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All hospital beds in Riverside County could be filled by the week of April 12 if local coronavirus cases continue to increase at the current rate, according to a modeling projection calculated by Geoffrey Leung, Riverside University Health System's chief of medical staff.

While the number of confirmed coronavirus cases in the United States is doubling about every three days, in Riverside County the pace is slightly slower, doubling about every four to five days, Leung said.

With 107 cases — and eight virus-related deaths — reported in Riverside County as of Thursday afternoon, this means there could be as few as 1,712 or as many as 3,424 COVID-19 patients in Riverside County between April 12 and April 21, according to surge projections. While not every patient will need to be hospitalized, it will likely put a strain on the county's 3,400 existing beds — about 30% to 50% of which are already in use.

The county is expected to run out of ventilators less than two weeks after the hospitals hit maximum capacity, Leung said. Between April 22 and May 5,if projections are correct, the county health care systems will not be able to provide life-saving assistance to everyone who needs it.

“We have been pretty accurate to date on our projections,” said Mike Mesisca, Riverside University Health System emergency and disaster medicine director.

The surge is expected to last several months, Leung added.As federal, state and local officials debate how long stay-at-home orders should remain in effect, he said there are "big risks" to withdrawing from a uniform approach to social distancing too early.

Leung said in Riverside County 1,000 deaths and 50,000 cases are likely to occur by early May. As of Thursday, more than 3,700 cases were reported in California by The New York Times and more than 80,000 cases were reported throughout the nation by Johns Hopkins University.

More than 3,000 swabs have been tested, though Leung said he is aware that the county is behind and not enough people are being tested. As a result, he suspects several hundred unknown coronavirus cases are present in Riverside County.

Rick Loftus, an Eisenhower Health virologist who has been treating coronavirus patients, looked further ahead and said over the next 12 to 18 months, he estimates that 4,000 people age 50 or above will die from COVID-19 related illnesses in the Coachella Valley and 11,000 will require ICU-level care.

Coronavirus FAQ:Everything you need to know

Coronavirus in Coachella Valley:Cases so far

Loftus also estimated that about 200 people under the age of 40 could die if the community doesn’t continue following the isolation and social-distancing guidelines.

The Desert Sun reached out to all 17 acute care hospitals in Riverside County to collect information on bed capacity and surge preparedness. Of the 17, seven provided bed totals; two declined to provide any information; and eight did not respond to The Desert Sun's request for information.

Hospitals that provided bed totals: Eisenhower Health, Desert Regional Medical Center, JFK Memorial Hospital, Loma Linda University Health, Riverside University Health System, Hemet Valley Medical Center, Menifee Valley Medical Center

Eisenhower Health, Desert Regional Medical Center, JFK Memorial Hospital, Loma Linda University Health, Riverside University Health System, Hemet Valley Medical Center, Menifee Valley Medical Center Hospitals that declined to provide any information: Kaiser Permanente Riverside Medical Center, both Riverside and Moreno Valley locations.

Kaiser Permanente Riverside Medical Center, both Riverside and Moreno Valley locations. Hospitals that did not respond to The Desert Sun's request for info: Corona Valley Regional Medical Center, Parkview Community Hospital, Riverside Community Hospital, San Gorgonio Memorial Hospital, Temecula Valley Hospital, Kindred Hospital – Riverside, and Southwest Healthcare System, both the Murrieta and Wildomar locations.

As county and local health officials prepare for a surge, here's what we know — and don't know — about hospital resources in the Coachella Valley and Riverside County.

For the hospitals that did not provide information or provided incomplete information, The Desert Sun is using 2018 hospital report data from California’s Office of Statewide Health Planning and Development to fill in information gaps. While it is the most recent publicly available data, the actual current day numbers could have changed since then and most likely would result in an increase in beds across all hospitals.

We know: The county has 3,400 hospital beds

In Riverside County — which has an estimated 2.4 million people, according to the U.S. Census — there are nearly 3,400 hospital beds among 17 hospitals, according to 2018 data from California’s Office of Statewide Health Planning and Development.

