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‘Worst is yet to come:’ SF may need additional 1,500 ventilators, 5,000 beds to confront coronavirus

4 min read
‘Worst is yet to come:’ SF may need additional 1,500 ventilators, 5,000 beds to confront coronavirus thumbnail

Mayor London Breed, health Director Dr. Grant Colfax and representatives from public and private hospitals said Wednesday the city may need up to 1,500 more ventilators and 5,000 more hospital beds to confront the surge in COVID-19 cases that is predicted to descend on San Francisco in as little as two weeks.

Since the crisis began, public health officials and San Francisco hospitals have been collaborating on a unified plan to address a predicted inundation of new patients brought on by community spread of the new coronavirus. The plan is anchored around two broad imperatives: Reduce the pressure on hospitals, and expand their capacity to handle more cases.

The plan — including the resources needed — was based in part on the eruption of cases in New York state, which have doubled every few days. While infectious disease experts have praised California’s early efforts to limit the spread of the virus, local health officials are bracing for a comparable onslaught.

The vast increase in ventilators and beds — along with the health care workers needed to staff those beds — would be required, should San Francisco follow the same trends as New York and fail to “flatten the curve” — reducing the number of new cases.

The model that helped determine San Francisco’s potential supply needs was developed by UC Berkeley clinicians, physicians, epidemiologists and research scientists, Colfax said. They looked at how the crisis evolved in places including Wuhan, China; Italy; and New York, and compared it to local data. That information, he said, was used to predict the virus’ spread in San Francisco over the next few weeks and months. He did not estimate the numbers of cases the city might face.

Despite the city’s aggressive efforts to prohibit public gatherings and get people to stay home and away from one another, “it is plausible that … we could have a scenario similar to the one that is playing out in New York this very day,” Colfax said. “I’m sorry to say the worst is yet to come. Yet we are preparing, as we have been since the very beginning of this emergency.”

San Francisco has about 1,300 staffed regular medical-surgical beds and 200 staffed intensive care unit beds in its hospitals. That, health and hospital officials said, is sufficient to meet an initial surge of new patients, but a second, larger wave would strain the city’s resources past their breaking points.

Breed sent letters to Vice President Mike Pence and Gov. Gavin Newsom on Wednesday requesting more personal protective equipment — like masks, face shields, gowns and gloves — more testing kits, more health care staff and regulatory changes to enable the city to handle more patients. City officials are also asking the federal and state governments to help supply the additional ventilators and beds.

“Our government and our hospital systems are currently stretched and approaching capacity, and we request your immediate assistance before we hit our peak patient load,” Breed wrote.

In a virtual news conference conducted online Wednesday, the mayor said: “We are still in a situation that requires a significant ramp-up. It requires the need for our state and our federal partners to step up more than they ever have before, and to move faster.”

Mary Ellen Carroll, director of the city’s Department of Emergency Management, said decisions about how staff and resources would be allocated will flow through the city’s Emergency Operations Center, which is staged in Moscone Center South during the crisis.

The emergency department will work “hand-in-hand with (the Department of Public Health) to identify the resources that are needed and to make the appropriate purchases and requests for aid through the state and federal governments,” she said.

“The public health threat we face as a city and a region calls for the highest level of collaboration among our hospitals,” said Mark Laret, president and CEO of UCSF Health. “By coming together, we can respond to this crisis for San Francisco and also show communities across the country how to prepare for their response.”

Also on Wednesday, Newsom said he’s looking to reopen a California Pacific Medical Center campus in San Francisco that halted inpatient services a year ago as part of a statewide plan to increase hospital beds in anticipation of the patient surge.

The state is in talks with Sutter Health, which owns CPMC, to potentially reopen its Pacific campus on Buchanan Street. That campus, which could provide around 150 beds, closed last year after Sutter moved to its new hospital on Van Ness Avenue.

Reducing the pressure on hospitals so they are able to care for COVID-19 patients rests in part on the community’s continued efforts to shelter in place, as all Bay Area counties instructed their residents to do to curb the spread of infections.

“Social distancing is, and will, save lives,” Colfax said.

Visitors to hospitals, long-term care facilities and residential facilities have also been restricted, elective surgeries have been canceled or postponed, and the city has worked to find places — such as vacant hotels and public buildings — where people can go if they have COVID-19 and do not require hospitalization but have no place to safely self-isolate.

When it comes to building capacity to care for new patients, St. Francis Memorial Hospital is opening a dedicated COVID-19 floor with 40 medical-surgical beds and eight ICU beds.

The city’s health department has also expedited the hiring of public health nurses, and it expects to add 220 registered nurses to its workforce.

San Francisco officials also closed City Hall to the public Wednesday until at least April 7 following a significant drop-off in the number of City Hall employees coming in to work each day. Like the rest of the Bay Area, departments have encouraged city workers to stay home and work remotely, if possible.

Dominic Fracassa is a San Francisco Chronicle staff writer. Email: dfracassa@sfchronicle.com Twitter: @dominicfracassa

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