As Coronavirus Cases Add Up, California Frantically Counts Tests, Beds and Masks

Gov. Gavin Newsom said Monday that California would be short about 17,000 hospital beds, raising his previous estimate of a 10,000-bed shortfall. The state was also short 1 billion protective gloves and hundreds of millions of masks, he said.

And the pace of testing remains stubbornly slow in California. New York state, with half the population, has conducted twice as many tests for the virus as the Golden State.

As of Monday, New York has tested 78,289 people, including 33,000 in New York City. Statewide, California had conducted 26,400 tests by Sunday, the most recent data available.

California, a state that its governor often describes as a nation unto itself, is meeting the threat of the coronavirus with strings of superlatives. The state with the biggest economy and largest population is harnessing the power and resources of the world’s most successful technology companies. Newsom said the state was also chartering flights to China to procure protective equipment and expressed concern for smaller states that might not have the same purchasing power.

Warning that America could be just days behind Italy, where the virus has claimed thousands of lives, officials in California have rushed to reopen hospitals that had been shuttered, buy motels to house the state’s more than 150,000 homeless people, and retrofit college dormitories to serve as hospital wards.

But whether all of this will be enough is the question on the minds of everyone while hunkering down at home.

Newsom has called up the National Guard to work at food banks, and President Donald Trump ordered a Navy hospital ship, with 1,000 beds, to sail to the Port of Los Angeles within a week.

“It will become the largest hospital in Los Angeles when it docks,” Mayor Eric Garcetti of Los Angeles said Sunday night.

In San Francisco, hospitals have checked out patients without critical needs and are looking for spare capacity wherever they can find it. One hospital, St. Francis Memorial, brought back into service four dozen vacant beds in a furloughed surgery unit. A bankrupt hospital in Daly City, south of San Francisco, was rescued from imminent closure with an infusion of state funds.

The city has also been laying out plans to turn convention centers into temporary shelters, and lease hotel rooms for health care workers and vulnerable people who cannot self-quarantine. Measures to combat the virus were being taken at the state, county and local levels, sometimes resulting in a confusing patchwork of directives, and the governor is also leaning heavily on the private sector.

Newsom has conferred with Elon Musk, the head of the electric carmaker Tesla, and Tim Cook, the head of Apple. The two executives, along with Facebook founder Mark Zuckerberg, have announced separately that their companies would give a total of 2 million protective masks to the state. Musk vowed to produce 1,000 ventilators, according to Newsom.

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Within a few minutes at a news conference over the weekend, the governor spoke of the ambivalence of the moment — a feeling of an abundance of resources and talent and yet the scarcities of crucial supplies as the virus spreads.

“I’ve had just in the last 48 hours the opportunity to speak to more scientists, more researchers, more engineers, more Nobel laureates, more CEOs of companies large and small than I have quite literally in years,” Newsom said.

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Even as Newsom announced the nation’s first statewide stay-at-home orders last week — meant to buy time for the state to prepare for a flood of patients — it became clear that too many people were ignoring the directive.

Over the weekend, people congregated at parks and playgrounds. There were still tours being conducted in Hollywood and pickup basketball games at Venice Beach.

Garcetti said that the sudden disruptions to normal life could be seen “in the clear skies and the empty freeways” but that “it still isn’t enough.” On Sunday he ordered golf courses and playgrounds closed. Beach communities shut down parking lots and boardwalks. Los Angeles County said it was closing hiking trails. And while at first Garcetti had said the city would rely on social pressure to enforce the measures, on Sunday he warned that the city was prepared to issue misdemeanor fines to those who disobey.

In San Jose, the police chief railed at a billiard club that had remained open and at people congregating outside. He said his officers were moving toward stricter enforcement.

Across California, a state with many large biotechnology companies, the promise of widespread access to testing for the virus has not materialized. And doctors said they were alarmed about shortages of protective equipment.

Officials in Los Angeles County announced Monday that the county had procured 20,000 extra tests but said they were prioritizing them for health care workers and the very sick.

The city of Los Angeles, which does not have a health department, is chipping in to help the county by using its own resources to test workers who are symptomatic, including emergency medical workers on the Police and Fire departments, health care workers, and those trying to get homeless people into shelters and take their temperatures. Over the weekend, a city-run drive-through test center was set up near Dodger Stadium.