Riverside County has 1.4 hospital beds per 1,000 people, lower than the national rate, which is 2.8 hospital beds per 1,000 people, according to a ProPublica analysis.

All 17 hospitals are community-level hospitals.

There are no Level 1 trauma centers, which can provide total care for any level of injury or illness.

Four hospitals are designated as Level 2 trauma centers, including Desert Regional Medical Center in Palm Springs, Riverside Community Hospital, Southwest Healthcare System and Riverside University Health System. A level 2 trauma center is able to initiate care for any injury or illness, but may not have the means to carry out the complete needed care.

in Palm Springs, Riverside Community Hospital, Southwest Healthcare System and Riverside University Health System. A level 2 trauma center is able to initiate care for any injury or illness, but may not have the means to carry out the complete needed care. The remaining hospitals are able to care for lower-level injuries and illnesses.

Of those 17, the Coachella Valley is home to three acute care hospitals, including Eisenhower Health in Rancho Mirage; Desert Regional Medical Center in Palm Springs; and JFK Memorial Hospital in Indio. The latter two are part of Tenet Healthcare, a national health care conglomerate.

Supervisor V. Manuel Perez has routinely identified the region as "ground zero" for Riverside County during the pandemic.

The Coachella Valley has 1,027 hospital beds, plus 150 new federal disaster beds in Indio, among its three acute care hospitals:

Eisenhower Health: 463 hospital beds

463 hospital beds Desert Regional Medical Center: 385 hospital beds

385 hospital beds JFK Memorial Hospital: 179 hospital beds

Typically, about 49% of hospital beds nationwide are utilized at a time, according to Definitive Healthcare, which collects hospital data throughout the country.

Eisenhower Health: 30% of overall beds utilized as of March 23

30% of overall beds utilized as of March 23 Desert Regional Medical Center: Tenet declined to provide the number of beds currently occupied.

Tenet declined to provide the number of beds currently occupied. JFK Memorial Hospital: Tenet declined to provide the number of beds currently occupied.

Additionally, California National Guardsmen arrived in Indio on Wednesday to set up a 150-bed federal medical facility at the Riverside County fairgrounds that will care for non-coronavirus patients to lighten the demand on hospitals.

We know: The county has 438 ICU beds

About 13% of the county's hospital beds are intensive care beds equipped with a ventilator, which serious coronavirus patients will need to survive.

The high-risk populations in the Coachella Valley, including seniors over age 60 and immune-compromised individuals, are more likely to need a ventilator.

“In mass casualty scenarios, you start using other spaces in the hospital to carry out intensive care,” Mesisca said. “The number of licensed ICU beds in the county is continuing to increase each day as hospitals are turning regular beds into ICU beds to prepare.”

The Coachella Valley has 149 ICU beds among its three hospitals:

Eisenhower Health: 58 ICU beds

58 ICU beds Desert Regional Medical Center : 75 ICU beds

: 75 ICU beds JFK Memorial Hospital: 16 ICU beds

A portion of those ICU beds are already filled.

Eisenhower Health: 26% of ICU beds utilized

26% of ICU beds utilized Desert Regional Medical Center : Tenet declined to provide an occupancy figure.

: Tenet declined to provide an occupancy figure. JFK Memorial Hospital: Tenet declined to provide an occupancy figure.

We know: Riverside County is directing hospital surge plans

Mesisca said he has been working with all acute care hospitals in the county to guide them through surge plans. An acute care hospital is one that provides inpatient care for short-term illness and other related services such as surgery.

Gov. Gavin Newsom said earlier this week that hospitals need to increase their capacity by 40% in preparation for the surge.

“There are different trigger points at various times, but step one is that hospitals create additional capacity within their own beds,” Mesisca said. “Every skilled nursing facility in the county is to identify their capacity and then the plan is to transfer non-COVID patients from hospitals out to the nursing facilities to open up hospital beds.”

There are nearly 1,191 skilled nursing facilities in Riverside County, according to Medicare nursing home data.

