As coronavirus hospitalizations in Orange County rise faster than any other point in the pandemic and some hospitals temporarily close their emergency rooms to new patients because they’re full, state and county officials still haven’t released data on which local hospitals are closest to reaching their bed capacity, after weeks of requests from Voice of OC.
But in response to questions for this article, state officials said for the first time Wednesday they would soon be publicly disclosing hospital-specific data on a daily basis in the future, after a privacy review to protect patient confidentiality.
Officials did not say when they would be releasing the data.
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OC emergency rooms have seen a large uptick in recent weeks in how often they temporarily close to new patients being delivered by ambulance due to not having capacity, known as “diversion.”
Emergency rooms in the county temporarily closed to new ambulance transports for 235 total hours in the week ending Monday due to not having capacity, up significantly from 23 total hours in the full month of April, according to county data.
States like Florida have been publicly posting how many beds are occupied and available at each hospital, which shows which hospitals are reaching their capacity for intensive care patients.
In California, officials disclose overall hospital data across the whole county, but do not break down which hospitals are closer to reaching bed capacity and which are further away.
Voice of OC has repeatedly requested the hospital-by-hospital bed counts data in recent weeks from the Orange County Health Care Agency and California Department of Public Health (CDPH).
Neither have disclosed it, despite attorneys at the state agency determining in May that hospital-specific data must be disclosed under the California Public Records Act.
When asked for the data, county health officials have said they don’t have hospital-by-hospital data on bed availability, while state officials responded to a June 16 request by saying they would decide by July 13 whether the data would be released, citing the need to search for the information among other reasons.
“By July 13, 2020, CDPH will notify you as to its determination of whether records will be disclosed and, if not, the basis for the determination,” California Department of Public Health officials wrote in response to the June 18 request for the daily hospital-by-hospital coronavirus patient and intensive care totals and capacity.
Asked again this week why the data hasn’t been disclosed despite their attorney’s determination that it’s public under state law, state officials said they do plan on releasing the hospital-level data after a privacy review.
“When we release the hospital-level data through the [Public Records Act] process it first goes through our screening to meet HIPAA privacy criteria,” California Department of Public Health officials wrote in an emailed response to Voice of OC late Wednesday, referring to the federal law that protects individual patient information.
“We cannot release information that may identify a patient. To date, it has not been feasible for CDPH to do the privacy review needed on this data on a daily basis. Instead, we provide the data in the aggregate by county daily. And we provide the hospital-level data upon request,” the agency added.
State officials said they plan to post the hospital-level data on a daily basis in the future.
“We are working on a process to do the privacy screening on the hospital-level data daily and publicly post this data daily too. More to come.”
Coronavirus hospitalizations are now surging in Orange County and other large Southern California counties, with OC overtaking Los Angeles County’s hospitalization and intensive care rates.
Daily patient counts have been consistently rising by about 130 per week since mid-June – about six times faster than the months leading up to that point.
Orange County hospitals are preparing to go further into “crisis care” surge strategies like converting waiting areas and tents into treatment rooms, according to county health officials.
Hospitals across the county are being affected by the growth in coronavirus cases, according to county health officials.
“All hospitals are impacted. We initially saw the highest degree of hospital burden in the hot spots of the county (Anaheim and Santa Ana), but as COVID-19 has become more widespread we are seeing the burden shift to hospitals based on their size, not just location,” said Dr. Gagandeep Grewal, assistant medical director for emergency medical services at the Orange County Health Care Agency.
On paper, about 40 percent of all hospital beds in Orange County are still available, though county health officials caution that staffing shortages and other factors may mean not all of those remaining beds are available.
“We are seeing more [emergency room] diversion despite hospitals not being filled to inpatient capacity, meaning there is a disproportionate effect of COVID-19 on the hospitals, not only due to volume,” Grewal said.
“In addition, ability to staff the beds may be compromised as staff shortages may occur (infected staff and inability to surge staff due to overall demand). As such, ‘available’ beds may not be as available as once thought from a practical sense.”
State officials also caution that unoccupied beds in data doesn’t mean those beds are staffed and ready to receive patients.
“Unoccupied beds are not necessarily available beds. That is to say, the overall bed count minus the occupied beds does not necessarily equal available beds,” California Department of Public Health officials wrote in their statement Wednesday.
“There has to be appropriate staffing and other criteria to list a bed as available.”
Nick Gerda covers county government for Voice of OC. You can contact him at ngerda@voiceofoc.org.