BARBARA FERRER, Ph.D., M.P.H., M.Ed.
Director

MUNTU DAVIS, M.D., M.P.H.
County Health Officer

313 North Figueroa Street, Room 808
Los Angeles, California 90012
TEL (213) 288-8769 • FAX (213) 975-9601
www.publichealth.lacounty.gov

BOARD OF SUPERVISORS
Hilda L. Solis
First District
Mark Ridley-Thomas
Second District
Sheila Kuehl
Third District
Janice Hahn
Fourth District
Kathryn Barger
Fifth District

July 4, 2020
Dear Hospital Executives and Chief Medical Officers:
Last week I wrote to recommend that acute care hospitals review decompression plans and begin preparations
for surge planning. Today I write you to urge that you begin implementing your decompression plans.
Los Angeles County data is continuing to show a steep increase in the number of community cases of
COVID-19. The daily number of hospitalized COVID-19 patients continues to rise, and the LA County
Department of Health Services (LAC DHS) is projecting a marked increase in the coming weeks. If the
trajectory continues, the number of ICU beds—our most limited resource-- is likely to become inadequate in
the near future. The number of hospital beds is projected to become inadequate within the next 2-3 weeks.
See the June 29, 2020 Projections of Hospital-based Healthcare Demand due to COVID-19 in Los Angeles
County.
We recommend the following:
1. Take measures to free additional beds and staff to a) care for COVID-19 patients and b) protect
supplies for personal protective equipment (PPE) in preparation for a surge.
2. Develop internal triggers to determine if and what elective, non-essential procedures and nonessential outpatient services should be curtailed to prioritize PPE, equipment, hospital beds, and staff
for the care of COVID-19 patients. The decisions should be made in consultation with the hospital,
surgeon, and the patient.
3. Develop triage plans for the utilization of scarce resources such as ventilators.
4. Ensure staffing surge plans are ready for implementation should the need arise.
5. Encourage staff to always use of face coverings when around others both inside and outside of work
and to, when outside of work, avoid the “Three C’s”, which are a) Closed spaces, b) Crowded places,
and c) Close-contact settings such as close-range conservations with non-household members.
6. Plan for opening non-traditional care areas to help manage an increase in cases. After receipt of
required regulatory clearance, facilities could identify sites such as perioperative areas and operating
rooms to care for critically ill patients and ambulatory clinic space and waiting rooms for patients
who do not require ICU level of care.
7. Continue to secure reliable supply chains for testing kits/supplies and PPE. Optimize PPE supplies
where possible in case supply chains for PPE remain or become tenuous for some time.
8. Continue to monitor the LA County COVID-19 Hospitalizations and Hospital Capacity dashboard to
see the daily number and trends of available ICU beds and ventilators.
Thank you for your continued cooperation in these challenging and unprecedented times.