In Marin County, north of the Golden Gate Bridge, one crisis dovetailed with another. The county’s three hospitals are less concerned about mask shortages, said Laine Hendricks, a spokeswoman, because Facebook donated 40,000 N95 masks and 62,000 surgical masks it had bought during last year’s wildfires, when people were worried about smoke inhalation. “We are triaging requests from the hospitals for supplies,” Hendricks said. “The Facebook donation was helpful but in the long haul we will need more masks and we currently need face shields and gowns.”

Health authorities issued guidance to hospitals that effectively restrict testing, reflecting a lack of both testing kits and crucial medical supplies like masks and gowns to protect health care workers.

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The shift suggested that the state may never get a handle on exactly how many people are infected. Those who have only mild symptoms or believe they were in contact with an infected person but are not themselves sick are being told they do not qualify for testing.

Dr. Scott Morrow, the chief health officer for San Mateo County in Silicon Valley, which has among the highest concentrations of cases in the state, said Monday that it would be “quite helpful” to have broad-scale testing but that many constraints dictated that tests be given only to sicker patients.

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The United States was late to identify the severity of the crisis, and so officials say it is too late to pursue the strategy of South Korea, which instituted widespread testing to contain the pandemic. Instead, in California and other states, the focus is on identifying the sickest people and trying to save their lives.

In new guidance released to California hospitals on Friday from the state’s Department of Public Health, hospitals were told “broad-scale testing is not available.” Hospitals, the letter said, should focus on testing only the most severe cases: patients who are already hospitalized and showing symptoms of COVID-19; residents and staff members of long-term care facilities who have symptoms; and health care workers who have been in contact with patients and have come down sick.

“Persons with mild respiratory symptoms who do not otherwise need medical care and who are not in one of the above groups should not be routinely tested for COVID-19,” according to the letter. The Los Angeles County Department of Public Health issued a similar directive.

In neighboring Ventura County, with a population of more than 850,000, officials are worried that they do not have enough swabs to conduct even this rationed testing for very long.

County drive-through clinics are down to about 100 swabs each, Dr. Todd Flosi, chief medical officer of Ventura County Medical Center and Santa Paula Hospital, said Monday, and the hospitals need to conserve the limited supply they have.

“If we run out of swabs for the hospital, it will clog our other processes up,” Flosi said, “because if someone is sick enough to be admitted but a test shows that they don’t have COVID-19, you can remove them from strict isolation guidelines faster, and that frees up space and protective gear.”

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Ventura County Medical Center is in relatively good shape in terms of space to accommodate the expected influx of patients because it recently built a hospital building to meet strict state seismic building requirements meant to ensure that hospitals can withstand earthquakes. The old building can quickly be brought back to accommodate overflow, Flosi said, though administrators first need to figure out how to furnish it with beds. Cots and repurposed elected-surgery gurneys are among the options under consideration.

But the shortage of N95 and surgical masks and other protective gear to treat the number of patients in need of hospitalization is so dire that Ventura hospital officials are looking to the community to supply handmade masks and equipment.

One nurse’s son is using his 3D printer to make plastic face and eye shields for distribution. And a sewing circle that worked under the auspices of the nonprofit group that supports the county hospitals has shifted from helping to equip new mothers with necessities like burping cloths to sewing cloth masks from a pattern developed in consultation with the hospital’s medical personnel and guidelines from the Centers for Disease Control and Prevention.

Within 48 hours, the circle had grown to 150 sewers, who deliver the finished masks to a local trauma nurse in charge of quality control, said Amy Towner, the chief executive of the Health Care Foundation for Ventura County. She said sewers are innovating on the fly; after the hospitals’ laundry facilities said that elastic head bands would disintegrate with washing, they switched to a cloth tie-back pattern, and they are moving away from cotton to tea towel material after learning that would be more protective.

“A lot of our elderly population in particular want to help,” she said. “In World War II, women were making bullets to protect our country. Now they are at their sewing machines.”

This article originally appeared in The New York Times .

As Coronavirus Cases Add Up, California Frantically Counts Tests, Beds and Masks

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