
County ICU bed capacity shrinks, but hospitals are ready to deploy surge beds

Santa Cruz County has just a handful of available ICU beds remaining. Local hospitals are planning to expand their capacity, but it won’t be easy.
For those paying close attention to Santa Cruz County’s ICU capacity, the numbers can be shocking: at one point over the weekend, state data indicated a total of zero beds available.
Earlier today, according to state data compiled by Lookout content partner CalMatters, Santa Cruz had fewer free ICU beds per capita than almost any county in the state, excluding only Yolo, San Benito, San Joaquin, and Placer.
The fact that the county’s ICU capacity appears so diminished, but that Santa Cruz County has not joined other Bay Area counties in implementing California’s stay-at-home order early, might seem mystifying. But county officials caution there is more to these numbers than meets the eye.
“We have, on a per capita basis, a low number of ICU beds,” Dr. David Ghilarducci, the county emergency medical services director, explained Monday. Dominican Hospital typically has 16 staffed ICU beds, and Watsonville Hospital has six.
But Ghilarducci said both Dominican and Watsonville are able to expand their intensive care units as needed.
That’s not to say it will be easy.
“One of the biggest constraints is not the number of ventilators available or the number of IV pumps. It’s the people to staff those beds,” Ghilarducci said.
“Dominican has talked about adding another 10 or so ICU beds, almost doubling their capacity,” he said. “Watsonville has a little bit more trouble expanding. They do have the space, they have ventilators, but staffing is always an issue there. They could probably add another five beds roughly, if they’re really pressed.”
Equipment isn’t the problem, but local health care workers — already stretched to the max — will have to work even harder.
“One of the reasons it’s called intensive care is it requires intensive staffing. Usually one-to-one, one nurse per patient, and that takes a lot of people — that’s three or four nurses a day that have to attend to that patient,” Ghilarducci said.
Numbers can fluctuate by the hour as patients go in and out of the ICU, but for most of Monday, between three and four ICU beds countywide had been free.
While it’s not the crisis seen in other parts of California, three beds could easily be filled by a serious car crash, or if several people who attended the same gathering falling seriously ill with COVID-19.
Ghilarducci said both Dominican and Watsonville hospitals are very close to having to make the move to expand ICU capacity. “They’re sort of on the cusp. Nobody’s made a hard decision to do it yet, but they’re on the cusp.”
In normal times, local hospitals can reach out to other counties for help. But these are not normal times, and right now everyone is in need of extra hands.
So, while it is reassuring to know there are plans to add more beds, it’s still imperative that everyone continue to follow pandemic mitigation measures to avoid putting that extra stress on the system, county officials say.