California hospitals face twin crises of capacity and ‘moral distress.’

Hospitalizations and deaths have continued to soar in California as the state has emerged as the new epicenter of the coronavirus pandemic — and they don’t appear to be slowing down.

With just 2.5 percent of the state’s overall intensive care capacity available, officials have been rushing to get more so-called field hospitals, or alternative care sites, up and running. And while Gov. Gavin Newsom didn’t officially extend what were supposed to be three-week stay-at-home orders affecting most of the state’s 40 million residents, he said on Monday it was “self-evident” that the orders would need to be in effect well into January, in light of projections that more than 90,000 people in California could be hospitalized with the virus in coming weeks.

The state added 295,000 cases over the past week, according to a New York Times database, and is likely to reach 300,000 new cases this week, given the virus’s trajectory.

Dr. Mark Ghaly, the state’s secretary of health and human services, said on Monday that health care providers and state and local leaders were working frantically to prevent health care systems from tipping into what he and the governor described as crisis mode.

“We continue to build up our capacity,” he said. “When we look forward to that forecast of quite a few patients toward the end of January — that’s not a story that’s already been written.”

But as has been the case in the last couple of months, making sure health care facilities are sufficiently staffed has been the biggest hurdle. Nurses, doctors, janitors and so many others are exhausted. Help from other states and the federal government is scarce as so much of the nation suffers from the rapid spread of Covid-19.

In the next week or so, more Californians could hear that many hospitals are simply full. Patients who are unable to avoid going to the hospital will encounter hourslong waits in hallways.

The mere possibility that California’s caseload could overwhelm even the state’s emergency surge capacity is likely to harm workers, said Joanne Spetz, a professor at the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco.

“The term psychologists use is ‘moral distress,’” she said. “And that is a huge, looming and developing issue among health professionals.”

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