For weeks, San Francisco hospitals and public health officials have been working on a unified plan to relieve pressure on local hospitals and increase capacity during an expected surge in COVID-19 patients who will require hospitalization. While current efforts are sufficient to meet the needs of an initial surge of patients, the hospital system needs more support to meet a larger surge.
By analyzing the needs being called for in New York, where the hospital system is undergoing an unprecedented surge in COVID-19 patients, San Francisco estimates it could need as many as 1,500 more ventilators and 5,000 more hospital beds to meet a similar surge. Today, Mayor Breed officially requested more assistance from both the state and federal government to help local efforts to expand capacity in preparation for this surge. She also joined public health officials in calling on the public to continue to follow public health orders to stay home and limit outings to essential needs.
"From the beginning of the global coronavirus outbreak, we have been getting as prepared as possible in San Francisco," said Mayor Breed. "Our entire hospital system has been doing the work to create a plan and to ramp up our resources, but we cannot do this alone. We need support from the state and from the federal government to have the tools we need, whether it's more ventilators, more equipment, more hospital beds, or more medical staff to help operate these facilities, so that we can be ready for a surge that could overwhelm our system. We also need the public to do its part by staying home and helping us slow the spread of this virus. The more time we have to prepare, the better chance we have to meet the challenges posed by COVID-19. We all have a role and responsibility to slow the spread."
Currently, San Francisco has about 1,300 staffed regular medical-surgical beds and 200 staffed intensive care unit (ICU) beds in its hospitals. These beds have appropriate staffing and supplies today to care for an initial surge of patients with COVID-19. The Department of Public Health and San Francisco's hospitals, acting together as part of the Hospital Council of Northern and Central California, are preparing to care for more patients than we could handle with our current capacity.
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The call for more beds could include providing resources, logistical support, and funding to open pop-up hospitals, outfit existing spaces as medical facilities, and expand capacity at existing hospitals. As part of the hospitals' collaboration, Dignity Health's Saint Francis Memorial Hospital will open a new floor dedicated to COVID-19 patients in early April to add another 48 beds. San Francisco is also exploring expanding capacity by 150 beds.
While it's not possible to predict the exact timing or size of the surge, its severity will be diminished if San Franciscans strictly adhere to the Public Health Order to stay home. This is the single most important action that individuals can take to save lives, along with frequent hand washing.
"We know the virus is here. We are going to be dealing with its impact for some time, and we are doing everything we can to reduce its harms in our community," said Dr. Colfax. "In San Francisco, our approach is based on science, data and facts. We are attacking the problem of a hospital surge from two directions. The first is to decompress the hospital and health care system as much as possible now, to make room for new patients. The second is to have a strong, citywide plan for all hospitals that includes the right beds, staffing and supplies for multiple scenarios."
"A public health issue of this magnitude must be addressed with creative solutions, and there has never been a more important time for hospitals to work together," said David Klein, MD, MBA, President and CEO of Saint Francis Memorial Hospital, and chair of the San Francisco Section-Hospital Council Northern & Central California. "This collaborative effort to create a dedicated care center for COVID-19 patients is unprecedented and will help ensure hospital care is available for anyone who needs it."
"We appreciate the leadership of our San Francisco hospitals, Mayor Breed and the Department of Health in working collaboratively during such an unprecedented and challenging moment," said Bryan Bucklew, President and CEO, Hospital Council Northern & Central California. "Our hospitals are committed to providing the best care for our San Francisco community, the Bay Area and across the state."
"The public health threat we face as a city and a region calls for the highest level of collaboration among our hospitals," said Mark R. 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."
The first step in surge planning, which is already underway, is to decompress the current health care system. Those activities include:
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- Ordering San Franciscans—and Bay Area residents—to stay home to reduce the spread of the virus citywide, lessen infection among vulnerable populations, and diminish the demand on hospitals and the health system Restricting visitors to hospitals, long-term care facilities and residential facilities to protect the health of vulnerable populations and reduce their risk of exposure, complications and extended or initial hospitalization. Cancelling or postponing of elective surgeries and routine medical appointments, moving services to telephone and video conference as appropriate to reduce the volume of patients in the health system Providing childcare for health care workers at hospitals across the city to make it easier for them to continue working during the shelter in place order Providing places outside the hospital for people with suspected or confirmed cases of COVID-19 to remain safe and isolated, to free up hospital beds that are not providing hospital-level care Ordering enhanced cleaning of SROs, expanded shelter hours and more meals served in shelters and navigation centers to improve the health and safety of vulnerable populations and reduce hospitalizations.
The second step is to build capacity in the hospital system to care for more patients. Those activities include:
- All hospitals in San Francisco have been jointly planning, sharing protocols and information, and developing a unified approach; Opening a dedicated COVID-19 floor at Saint Francis Memorial Hospital, with 40 medical-surgical beds and 8 ICU beds, that is equipped and staffed through contributions of Saint Francis, ZSFG and UCSF; Expedited hiring of DPH nurses that will add some 220 registered nurses to the workforce; Increasing hospital and staff capacity and coordinating supplies and equipment citywide; and Increasing the amount of supplies and equipment, including personal protective equipment (PPE), through advocacy at the state and federal level, supplemented by the support of donors.
Letter from Mayor Breed to Governor Newsom - March 25, 2020
Letter from Mayor Breed to Vice President Pence - March 25, 2020
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