Contra Costa County at risk for high COVID-19 infection rates, hospitals struggle to prepare

Facing an unprecedented health crisis across the country, Contra Costa County health providers are struggling to ramp up their preparations for an expected flood of COVID-19 coronavirus patients.

In a fresh study released Tuesday through ProPublica, the Harvard Global Health Institute for the first time gives a sense of which regions will be particularly stressed and should be preparing most aggressively right now.

Dr. Ashish Jha, director of the Institute, who led a team of researchers that developed the analysis, said:

“(In most scenarios) vast communities in America are not prepared to take care of the COVID-19 patients showing up.”

Under the researchers’ best-case scenario, Americans will act quickly to slow the spread of the virus through social distancing, and the infection rate among adults will remain relatively low at 20 percent, or 49.4 million people over the age of 18, less than twice the number of people who get the flu each year.

As of 2018, Contra Costa County had 1,730 total hospital beds, of which about 61 percent were occupied, potentially leaving only 680 beds open for additional patients.

The bed count includes 200 beds in intensive care units, according to data from the American Hospital Association and the American Hospital Directory. Intensive care units are best equipped to handle the most acute coronavirus cases.

Contra Costa County has a population of about 1.1 million residents; 14 percent are over the age of 65. The experience in other countries has shown that elderly patients have significantly higher hospitalization and fatality rates from COVID-19.

In the moderate scenario, in which 40 percent of the adult population contracts the disease over 12 months, Contra Costa would be one of the regions that would need to expand capacity.

It is estimated that about 8 percent of the adult population would require hospital care. In a moderate scenario where 40 percent of the population is infected over a 12-month period, hospitals in Contra Costa would receive an estimated 70,200 coronavirus patients.

The influx of patients would require 2,340 beds over 12 months, which is 3.5 times the available beds in that time period. The Harvard researchers’ scenarios assume that each coronavirus patient will require 12 days of hospital care on average, based on data from China.

In Contra Costa County, the Harvard study said intensive care units would be especially overwhelmed and require additional capacity. Without coronavirus patients, there are only 81 available beds on average in intensive care units, which is 6.2 times less than what is needed to care for all severe cases.

Ben Drew, director of communications for John Muir Health, said Wednesday that the hospital system has added “several nurses” to assist with the triaging of patient calls. John Muir has also canceled elective surgeries and procedures until at least March 27. John Muir hospitals in Walnut Creek and Concord are also putting aside rooms specifically prepared for virus patients.

Drew also said that the Walnut Creek health center has sufficient supplies to care for coronavirus patients and keep staff safe. He added:

“For shortages of certain pieces of equipment, we are exhausting all possible sources to ensure we maintain appropriate levels.”

But what about the coronavirus test? Drew admitted:

“We do not have enough COVID-19 tests available to test every John Muir Health patient. This means that COVID-19 tests are being prioritized for patients who meet high-risk criteria as outlined by the CDC.”

Kerri Leedy, a Kaiser Permanente representative said:

“We are prudently managing our resources to ensure we have adequate access to protective equipment and medical supplies needed for the screening and treatment of patients with potential and confirmed COVID-19 infections … We are working with our supply chain vendors and other sources to be prepared to meet the needs of our staff and patients.”

Leedy declined to give any numbers on staffing, but added:

“(W)e have contingency plans in place to manage both higher numbers of patients in our facilities and illness among staff. We are able to manage this in part with fully licensed or certified seasonal contract staff.”

A spokesperson for Sutter Health said:

“We continue to work closely with state and local officials to prepare for a surge in patients. We are also leveraging the strength of our integrated network to increase our capacity to use non-hospital based strategies like video visits and walk in care to treat patients who do not need emergency-level care.”

Sutter’s representative also said the hospital group is struggling with the availability of supplies and virus tests.