California scrambles to avoid Covid-19's worst-case scenario: 'It will take a heroic effort'

Leaders in California are scrambling to prepare the state amid a shortage of hospital beds, limited access to masks and ventilators and a patchwork approach to testing, as a surge of cases in New York provides a warning of how quickly the coronavirus crisis could spiral out of control.

The number of cases in New York state had soared by Tuesday morning, with 25,665 confirmed infected and 210 deaths. “We are now, in New York City, the epicenter of this crisis in the United States of America,” Mayor Bill de Blasio said Sunday. “The worst is yet to come.”

Three thousand miles west in California, where a statewide stay-at-home order took effect Friday, California’s governor, Gavin Newsom, was readying the state for a 90-day surge in cases, a demand that would require adding 50,000 hospital beds to the state’s portfolio. Tuesday saw the death of a patient under the age of 18 in Los Angeles, who is believed to be the nation’s first child to have died from the virus.

Newsom has projected a growing need for hospital beds over the past week as the governor has used Facebook Live to hold near-nightly press conferences. Newsom said on Monday night the state was also hoping to secure 1,000 beds in hotels to shelter the unhoused during the outbreak.

The number of coronavirus cases in California surged had surpassed 2,500 by Tuesday afternoon, with 50 deaths reported statewide, according to tracking by the San Francisco Chronicle.

The Bay Area remains the hardest hit so far, with more than 800 confirmed cases across four counties. But Los Angeles is climbing the list, with 662 cases and 11 deaths, including the patient under 18. An LA health official said it was “a devastating reminder that Covid-19 infects people of all ages”.

“It underscores the enormity of the challenge in front of us and how it can impact anybody,” Newsom said about the teenager’s death. Half of all positive cases in California fell in the 18-to-49 age range, Newsom said in a news conference Tuesday evening. “Young people can and will be impacted by this virus,” he said.

The governor hopes a navy hospital ship bound for Los Angeles and two army field hospitals opening in Riverside and Santa Clara counties will help meet the need for hospital beds.

The state also faces a scarcity of protective equipment that has forced state officials to turn to leaders in private industry, including Tesla’s Elon Musk and Apple’s Tim Cook, to assist in production.

Related: Tests, masks, beds: health workers grapple with shortages as coronavirus crisis grows

California is sprinting to get hold of about 1bn sets of gloves and hundreds of millions of gowns, surgical masks and face shields, he said at a press conference late Monday.

“It’s going to take an heroic effort” to obtain enough personal protective equipment to deal with a sudden surge in coronavirus cases, Newsom said.

A steep rise in hospitalizations related to the coronavirus in Los Angeles county may be an early warning sign of what’s to come. As of 6 March, five people in the county had been hospitalized with the coronavirus at some point, according to the Los Angeles Times. By Monday, two weeks later, that number had climbed to 90, with officials reporting that 536 people in Los Angeles county have tested positive for the virus.

Doctors and hospital administrators are hurrying to draft policies on how to handle decisions on triage and hospital beds in the coming weeks.

“We don’t have much time,” a Los Angeles emergency room physician, Dr Marc Futernick, told the LA Times. “These are decisions that we need to make really soon before we are in the throes of the tsunami.”

California’s patchwork response to testing has also left it struggling to keep pace with the virus, and the state is now looking to establish a coordinated approach. At least 22 state laboratories, seven hospitals and two private outfits are conducting tests in California, but it remains hazy how testing at those sites is being tracked.

“We are cobbling together various approaches,” Susan Butler-Wu, an associate professor of clinical pathology at the University of Southern California’s Keck School of Medicine, told the LA Times. “The whole thing is badly discombobulated ... I think 100% that the system is broken.”

About 26,400 tests in California had been conducted by Monday afternoon. New York, which has half as many residents and the nation’s largest number of cases, had conducted 91,200 tests, according to the Covid Tracking Project, an independent group.

Numbers from that group put California below the national average of about 90 tests performed for every 100,000 residents.

When asked by reporters about the state’s lack of testing, Newsom said that states had different ways of counting the figures, adding that some test protocols in California were under way but not reflected in the total numbers.

Newsom has implored residents to observe restrictions and stay at home to curb the spread of the virus. After beaches and state parks over the weekend saw an expected crush of visitors hiking and jogging – activities still permitted under the California lockdown – Newsom yesterday closed parking lots at dozens of such areas.

“Normally that would light up my heart to see tens of thousands of people congregating down in Malibu and other parts of our beautiful state,” Newsom said. “One cannot condemn that, but one can criticize it. We need to practice common sense and socially distance.”

Local officials had already moved to close parking at popular beaches in Malibu, Santa Monica, Los Angeles, San Diego and San Francisco. Parks in scenic Marin county, north of San Francisco, were closed and access was restricted to many of the trails in the Santa Monica Mountains that run through Los Angeles county.

As Donald Trump voiced his desire to get Americans back to normality by Easter, Newsom had a more sober outlook on the shutdown situation in California on Tuesday. “We’re trying to bend that curve but we haven’t bent it,” he said. “Early April, that would be misleading to represent, at least for California.”

If the state continues to follow the current protocols for the next six to eight, or even the next eight to 12 weeks, “we’ll be in a very different place than we are today”, he said. “But I think April for California will be sooner than any of the experts that I talk to would believe is possible.”

Vivian Ho and agencies contributed reporting