spokeswoman Brooke Federico.
Intern Laine Henry contributed to this report.