California learns costly pandemic lesson about hospitals

SACRAMENTO, Calif. (AP) — California spent nearly $200 million to set up, operate and staff alternate care sites that ultimately provided little help when the state's worst coronavirus surge spiraled out of control last winter, forcing exhausted hospital workers to treat patients in tents and cafeterias.

It was a costly way to learn California's hospital system is far more elastic than was thought at the start of the pandemic. Through desperation and innovation, the system was able to expand enough to accommodate patients even during the dire surge that saw hospitalizations top 20,000 and nearly 700 people die weekly.

“Definitely some hospitals, particularly in the Los Angeles area, were at the breaking point, but we did not see that much use of the alternate care sites relative to what was contemplated," said Janet Coffman, a health policy professor at University of California, San Francisco. "As dire as the situation was in the winter, it could have been even worse.”

In the early weeks of the pandemic, Democratic Gov. Gavin Newsom ordered alternate care sites be set up in a former professional basketball arena, two state centers that usually treat people with developmental and intellectual disabilities, and other facilities.

It was part of an early plan to add an extra 66,000 hospital beds as California prepared for a projected crushing load of COVID-19 patients, one of many steps taken by the governor as he imposed the nation's first statewide lockdown.

Ultimately, the state spent $43 million to set up eight sites, $48 million to hire contract employees and $96 million to operate them under a scaled-back plan, according to tallies that The Associated Press requested from the departments of Finance and General Services and the Health and Human Services Agency.

The...