SACRAMENTO–As California continues its health first approach to fighting the COVID-19 pandemic amid an unprecedented surge, the California Department of Public Health (CDPH) issued a new public health order to reduce pressure on strained hospital systems and redistribute the responsibility of medical care across the state so patients can continue to receive lifesaving care.
“If we continue to see an alarming increase of COVID-19 patient admissions at hospitals statewide, some facilities may not be able to provide the critical and necessary care Californians need, whether those patients have COVID-19 or another medical condition,” said Dr. Tomás J. Aragón, CDPH Director and State Public Health Officer. “This order helps ensure that patients continue to receive appropriate medical services by better distributing available resources across the state to prevent overwhelming specific hospitals, counties and regions. As we continue to see the effects of holiday travel and gatherings in our emergency rooms and ICUs, we cannot underscore enough how critically important it is for Californians to stay home, wear masks and avoid getting together with people outside their immediate households to slow this alarming surge of hospitalizations.”
COVID-19 hospitalizations have increased 17% in the past two weeks, while COVID-19 ICU admissions have increased 21% in the same time. Many California hospitals are experiencing significant strains on their ability to provide adequate medical care to their communities, and the responsibility of care must be shared across the state to ensure adequate health care resources.
To preserve services for the sickest patients, the public health order requires some non-essential and non-life-threatening surgeries to be delayed in counties with 10% or less of ICU capacity under the Regional Stay at Home Order where the regional ICU capacity is at 0%. Examples of procedures that may be delayed include carpal tunnel release and non-urgent spine surgeries. Surgeries for patients who have serious and urgent medical conditions will continue. Examples of procedures that will continue include serious cancer removal and necessary heart surgeries. The order will remain in effect for at least three weeks and will continue until rescinded.
To ensure a better distribution of patients across the state’s hospital system, the order requires hospitals statewide to accept patient transfers from facilities that have implemented contingency or crisis care guidelines as long as those transfers can be done capably and safely. On December 28, 2020 CDPH provided guidance to health care facilities on implementing the Crisis Care Continuum Guidelines issued in June 2020. With the current surge in the pandemic, many hospitals are stretched to capacity, and the guidelines support facilities that are adapting their operations and space, including staff and other resources, to handle the surge as best as possible.
The following counties are impacted by the order:
San Joaquin Valley: Fresno, Kern, Kings, Madera, Merced, San Benito, San Joaquin, Stanislaus. Southern California: Imperial, Los Angeles, Orange, Riverside, San Bernardino, San Diego.
“When hospitals are overwhelmed and overflowing, they are no longer able to provide the traditional standards of care we expect, but if health care resources are available elsewhere, we should ensure Californians can receive appropriate care,” said Dr. Aragón. “We must ensure our entire health care system does everything it can to prevent our hospitals from shifting to crisis care standards for people who are seriously ill with COVID-19 or other critical medical conditions. California is committed to an equitable California for All approach to health care access and standards of care.”