As cases of COVID-19 increase across the state, California hospitals are bracing for a spike in patients that could leave them scrambling for available beds.

In California alone, at least 1.2 million people over the age of 18 are projected to need hospitalization from the disease, according to an analysis published March 17 by the Harvard Global Health Institute and the Harvard T.H. Chan School of Public Health. The projection accounts for the fact that Californians over 65 are more likely to be hospitalized than younger people as a result of the disease.

Whether California hospitals will be able to handle the influx of patients from COVID-19 largely depends on how fast the virus spreads (which experts say depends on the state’s ability to maintain social distancing) and whether hospitals across the state take actions to free up more beds.

California needs 50,000 additional hospital beds to meet the incoming surge of coronavirus patients, Gov. Gavin Newsom said last week. In response to the estimates, Newsom said the state’s existing hospitals, which currently have 75,000 beds, have agreed to expand their capacity by 40 percent — adding another 30,000 beds by using outbuildings on existing campuses and setting up tents in parking lots.

In addition, the state also has already secured at least 3,000 additional beds. Those include 1,000 beds on the Navy medical ship Mercy and hundreds more at several hospitals the state is leasing.

The Harvard analysis was published before Newsom made those announcements. Increasing the number of available hospital beds would change the projections on the maps shown below.

A separate, dynamic model released last week by the University of Washington’s Institute for Health Metrics & Evaluation predicted - as of March 30 — that California would likely have enough available hospital and ICU beds to handle the worst day of the outbreak, which it suggests will occur in late April. That study predicted that hospitals in some states, particularly in New York, would not have enough beds to meet the surge.

The calculations by Harvard show that if 20 percent of the population of California contracts COVID-19 within six months, hospitals across the state would be overrun with more patients than they have available beds, if they did not increase capacity. In some areas, the demand for beds would be more than triple the current capacity.

If the 20 percent spread occurs over 12 months, without adding beds or freeing up beds by limiting non-essential surgeries, the vast majority of California hospitals will still be overcapacity, according to the Harvard model.

If the timeline of infection can be slowed to 18 months, many more California hospitals will have sufficient beds to handle the increase in patients even without adding or freeing up beds. That’s precisely the rationale behind the concept of social distancing, which is intended to bring about a “flattening of the curve,” meaning the same percentage of the population gets the disease, but spread out over a longer period of time.

This story was originally published March 31, 2020 at 8:37 AM with the headline "See where COVID-19 could overrun hospitals — if California doesn’t add beds or slow spread."