What public health leaders mean by ‘0% ICU beds available’

Intensive care bed availability in Southern California has been reported at 0% capacity by state and county health officials. 

But that alarming figure carries a big asterisk: it doesn’t mean there are no open ICU beds that day. 

In the context of the coronavirus pandemic’s bleakest chapter, the state Department of Public Health’s front-and-center metric, “current ICU capacity by region,” takes the actual percentage of remaining adult ICU beds each day and tweaks it to reflect the lopsided share of COVID-19 patients in intensive care compared to others who also need those beds for life-saving treatment and equipment, such as ventilators. Beds for newborns and children are excluded. 

“The ICU is an important tool to save lives for those with COVID-19 and other critical medical conditions such as cancer, heart attacks and strokes,” according to the state Department of Public Health. 

“If a disproportionate number of ICU beds are being utilized to treat COVID-19 patients, then patients with non-COVID medical issues may not be receiving or be able to receive the level of care they need.” 

As intensive care units fill with coronavirus patients like never before, the state’s calculation hinges on an ideal that no more than a third of a region’s intensive care patients have COVID-19. 

If more than 30% of ICU beds are in use by COVID-19 patients in a county, or the region as a whole, it’s reported available ICU capacity is reduced by half a percentage point for each percentage point over that threshold. 

For example, 9.2% of Orange County’s staffed adult ICU beds were available by Friday, Dec. 18, according to the OC Health Care Agency. But because 57% of the county’s 628 active ICU beds were taken by coronavirus patients – well above the state’s 30% limit – Orange County’s capacity was downgraded to 0%. 

An absolute zero might give the wrong impression, because Orange County’s ICUs still had a meager 59 vacant adult beds, according to a county report. 

“When you see 0%, that doesn’t mean there’s no capacity, no one’s allowed into an ICU,” Gov. Gavin Newsom said on Friday. “It means we’re now in our surge phase, which is about 20% additional capacity that we can make available through the ICU system.” 

“I don’t want people to be alarmed by that, except I do want to raise the alarm bell about what we all must do individually and collectively to address this rate of growth,” Newsom said.

GRTWT.