Santa Barbara County officials established plans to use facilities in Santa Barbara and San Luis Obispo County as alternative care sites for COVID-19 patients if there is a surge in cases that overwhelms existing health facilities.
The Board of Supervisors on Tuesday unanimously agreed to lease the vacant Sears building in La Cumbre Plaza in Santa Barbara if hospitals become too full on the South Coast.
The county is seeking to transform the 72,000-square-foot building into a 200-bed “congregate care” facility should the region’s health system face an overwhelming surge of coronavirus patients in the future.
The Sears site, at 3845 State St., would be designed to house patients infected with the novel coronavirus and sick from the disease it causes, COVID-19.
The alternative care facility will cost the county about $39,600 a month once patients and employees occupy the site, according to a staff report to the board.
“This is a measured, reasonable investment that provides tremendous capacity to protect in the event of future needs,” Second District Supervisor Gregg Hart said.
Hart said “this is the last step in the process.”
First, “all of the hospitals — if needed — will reduce the elective surgeries they are offering to the public to preserve capacity in their hospitals for COVID patients,” he said.
Then, Hart said, “all of the hospitals have additional surge capacity within the hospitals, too, because the next step they would activate internally within their hospitals.”
He continued: “Only in the event that both of those systems proved inadequate to the need would these additional facilities need to be used.”
Cottage Health, which operates three hospitals in the county, announced last week it will reduce its number of scheduled elective procedures by half at its Santa Barbara location starting Monday.
The decision will assure Santa Barbara Cottage Hospital can provide life-saving care for the predicted surge of COVID-positive cases while caring for patients who require emergency and essential care for non-COVID conditions, Cottage Health CEO Ron Werft said in a statement.
A new peak could manifest itself as a sudden spike in cases, which would mean more people are infected with novel coronavirus at the same time, and during flu season, which could overburden healthcare systems, the county’s report said.
At the beginning of the pandemic, a top priority was identifying a total capacity of 500 beds throughout the county to deal with the eventuality of housing the overflow of COVID-19 patients, Assistant County Executive Officer Barney Melekian said.
A surge capacity of 500 beds is “an insurance policy,” Melekian said.
“Knock on wood,” he said. “We have not come close to even needing that since the pandemic began, but it’s seemed like a prudent measure to have the capacity to do that.”
County officials “ultimately landed sort of a bifurcated system” after identifying sites through the county, including centrally located areas in Buellton and the Santa Ynez Valley, Melekian said.
If necessary, the Cal Poly Recreation Center has beds available for Santa Barbara County residents in the event of a COVID-19 surge in the North County, Melekian explained.
“The North County 250 beds, we have an arrangement with Cal Poly, San Luis Obispo, in San Luis Obispo County to handle North County overflow in the event the county hospital system is overwhelmed,” Melekian said.
In April, San Luis Obispo County officials converted the site into a large facility to care for COVID-19 patients.
County officials are in the process of developing a formal memorandum of understanding, but San Luis Obispo County officials “have agreed, in principle, any overflowing patients from North County could go to their facility,” Melekian said.
The county doesn’t have to compensate San Luis Obispo County for the use of its facility, according to Hart.
Melekian said county officials examined UC Santa Barbara, the empty Sears building and other places on the South Coast, including the option of setting up field tents and field hospitals.
The Sears facility had the “best capacity and the ability to grow,” he said.
Units can be added as needed at the Sears site, he added.
“We set aside 250 beds, but the truth of the matter is we could go beyond that if we had to,” Melekian said.
The lease arrangement was conducted in conjunction with Cottage Health, “who has been directly involved with us in terms of helping us plan to set up the site,” Melekian said.
The county’s report states the length of the sublease is six months, and there’s an option to extend it for up to 18 months.
The sublease consists of three transition phases, Melekian explained.
Phase one would start “somewhere” between the end of July and end of August, he said.
Phase two commences upon the county undertaking any tenant improvements to the premises or supplies on the site. It could take three to four weeks to prepare the building for COVID-19 patients.
“There is planning again in conjunction with Cottage Hospital,” Melekian said. “We are working with Public Health to identify trigger points for when that would start.”
The facility will require extensive cleaning and possible upgrades to electric, heating, ventilation, and air conditioning, and other upgrades to make the facility “ready to operate,” the report said.
The site improvements are estimated to cost up to $1.2 million, and the county’s job order contractor would perform the work.
