Where California expects to fight coronavirus this fall: High schools, fairgrounds and gyms
Gov. Gavin Newsom and local governments around California are turning to some unlikely places to build more hospital beds just in case a new wave of coronavirus patients overwhelms the state’s medical capacity.
On the Central Coast, San Luis Obispo County spent over $3.5 million refashioning a gymnasium at Cal Poly so it can accommodate more than 900 patients. It used emergency powers to speed the project with no-bid contracts, according to records obtained by McClatchy.
In the Sierra foothills, health officials are making room for 30 beds at Calaveras High School in San Andreas.
And in Sacramento, hundreds of hospital beds are now lined up where NBA stars once played before thousands of fans at Sleep Train Arena.
So far, few patients are being cared for in the so-called alternate care sites Newsom called for in March when his administration projected millions of California coronavirus infections and warned that it needed 50,000 new hospital beds to manage a coming surge of patients.
That worst-case scenario has not yet unfolded and Newsom on Wednesday eased some of his public health restrictions to begin allowing hospitals to resume scheduling non-emergency surgeries.
He insists the temporary hospitals under development around the state are still necessary.
“I don’t know that the word over-planning in a pandemic applies. I think that we are appropriately planning,” Newsom said last week.
“We have to provide the capacity in the system, and make sure we procure that capacity before we enter into that next phase,” he continued. “So every one of those beds, from my perspective, are important in terms of our capacity to deliver on the hope and promise that we can start to ease up on the home orders.”
This week, even as states in the Southeast and some California cities pressed to reopen their economies, Centers for Disease Control and Prevention Director Robert Redfield told The Washington Post that a second wave of coronavirus cases anticipated this fall could prove more devastating than what has occurred so far.
“There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through” in part because the outbreak will coincide with flu season, he said.
Jacqueline Merrill, a public health expert and professor of nursing in biomedical informatics at Columbia University’s School of Nursing, said Californians will be glad they have empty beds ready for a second surge of coronavirus infections if it comes.
“This is an inherent problem to public health,” she said about what today appear to be thousands of unused hospital beds placed in California fairgrounds and gyms. “That is, it’s been a constant bugaboo of the system. When public health is working, you don’t see it. So, you rarely see the direct fruits of your investment in public health because, if public health is working properly, there isn’t an emergency. There isn’t a problem.”
Treating coronavirus patients
Newsom’s administration is responsible for four of the extra capacity sites that are in use or under construction in California: the temporary hospital under construction at Sleep Train Arena, a hotel in San Carlos, a state hospital in Tulare County and a former state hospital in Orange County.
The other locations are the work of local governments that raced to build medical capacity.
The California Office of Emergency Services is not overseeing them. They are being built with local funds, although some could be eligible for federal reimbursement, California Office of Emergency Services spokesman Brian Ferguson said.
One at the Santa Clara Convention Center that can accommodate 250 patients has treated people infected with coronavirus.
Another at the Riverside County Fairgrounds will have a capacity of 125 patients. The Army Corps of Engineers built a temporary facility at the Redding Civic Auditorium to relieve pressure on hospitals by opening beds for patients who do not have coronavirus.
The one under development at a high school in Calaveras County would add 30 hospital beds for a rural county that normally has just 25. “
“We want to have it staged and ready to go,” Calaveras County Public Health Officer Dean Kelaita told the county Board of Supervisors earlier this month, according to the Calaveras Enterprise. “We are hoping for the best but preparing for the worst.”
No-bid contracts for temporary hospital
The largest temporary hospital by far is the one under development at Cal Poly in San Luis Obispo County. The county began planning for it on March 17, two days before Newsom handed down a statewide order advising Californians to stay at home.
“At the time, we didn’t know what to expect,” said Dr. James Malone, chief medical officer of San Luis Obispo’s French Hospital Medical Center and a colonel in the Army Reserve. “But, as we say in the military, luck favors the prepared.”
If necessary, the facility could expand to more than 900 beds, staffed by a Medical Reserve Corps that already has 250 volunteers. So far, the price tag is at least $3.5 million for initial medical supplies and equipment.
A contract between Cal Poly, the CSU Board of Trustees and the county for use of the facility ends on June 27. The agreement states there is no cost to the county except for any necessary repairs.
Malone and others behind the project moved quickly, worried that the rural community would be left behind if it experiences a coronavirus surge and state officials were tied up in Los Angeles or the Bay Area.
“If we don’t get it done, nobody is likely to come to our rescue if we get in trouble,” he said.
Generally, projects of its size would go through a series of approvals, including by the county Board of Supervisors or city councils. Governments are required by law to go through a competitive bid process to solicit proposals from potential companies before hiring contractors.
None of that happened in the development of the alternate care site.
Days before planning began, an emergency proclamation ratified by county supervisors gave the county Office of Emergency Services “authority to take all action to protect life and property,” a county spokeswoman said.
Newsom’s proclamation of a state of emergency, meanwhile, suspended bidding requirements “to allow public agencies to quickly respond to the threat of the spread of COVID-19.”
Contracts acquired by McClatchy through a public records request detail the local businesses paid to perform the work.
McCall Plumbing & Mechanical Inc. got two contracts for up to $325,000 to design and install temporary oxygen supply equipment and piping; Trust Automation was hired for up to $500,000 to design and construct overhead truss structures and partition walls.
Other contracts went to electricians and security guards. The Sacramento Bee has submitted a California Public Records Act request seeking the state’s agreement with Sleep Train Arena and The Sacramento Kings.
‘A surge could happen later’
Today, rows of beds cover a basketball court, racquetball courts have been converted into changing rooms for medical staff, and hallways serve as hand-washing stations. Thousands of dollars of medical supplies — including scrubs, gowns and gloves — are stored in stacks of boxes.
With no patients, the massive center feels nearly empty. A security guard sits outside a gym filled with thousands of dollars of supplies, and administrators work on computers set up in impromptu offices.
Last week, nurses performed a walk-through training with a volunteer acting as a patient to learn the intake and care process and procedures.
Public health officials say Newsom’s stay-at-home order is effectively flattening the curve, preventing what might have otherwise been an early surge in local cases.
Still, they say the risk of heightened community spread increases as society begins to open up, a lesson California learned in a 1918 pandemic when a second wave of the flu killed more people than the first.
“I think a surge could happen later,” Malone said. “We don’t expect it at all in the next few weeks, that the hospitals would be overrun so we’d have to start putting patients there. But we’re going to keep training and be ready to do it.”
This story was originally published April 23, 2020 at 5:00 AM with the headline "Where California expects to fight coronavirus this fall: High schools, fairgrounds and gyms."
