Bay Area hospitals face the challenge of a lifetime

For Bay Area hospital workers, the looming COVID-19 surge is the challenge of a lifetime.

How do you formulate a strategy to avoid the scenario that overwhelmed hospitals in China and Italy and is now devastating New York City, where 13 people died in a single hospital Wednesday afternoon?

The task weighs heavy on Paul Lorenz, CEO of Santa Clara Valley Medical Center since 2012. He knows that Dr. Anthony Fauci, the nation’s top infectious disease expert, is right when he warned, “An outbreak, a pandemic like this could overwhelm any system in the world.”

It’s Lorenz’s job to craft a strategy for Santa Clara County hospitals to keep that from happening.

The magnitude of the challenge facing him and his fellow hospital administrators in Alameda, Contra Costa, Marin, San Mateo and San Francisco counties heavily depends on public cooperation.

“Our success will ultimately be determined by how seriously people shelter in place and practice social distancing,” Lorenz said. “That’s the most important thing. Everyone needs to play their part. Every encounter matters.”

No one wants to see Bay Area doctors forced to ration care and choose who gets a ventilator. No one wants to see front-line health care workers, their families and their patients put at risk for lack of protective equipment. And no one wants to see a steady stream of people dying in hospital beds, with no end in sight.

Ultimately, whether Bay Area hospitals can manage COVID-19 cases depends on how willing people are to continue sacrificing individual conveniences for the common good.

“People need to realize that everyone in the health care system, not just in Santa Clara County, but everywhere, is committed to doing their part to fight this,” Lorenz said. “But we need to make sure everyone in the community is doing their part so we can be successful in our work.”

Lorenz has focused on increasing the number of hospital beds available in the county and making sure hospitals have the staffing and equipment they need to operate.

It’s a more significant challenge in the Bay Area than in other regions. California ranks 47th in the United States in the number of beds per resident, with just 18 per 10,000. And Bay Area counties have even fewer beds per capita than the state average.

Lorenz is giving special attention to increasing the number of intensive care unit beds. Prior to the coronavirus pandemic, Bay Area counties had 1,226 ICU beds available. The situation wasn’t helped in Contra Costa County, for example, when Doctors Medical Center in San Pablo closed in 2015. Santa Clara County’s purchase in 2018 of O’Connor Hospital in San Jose and Saint Louise Hospital in Gilroy is proving to be a lifesaver — literally.

Lorenz wants to make 600 ICU beds available in Santa Clara County to fight the pandemic. That would roughly double the county’s current supply. For every two ICU critical care beds, California law requires one nurse for each shift.

“We can ramp up beyond the 600 beds if we have additional ventilators and staffing resources,” he said. A key part of the county’s strategy is to work with other regional hospitals and share resources if one county is hit harder than others.

Bay Area hospitals are hiring people who have retired and are willing to come back to work. They are also bringing in new hires from outside the area and discussing how best to manage the crucial staff-topatient ratios in order to maintain quality care.

It’s a delicate balance — one that requires a methodical approach. It’s not just additional doctors and nurses that are needed. Hospitals have teams of housekeepers, maintenance workers, cooks, dietitians and more who are essential.

“Teamwork is the key,” said Lorenz. “It’s really all about everyone doing their part. It is the challenge of a lifetime, not just for those trying to save lives and protecting the public, but for every single person sheltering in place.”