What we don't know:Total bed capacity in the county's skilled nursing facilities

In the western parts of Riverside County, the parent company that oversees Hemet Valley Medical Center and Menifee Valley Medical Center has taken steps to expand their hospital capacity by setting up surge tents and initiating the process to expand their labor pool, said Tim Lineberger, KPC spokesman. The two hospitals are also in the process of identifying other parts of the hospitals that can hold additional beds.

“We are taking steps to deploy portable quarantine and HVAC systems that will enable us to create additional negative pressure suits and corridors,” Lineberger said in an email. “This will increase capacity, optimize unused spaces in the facility, and help safeguard staff and the general patient population against any possible airborne transmissions.”

Lineberger said their hospitals need local and state leaders to help them secure enough personal protection equipment for their staff.

We don't know how the Coachella Valley will weather a surge

All three Coachella Valley hospitals have plans in place to expand their capacity before a surge hits, but the total number of beds each hospital could add under disaster circumstances is not currently known.

Eisenhower Health: A new COVID-19 unit adds 17 beds, according to media coordinator Lee Rice. The hospital also added seven negative pressure rooms in the emergency department, and one negative pressure room in a different unit. A negative pressure room is used to contain airborne contaminants within the room. The hospital is also working to convert another entire unit in the hospital with 44 hospital rooms for individuals suspected of having coronavirus, but who haven’t yet been diagnosed.

A new COVID-19 unit adds 17 beds, according to media coordinator Lee Rice. The hospital also added seven negative pressure rooms in the emergency department, and one negative pressure room in a different unit. A negative pressure room is used to contain airborne contaminants within the room. The hospital is also working to convert another entire unit in the hospital with 44 hospital rooms for individuals suspected of having coronavirus, but who haven’t yet been diagnosed. Desert Regional Medical Center: The hospital could expand the intensive care unit to as many as 75 beds, up from the current total of 31 beds, according to Tenet Healthcare spokesman Todd Burke. The hospital also can add an additional 47 general hospital beds in various hospital lobbies, and possibly erect up to 16 decontamination and surge tents on hospital grounds with up to 230 cots for patients. The hospital has already erected two, empty, yellow triage tents.

The hospital could expand the intensive care unit to as many as 75 beds, up from the current total of 31 beds, according to Tenet Healthcare spokesman Todd Burke. The hospital also can add an additional 47 general hospital beds in various hospital lobbies, and possibly erect up to 16 decontamination and surge tents on hospital grounds with up to 230 cots for patients. The hospital has already erected two, empty, yellow triage tents. JFK Memorial Hospital: The hospital erected one empty, yellow triage tent that can be used for patient overflow. Tenet would not provide additional information about JFK's surge preparation.

Burke said if the curve of cases is not flattened, then “the number of cases will certainly continue to rise at a rate that no hospital will be prepared for. Wash your hands, wash your hands, wash your hands.”

We don't know: How many ventilators are in Riverside County

Once hospitals hit the point where their intensive care units are at capacity, then they are expected to convert some of their regular hospital beds into intensive care beds by bringing in needed equipment such as additional ventilators.

Without enough ventilators, it won't matter how many beds each hospital has when it comes down to providing care for the most severe coronavirus cases.

“We think we would be out of ventilators 10 to 14 days after we hit hospital capacity unless we put surge plans in place to get additional ventilators,” Leung said.

Leung declined to share how many ventilators are currently in the county, because that number changes every day as the county works to acquire more.

However, the county has approached non-operational medical facilities, such as outpatient surgical centers, to collect additional ventilators. The county also has requested help from the federal government to acquire more.

Additionally, if the county hits maximum capacity next month, physicians could safely hook up two patients to a single ventilator, if needed.

In the Coachella Valley, the total number of ventilators is not known.

Eisenhower Health: 95 ventilators

95 ventilators Desert Regional Medical Center: Tenet refused to provide details.

