SACRAMENTO (AP / CBS SF) – California spent nearly $ 200 million building, operating, and staffing alternative care facilities that ultimately did little good when the state’s worst coronavirus surge last winter spiraled out of control and drained Hospital workers were forced to treat patients in tents and canteens.
It was a costly way to learn that California’s hospital system is far more resilient than was thought at the start of the pandemic. Desperation and innovation have allowed the system to expand enough to cater to patients, even during the terrible surge in hospital admissions over 20,000 and dying nearly 700 people a week.
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“Definitely some hospitals, especially in the Los Angeles area, were on the verge of the breaking point, but we didn’t see as much use of the alternative care centers compared to what was being considered,” said Janet Coffman, professor of health policy from the University of California, San Francisco. “As bad as the situation was in winter, it could have been worse.”
In the first weeks of the pandemic, Governor Gavin Newsom ordered the establishment of alternative care facilities in a former professional basketball arena, two state centers that usually treat people with developmental and intellectual disabilities, and other facilities.
It was part of an early plan to add an additional 66,000 hospital beds as California prepared for an expected crushing load of COVID-19 patients, one of many steps the governor took when imposing the country’s first statewide lockdown.
Ultimately, the state spent $ 43 million on setting up eight locations, $ 48 million on hiring contract workers, and $ 96 million on running it on a scaled-back plan, according to the The Associated Press from the Finance and General Services Departments and the Health and Human Services Agency.
The sites together treated 3,582 patients, records show, but half were in the first three months of the pandemic, when the number of infections was still low and it turned out the traditional hospital system could have handled them on its own. The sites reopened in early December and treated fewer patients over the next three months, although many hospitals were overcrowded.
The traditional hospital system came through the worst of the pandemic with little overflow into alternative care facilities because the state temporarily eased the staffing relationship between nurses and patients – to protect the sick and their carers – and because of a scramble, temporary outsiders, said Stephanie Roberson , Director of Government Relations for the California Nurses Association.
Brian Ferguson, a spokesman for the state emergency services bureau, said officials learned that it was better to align the state’s efforts with existing health facilities than to build makeshift, stand-alone hospitals.
For example, two empty hospitals reopened during a surge last summer, one each in Northern and Southern California, as the most populous state, New York, overtook most cases in the country. But she didn’t use them again during the winter wave, instead choosing to work more closely with existing hospitals.
Similarly, in early April 2020, Newsom announced that the Sleep Train Arena, the former home of the NBA’s Sacramento Kings, would be converted into a 400-bed hospital. In the end, only nine patients were treated within 10 weeks because existing hospitals in the area were treating other cases.
The state never reopened this main arena when the virus picked up again around Thanksgiving Day, instead treating 232 patients in the much smaller adjoining practice facility.
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“In hindsight, you could say, ‘Well, we would have the money we spent renting Sleep Train and we could have put it back into the hospital system or we could have put it back into PPE procurement ( personal protection (equipment) or any number of things, ‘”Roberson said. “But these are lessons we’ve learned.”
She added, “As we move forward, we need to look at all of these missteps and do better.”
Officials learned to be more flexible with opening and closing facilities and “quickly flip the location for added value or purpose” when it wasn’t needed for patients, Ferguson said.
For example, the surge centers were all closed until March when the worst wave of infections subsided. But two were shifted to other pandemic-related tasks – one was used for coronavirus testing and the other was used for antibody infusion treatments.
Likewise, contracts for medical personnel traveling at the start of the pandemic required them to work at the alternative care locations, even if they weren’t often needed. But contracts during the winter break have been rewritten so that “in cases where they are no longer needed, they can be quickly moved to a hospital” or to do other duties like administering vaccinations, Ferguson said.
State officials had planned to rely more on the newly formed California Health Corps of medical professionals, especially after 95,000 people initially answered Newsom’s call for volunteers.
But only a fraction actually qualified or registered.
“When the health corps wasn’t working as hoped, travelers were the next best option,” said Coffman, who studies health workers. “Yes, contract travelers are expensive, but at least you can rest assured that we can count on someone who will take good care of patients and have the necessary skills.”
California spent $ 612 million on contract doctors and $ 2.2 million on the health corps, most of which it hopes to get back from the federal government or the facilities they worked in.
The state has budgeted $ 74.5 million for the fiscal year beginning this month to cover late bills or if there’s another spike that needs the state to reboot.
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“If things turn for the worse – mostly Delta variant … we still want to move fast,” said HD Palmer, spokesman for the California Department of the Treasury.