California explains ICU projections, but questions remain

Hospital Bed
Posted at 5:20 PM, Jan 26, 2021
and last updated 2021-01-26 20:23:15-05

SACRAMENTO, Calif. (KERO) — The state of California used ICU projections in its decision to lift the stay-at-home order on Monday. But a lot of questions remain after just portions of that data was revealed on Tuesday. 23ABC's Bayan Wang took a look at the breakdown given by the Secretary of California Health and Human Services Dr. Mark Ghaly.

On Tuesday Dr. Ghaly detailed the formula used to project ICU capacity in California's 5 regions. This comes as several local politicians asked for more transparency on how the state's decisions were made during the pandemic.

In an interview on Monday with 23ABC, Assemblyman Vince Fong questioned the governor's decisions.

Assemblyman Vince Fong discusses governor's decision to lift stay-at-home order

"We need more transparency. We need more clarity. The governor can't keep changing the rules without presenting the data behind the projections that he's using," he said. "We are seeing glaring inconsistencies about what methodology he is using and he continues to move the goal post in a manner that defies logic. Californians are fed up with being kept in the dark for almost 11 months with no indication that this Governor will be truly transparent to the public whom he ostensibly serves."

It's frustration like that from Fong that has been echoed by the Kern County Board of Supervisors during the pandemic. Questions about where the data is coming from in Governor Gavin Newsom’s decision-making have resurfaced as he lifted stay-at-home orders Monday sending all counties back to the state's tiered-based system.

On Tuesday, Dr. Ghaly gave some details of the formula used to project the ICU capacities of California's 5 regions: Northern California, Bay Area, Greater Sacramento, San Joaquin Valley, and Southern California. Kern County is part of the San Joaquin Valley region.

Formulas for ICU Projections

"We used that formula, then to look at what we predict will be the ICU admissions, again using that rate of transmission, that are-effective, to project what the number of cases would be."

That formula allowed the change in the stay-at-home orders.

According to ABC News, "The state said the Southern California region, which includes more than half the state’s population, will go from no ICU capacity under the state’s weighted formula to 33.3% capacity in four weeks, the most of any region. The San Joaquin Valley just to the north will jump from 0% to 22.3%, the state projects, while the San Francisco Bay Area will reach 25%, up from 8.2% now. The 13-county Greater Sacramento region is projected to have 27.3% capacity. But it’s currently stuck at 9.9% — virtually the same level it was two weeks ago when state officials abruptly lifted the stay-at-home order there. Only the rural Northern California region never was under the order. However, the state now projects its capacity will fall from 47.9% to 18.9%. State officials did not explain the reasons for the steep decline."

Still, questions remain about the information used in this data, and if it’s enough to help make those decisions including from Yaneer Bar-Yam, an expert in the quantitative analysis of pandemics.

Yaneer Bar-Yam

"So what they're doing is they're saying we can tell you how many hospital beds will be occupied but that's based on assuming that it will keep going down. It's pretty obvious that if they relaxed the restrictions, the number of new cases is going to go up. So that's what the problem is. So the problem is not anything in this formula, the problem is what did they assume is going to be the reproduction rate in a week or two."

And that's why Bar-Yam thinks the model isn't as important as the state's strategy, which he believes could be improved.

"Before you talk about the model you have to figure out what the strategy is, and the problem currently is they're using what we call a red zone strategy - they say 'hey we're expecting there to be a few empty hospital beds, so why don't we fill them.' That's basically the narrative."

23ABC reached out to the state to get more information about the formula but they haven't responded yet. Meantime, Fong's office said they are going to connect with Kern County Public Health soon to discuss the info released by the state.