Tenet refused to provide details. JFK Memorial Hospital: Tenet refused to provide details

Burke declined to provide the number of ventilators at Desert Regional Medical Center or JFK Memorial Hospital, though he said the hospitals “can safely and appropriately care for our patients with the necessary supplies and equipment.”

When asked if Eisenhower Health has enough ventilators, Rice said more were needed and that the hospital was looking at various suppliers to assist them.

We don't know: How many masks are at Riverside County hospitals

All 17 hospitals in the county declined to say how many masks they currently have, but most agree there will be a shortage.

Staff at Eisenhower Health are currently reaching out to non-traditional vendors for personal protective equipment. While several community members have donated N95 respirator masks, Rice said the hospital still needs assistance from local and state leaders in obtaining critical supplies.

Burke declined to provide information on the supply of masks at Desert Regional or JFK Memorial hospitals.

We don't know: Where all Riverside County coronavirus patients are being treated

Riverside County has declined to provide information about which hospitals are treating patients, as well as each patient's city of residence, age and gender. Riverside County officials said that information has been withheld to protect patient privacy.

However, county officials announced on Thursday that they plan to start releasing patients' age, gender and city of residence moving forward.

At least 41 of the county's 107 positive cases were patients from the Coachella Valley, according to health officials.

Eisenhower Health: There are currently four coronavirus patients at Eisenhower.

There are currently four coronavirus patients at Eisenhower. Desert Regional Medical Center : Tenet declined to provide current number of cases.

: Tenet declined to provide current number of cases. JFK Memorial Hospital: There is at least one coronavirus patient at JFK Memorial Hospital, according to Conrado Barzaga, Desert Healthcare District CEO. Tenet declined to confirm or provide total number of cases.

We know: There are 925 physicians and 3,297 nurses in the Coachella Valley

If coronavirus cases surge beyond local hospitals' capacity, it's going to put a strain on current health care staff. Not only will there be more patients than physicians will be able to attend to, but the likelihood that some health care workers will be sidelined because of their own coronavirus diagnosis is high.

There are 925 physicians among the three Coachella Valley hospitals:

Eisenhower Health: 400

400 Desert Regional Medical Center: 400

400 JFK Memorial Hospital: 174

There are 3,297 nurses among the three Coachella Valley hospitals:

Eisenhower Health: 2,000

2,000 Desert Regional Medical Center: 1,005

1,005 JFK Memorial Hospital: 292

The pop-up hospital constructed by California National Guardsmen in Indio is not yet staffed. The county will be tasked with working alongside the California Medical Association to find health care workers from outside of the area to fill the facility.

We know: Rural hospitals face a unique plight

On the far eastern edges of Riverside County, officials at Palo Verde Hospital in Blythe are worried about how the pandemic will impact rural hospitals like theirs.

“I think there are many people who do not understand the plight of the rural community,” said Sandra Anaya, Palo Verde Hospital chief executive officer. “People frequently have unrealistic expectations of the rural facility. We cannot be compared to a large university or health care system. Our plight, as institutions, are very different and unique.”

Palo Verde Hospital has:

51 hospital beds

Six ICU beds

Four ventilators

10 physicians

Up to 50 nurses

Anaya said Palo Verde has significantly fewer workers and health care providers, but is able to provide basic services and route patients to larger facilities by ambulance or helicopter. It is 108 miles away from another hospital — JFK Memorial in Indio is the closest.

“In essence, we stand alone and often feel it,” she told The Desert Sun.

Many of the workers at Palo Verde do not even live in Blythe but split their time between home — which can be three to four hours away — and the rural desert.

“They are dedicated professionals who work hard on our behalf,” Anaya said. “The challenge is even more significant. We live here when we work and go home to our families when we can.”

Currently, the hospital has no coronavirus cases, but Anaya noted that the hospital serves many in the farmworking community who continue to work while most others are isolated at home under Gov. Gavin Newsom’s orders.

Desert Sun reporter Nicole Hayden covers health and health care in the Coachella Valley. She can be reached at Nicole.Hayden@desertsun.com or (760) 778-4623. Follow her on Twitter @Nicole_A_Hayden.