San Diego County Public Health Officer Wilma Wooten speaks at a press conference about the coronavirus pandemic. / Photo by Adriana Heldiz

County officials released projections Wednesday on just how many people the novel coronavirus could infect in San Diego. The projections contain two alarming possibilities: The number of COVID-19 cases may not peak for at least six weeks, and even when the peak occurs we may not have enough hospital beds for the patients who need them.

After questions from Voice of San Diego, officials released a chart that shows how quickly the virus would have spread had they done nothing and how quickly the virus may spread now based on current social distancing restrictions.

Image courtesy of San Diego County

The first curve, in blue, shows how fast COVID-19 could have spread with no official action. The second curve, in green, shows how quickly the virus might spread “if we can do the proper social distancing,” said Dr. Eric McDonald, a public health officer who oversees the county’s epidemiology department.

Both curves show that eventually the number of patients who need to be hospitalized may outstrip the number of hospital beds in San Diego County.

There are several important caveats regarding hospital beds, said McDonald.

First, the current model assumes that all hospital beds are available. In other words, it assumes no other patients would need hospitalization for any other reason during the outbreak. McDonald acknowledged that some beds will obviously be taken up by other patients who need care unrelated to COVID-19.

The more time that passes, however, the more local hospitals will also be able to increase the number of beds they can offer, said McDonald.

Local hospitals may be able to increase their bed capacity by as much as 40 percent, he said. Most local hospitals have already erected tents where they can treat and screen COVID-19 patients.

San Diego is also home to two military hospitals, which may provide extra beds in a worst-case scenario. The number of military beds is not included in the county’s projection.

McDonald said that he and other public health officials are working to refine the county’s projections. He said more information about the true height of the coronavirus peak will be available in the days ahead. The current projections are based on an “extremely simplified model,” he said.

The first curve in the chart represents how fast San Diego’s health care system would be overwhelmed if the number of cases doubled every three days. The second curve in the chart represents how quickly it would be overwhelmed if the virus doubled every six days.

McDonald did not say how fast he thinks the virus is spreading in San Diego currently.

Image courtesy of San Diego County

Based on extremely limited testing, the virus appears to be doubling faster than every six days in our region. Officials have repeatedly said that the number of confirmed cases only represents the “tip of the iceberg,” because of limited testing. McDonald has said the number of actual cases is at least 10 times as high as the number of confirmed cases.

Overwhelming the system more quickly would also mean that hospitals have less time to stock up on protective equipment like gloves and gowns. It would also give them less time to obtain ventilators, which are important for treating extreme cases of COVID-19. County officials have already admitted there is a shortage of some protective equipment, though they say new supplies are slowing trickling in each day.

It is critical that San Diego residents only go outside for absolutely essential activities, said McDonald. “That is what is going to buy us the time we need, flatten the curve and allow us to handle what will be a large number of illnesses and, I’m afraid, deaths that are coming in the days ahead,” he said.

Will Huntsberry

Will Huntsberry is a senior investigative reporter at Voice of San Diego.

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