Patients with COVID-19 would receive care at the facility only “if the entire hospital system within the county is overwhelmed,” Melekian said.
The project in Santa Barbara would be carved out from the county’s federal Coronavirus Aid, Relief and Economic Security (CARES) Act money, County Executive Officer Mona Miyasato said.
The location at La Cumbre Plaza was selected in part because it’s centrally located to strategically serve a highly populated area of the tri-counties region, according to county staff.
The alternative care site on the South Coast is a “wise improvement decision,” Fifth District Supervisor Steve Lavagnino said.
“The virus doesn’t have city boundary lines, (and) county lines,” Lavagnino said. “We have to look at this (the Sears site) as a regional approach.”
The Sears building has been vacant since 2019, when the department store was listed as a location around the nation scheduled to be shuttered.
The lease agreement item was listed under the administrative agenda, and the supervisors pulled the item for discussion after public comment.
Public Health Director Briefs Supervisors on COVID-19
The county Public Health Department reported 184 new COVID-19 cases Tuesday, with a total of 4,323 cases in the county.
The number of positive cases increased 43 percent in the past 14 days, and doubled in the last 28 days, Public Health Director Van Do-Reynoso said.
“I’d like to note though that 91 percent of the cases are recovered,” Do-Reynoso said Tuesday morning.
The county’s contact investigation and tracing team were working on roughly 247 cases on Tuesday, Do-Reynoso said.
The latest numbers on Tuesday evening showed 76 COVID-19 patients being treated in local hospitals, with 22 in intensive care units.
“These numbers account for a small fraction of the total patients hospitalized in the county,” Do-Reynoso told the supervisors. “When we account for all of the other non-COVID patients hospitalized, Santa Barbara County has 34 percent of medical-surgical beds available, and 38 percent of intensive care unit beds available.”
There are 80 percent of ventilators available at hospitals in the county, according to Do-Reynoso.
Fifty-seven percent of COVID-19 cases are transmitted from person-to-person contact, she said, while 42 percent were due to community spread.
In addition to the impact of the general population, Do-Reynoso said, community spread increases the likelihood of expanded transmission of COVID-19 in congregate settings such as nursing homes, homeless shelters, jails and prisons.
“Infection of these vulnerable populations can be catastrophic,” she said.
As of Monday, 14 percent of the total positive COVID-19 cases in the county can be attributed to farmworkers, Do-Reynoso said.
Of the total cases in Santa Maria, Public Health has identified 20 percent as attributed to farmworkers, Do-Reynoso said.
Third District Supervisor Joan Hartmann asked Public Health officials if the county’s community spread is greater because of visitors from areas with a surge of COVID-19 cases.
“Our community transmission rates are similar to other counties that don’t have the tourism industry that we do,” Do-Reynoso said.
The county has been on a state watchlist for 29 days, and is still not meeting all of California’s monitoring metrics, she said.
The county needs to report an average of 150 COVID-19 test results per day per 100,000 people, and is reporting 239 tests per day.
“We are good in this metric,” Do-Reynoso said.
The state gets concerned if the county’s COVID-19 case rate is higher than 25 new cases per 100,000 residents in a 14-day period, which would be 112 new cases for Santa Barbara County.
“As of yesterday (Monday), we are clocking 242,” she said. “That’s exceeding the state rate quite a bit, almost 10 times.”
The county isn’t meeting the state’s metrics for COVID-19 testing positivity, according to the latest numbers.
“The state gets worried if our rate is above 8 percent,” Do-Reynoso said. “As of yesterday (Monday), we were clocking in close to 10 percent …In the other categories we are meeting the criteria.”
Do-Reynoso said she anticipates “further modifications from the governor (Gavin Newsom) given we are still on the monitoring list.”
It’s critical “we work together to decrease the growth in the new cases,” Do-Reynoso said.
As of last week, 6,635 businesses countywide submitted the self-certification forms to reopen safely, with the majority of them within city areas, Assistant County Executive Officer Nancy Anderson said.
“Our top three sectors continue to be dine-in restaurants, retail stores and office workspaces — two of which have been impacted by yesterday’s (Monday) statewide order,” Anderson said.
Newsom ordered additional business closures this week in response to growing statewide COVID-19 hospitalizations, and the county issued a health officer order Tuesday afternoon implementing the mandate and more local details.