Monterey County's ICU beds are near full capacity due to Covid-19.

ICU beds are full or nearly full in three hospitals in Monterey County, while a fourth rural hospital is struggling to find enough staff to take care of lower acuity Covid-19 patients, some who were transferred from other hospitals, doctors told the Monterey County Board of Supervisors Tuesday, Dec. 8. And cases due to exposure over the Thanksgiving holiday are just now trickling in with the specter of more cases to come, one doctor said.

The hospital situation could lead to Monterey County Health Officer Edward Moreno imposing a state regional stay-at-home order ahead of the state's schedule, which is triggered when a region reaches 15 percent or less of ICU-bed capacity. The Bay Area Region, of which Monterey County is a part, currently has 24.5 percent of ICU beds unoccupied and availability. Monterey County's available ICU capacity, as calculated by the state, is at 20 percent. 

Moreno said the state's formula may not reflect realities experienced by hospitals at county levels, and that seemed to be the case as one doctor after another from the four hospitals in the county reported that their hospitals are struggling to keep up with the influx of patients.

"The reality the hospitals are functioning as full, we're having a hard time taking care of ICU patients, however you define those," said Allen Radner, Chief Medical Officer and infectious disease expert for Salinas Valley Memorial hospital. 

Earlier on Tuesday, a spokesperson for the hospital told the Weekly that the ICU capacity had been reached at SVMH.

Since the start of the pandemic, Radner has objected to answering questions about ICU bed capacity and today opened his statements to the board by saying there was an "obsession" with using ICU beds as a metric since the state tied restrictions to ICU capacity. 

"Unfortunately that's a very complicated and nuanced number," he said. All four of Monterey County's hospitals had increased their ICU capacity with "surge" beds. "The reality is we can turn any bed into an ICU bed if we have a ventilator," he added.

But it also depends on nursing staff availability, Radner said: "Depending on which number you look at, we are anywhere between 40- to 100-percent filled in our ICUs." 

Radner said all of Monterey County's licensed ICU beds are full, and the surge ICU beds aren't quite full, but are populated by people who in normal times would be in a licensed ICU bed because they require close monitoring. 

Martha Blum, infectious disease expert at Community Hospital for the Monterey Peninsula, echoed a similar message in her remarks to the board.

"Our capacity is zero," said Blum, speaking of all four hospitals, which she said have over 100 Covid patients combined. She said CHOMP has been running between 18-23 ICU patients—its official capacity is 20—over the past week. Not all are Covid-19 patients, but the influx of infected patients is straining the system.

The hospital is canceling surgeries because there is no bed space for recovering patients. Some patients who came into the emergency department yesterday are still waiting for beds in the hospital, Blum reported. 

At Mee Memorial Hospital in King City, Chief Medical Officer Robert Valladares said the 25-bed facility (with no ICU beds) is taking in less ill Covid-19 patients from other hospitals in the county. They are having staffing challenges, however. 

The doctors' message remained the same about members of the public taking the virus seriously and doing everything they can to stop the spread.

Also on Dec. 8, the Monterey County Health Department reported 16,840 cumulative cases, up by 238 from yesterday, with a sharp jump in hospitalizations from 97 to 105. As of yesterday, 136 people have died from Covid-19 in Monterey County.

The state is reporting that Monterey County's test positivity rate is 11. 6 percent, with 36.7 cases per 100,000 residents reported each day.