Hospital bed and intensive care unit capacity could soon become a concern in the Inland Empire, where coronavirus cases continue to rise in two Southern California counties with the second- and fifth-highest number of cases reported in the state.

Across all hospitals in Riverside County, intensive care beds are 99% occupied as of Sunday, said spokeswoman Brooke Federico — a 19% increase over the past two weeks. There are just five empty ICU beds remaining in Riverside County. 

Of the 380 ICU patients in Riverside County, 28% are confirmed COVID-19 patients.

Overall, the county’s hospital beds are currently 63% occupied. This means hospitals have flexibility to convert some of those empty beds to ICU beds under their surge plans, which is what hospitals plan to do in the coming week, Federico said.

In neighboring San Bernardino County, ICU beds are at 89% occupancy. County spokesman David Wert said he couldn’t immediately provide additional information.

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Gov. Gavin Newsom on Sunday asked both Inland Empire counties to order bars to close to stop the slow the spread of the virus. Counties under a mandatory bar closure order are Los Angeles, Fresno, San Joaquin, Kings, Kern, Imperial and Tulare.

Imperial County, an agricultural region of about 182,000 people on the northern side of the California-Mexico border, reported a week ago that its ICU beds were at capacity. Newsom urged Imperial County this week to “pull back” and reinstate its stay-at-home order as cases surge at a level not seen anywhere else in the state.

What we know about Riverside County surge plans

In Riverside County — which has an estimated 2.4 million people, according to the U.S. Census — there are nearly 3,400 hospital beds among 17 hospitals, according to 2018 data from California’s Office of Statewide Health Planning and Development. 

Riverside County has 1.4 hospital beds per 1,000 people, lower than the national rate, which is 2.8 hospital beds per 1,000 people, according to a ProPublica analysis.

Of those 17 hospitals, the Coachella Valley is home to three acute care hospitals, including Eisenhower Health in Rancho Mirage; Desert Regional Medical Center in Palm Springs; and JFK Memorial Hospital in Indio. The latter two are part of Tenet Healthcare, a national health care conglomerate. 

Mike Mesisca, Riverside University Health System emergency and disaster medicine director, previously told The Desert Sun he worked with all acute care hospitals in the county at the start of the pandemic to guide them through surge plans. An acute care hospital is one that provides inpatient care for short-term illness and other related services such as surgery. Now, hospitals must lean into those surge plans.

“There are different trigger points at various times, but step one is that hospitals create additional capacity within their own beds,” Mesisca said.

Riverside County: What we know about coronavirus surge plans

Once hospitals hit the point where their intensive care units are at capacity, then they are expected to convert some of their regular hospital beds into intensive care beds by bringing in needed equipment such as additional ventilators. 

Without enough ventilators, it won’t matter how many beds each hospital has when it comes down to providing care for the most severe coronavirus cases. However, just 32% of Riverside County’s 510 ventilators are in use as of June 26.

Both counties already on state watch list

Both Inland Empire counties have been on the state’s “Targeted Engagement” watch list since mid-June. 

The state added Riverside County on June 17 due to its increase in cases and hospitalizations. The county failed to stay within acceptable metrics three days in a row for four different state standards.

As of Sunday, these are Riverside County’s reported metrics, according to its public health department and the California Department of Public Health:

• Coronavirus cases: Riverside County has confirmed 152 coronavirus cases per 100,000 people over the past two weeks. The state’s acceptable guideline is 100 cases per 100,000 people or fewer in that time frame.
• Positivity rate: The county’s testing positivity rate over the past seven days was 10.6%, which is higher than the state’s 8% standard.
• ICU bed availability: Just 1% of ICU beds are currently available. The state requires county’s have 20% or more ICU beds available.
• Testing rate: The county has conducted about 144 coronavirus tests per day per 100,000 residents on average over the past week. The state recommends counties test 150 people per day per 100,000 county residents.

While Riverside County’s brought down its overall rate of hospitalizations to an acceptable level in the past two weeks — one of the original metrics that the state flagged — it started inching toward an unacceptable ICU bed utilization increase during that same time period, according to the state. 

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“We continue to remind the public about how to protect themselves and their loved ones by slowing the spread of the disease,” said Federico, the county spokeswoman. “First, wear face coverings. When everyone wears face coverings, transmission can be reduced up to 90 percent. Second, keep six feet of distance from others who don’t live in the same household. Frequently wash hands for at least 20 seconds. Finally, only visit places that are taking steps to protect their visitors, customers and employees.”

San Bernardino County has been on the state’s watch list since June 21. As of Sunday, these are the county’s reported metrics, according to its public health department and the California Department of Public Health:

• Coronavirus cases: San Bernardino County has confirmed about 140 coronavirus cases per 100,000 people over the past two weeks. 
• Positivity rate: The county’s testing positivity rate over the past seven days was 10%.
• ICU bed availability: About 19% of ICU beds are currently available. 
• Hospitalizations: The number of hospitalizations over the past three days increased 19%. The state guidelines say counties shouldn’t go over 10%.
• Testing rate: The county has conducted about 135 coronavirus tests per day per 100,000 residents on average over the past week. 

Desert Sun reporter Nicole Hayden covers health in the Coachella Valley. She can be reached at Nicole.Hayden@desertsun.com or (760) 778-4623. Follow her on Twitter @Nicole_A_Hayden.

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