Marin and County Hospitals Prepare for Surge

Public Health Division coordinates with health care providers for COVID-19 cases

A CLOUD LOOMS OVER BEAUTIFUL MARIN – Photo by Melanie Nathan taken 4/7/2020 as COVID-19 is poised for rampant spread

San Rafael, CA – As COVID-19 cases continue to climb in the Bay Area, the Marin County Department of Health and Human Services (HHS) and local health care providers are positioned to respond to increased demands on Marin’s hospital system, including significant hospital surge.

Currently, hospitalizations from COVID-19 and similar respiratory illnesses are within Marin’s hospital bed capacity. However, scientific modeling predicts a continuous increase of COVID-19 cases, creating potential surge over the next two to six weeks. Hospital surge is the point during a significant emergency when demand surpasses capacity in hospitals, long-term care facilities, community care clinics, and/or emergency medical services.

Since January, Marin HHS has worked with Kaiser Permanente Medical Center, MarinHealth Medical Center, Sutter Novato Community Hospital, and Kentfield Rehabilitation Hospital to increase capacity during an expected surge in COVID-19 confirmed cases or other patients who will require hospitalization. The typical capacity of Marin hospitals is 239 beds, including the appropriate staffing and supplies to care for patients who are ill, injured, or diagnosed COVID-19. Collectively, Marin hospitals have identified opportunities to increase staffed bed capacity by about 67% to approximately 400 staffed beds, which includes nearly doubling Intensive Care Unit beds. 

In addition, the North Bay Incident Management Team (NBIMT), a multi-disciplinary team made up of emergency response experts, is working alongside hospitals and emergency medical services to refine existing emergency response plans for various levels of surge, including catastrophic surge. That includes creating decision points so appropriate actions for a next level of surge can be made prior to entering that level of surge, effectively helping Marin’s hospital bed capacity scale up in step with surge demands. When the number of injured or ill patients exceeds the expanded capacity of area hospitals, NBIMT would activate external health care surge options, including staffing, equipment, and supplies at designated facilities or alternate care sites in Marin.

“We’re fortunate to have the time and resources to prepare for surges in Marin,” said Deputy Public Health Officer Dr. Lisa Santora. “These efforts, combined with those being taken at the state and federal level to increase capacity regionally, make us all more secure that we’ll manage any surges we face.”

Marin Public Health, local hospitals, and health care partners have taken several steps to increase Marin’s collective readiness for potential hospital surge, including:

  • Restricting visitors to hospitals and long-term care facilities, to protect the health of vulnerable populations and reduce their risk of exposure;
  • Cancelling or postponing of elective surgeries and routine medical appointments, moving services to telephone and video conferencing as appropriate to reduce the volume of patients in the health system;
  • Providing child care for health care workers to make it easier for them to continue working during the shelter in place order;
  • Providing places outside of the hospital for people with suspected or confirmed cases of COVID-19 to remain safe and isolated, to free up hospital beds that are not providing hospital-level care;
  • Increasing hospital and staff capacity and coordinating supplies and equipment countywide;
  • Marin’s Medical Health Operational Area Coordination (MHOAC) program has procured and distributed resources such as personal protective equipment (PPE), and continues to increase inventory of supplies through advocacy at the state, supplemented by the support of donors;
  • Marin Emergency Medical Services Agency (EMS) developed pre-hospital guidance to protect first responders and to reduce medical surge;
  • Marin Public Health, MarinHealth and Kaiser Permanente have all established their own field-based testing locations; and
  • Marin Public Health increased its surveillance program to monitor cases of severe respiratory illness resulting in hospitalizations, which is can be an early indicator of potential surge.

“The modeling that we’re using to predict surge is very clear on one point—the most important way to control the number of cases that roll into our hospitals is through sheltering in place,” Santora said. “Through measures like staying home as much as possible, physical distancing, and good hygiene, we are literally helping control surge levels, together.”  

Visit the official Marin County coronavirus webpage to review answers to frequently asked questions or subscribe to receive email updates. Individuals can contact Marin HHS about the coronavirus by calling 415-473-7191 weekdays between 9:30 a.m. and noon and 1-5 p.m. or by emailing



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