California has just reached the count of 2 million COVID-19 cases, the most of any state in the country. In Orange County 1,854 people are hospitalized, a rate more than twice as high as the previous surge in July of this year. Fullerton has recorded over 6,000 cases, including 200 more on Dec. 23—nearly 1,000 in the past week alone. Hospitalizations are at an all-time high with nearly 400 patients in Intensive Care Units (ICUs), straining the resources and staff of hospitals across the County.

Fullerton’s St. Jude Medical Center, named for the patron saint of desperate situations, will not confirm the number of patients currently undergoing treatment there, but a California Department of Public Health site that tracks COVID-19 cases shows a Fullerton hospital, presumably St. Jude, with 182 COVID-19 patients, 21 in ICU beds. Additionally, Dr. Faisal Qazi, a St. Jude neurologist, reported on social media that the hospital was at -4% capacity overall, with ICU rates at -8%, and that the case load was expected to double.

On Dec. 15 the Orange County Health Care Agency (OCHCA) announced that three hospitals in OC, including St. Jude, had requested Mobile Field Hospitals, but a St. Jude spokesperson quickly refuted the claim. St. Jude’s Dru Ann Copping explained that “Western Shelter” tents provided by the OCHCA since erected in the facility’s parking lot were not for patient treatment,  but rather to provide “additional flexibility in creating waiting and triage areas, if needed.” Triage is a system of prioritizing incoming patients for medical care. Earlier in the year similar tents could be seen outside the hospital’s emergency entrance. Copping explained that they were removed after a few weeks because they “proved unnecessary” at the time. She was unsure if the tents would even have beds at all.

Tents for receiving and possibly triaging patients recently reappeared in a parking lot of St. Jude Medical Center.

Whether for treatment or triage, the reappearance of the tents—not yet open—signals both the unprecedented size of the current surge and the expectation that it will become worse in coming days and weeks. Despite the desperate urging of healthcare professionals locally or nationally, many people chose to mix households for Thanksgiving celebrations, yielding a predicted wave of infections, hospitalizations, and deaths, weeks later. A second, possibly worse, wave is expected to follow the December holidays, as millions of Americans choose to travel for Christmas, whether near or far, to spend it with family and friends.

St. Jude Medical Center is reportedly absorbing the increase in COVID-19 patients better than some other hospitals in Orange County. “Our surge planning and preparation—including the capacity to quickly transition regular medical units into dedicated COVID or critical care units—continues to allow us to meet the needs of our community,” St. Jude spokesperson Copping explained. Unlike UCI Medical Center, where a large outdoor MFH has already been set up, the expansion of treatment spaces at St. Jude is internal rather than external. “While this surge is creating an enormous amount of stress and strain, we continue to be able to work with regulatory agencies to convert and reconfigure areas to accommodate patients,”  Copping said. State regulatory agencies have reportedly allowed use of older facilities on a temporary basis.

To that end, at the original St. Jude hospital building, now nearly obscured from view by the newer towers, has once again been pressed into service to help absorb the increased number of patients. At least two floors of the 1957 structure, long unused for the purpose, are currently in use as non-COVID-19 medical wards. As many as 60% of the hospital’s patients are there for COVID-19 treatment and are separated from other patients not suffering from the virus-causing illness, as the staff continue to convert areas previously not in use for medical purposes into patient care rooms.

No matter how much space is available, however, it is adequate staffing that ultimately determines how many patients can be cared for in hospitals at any given moment. St. Jude is able to call up traveling nurses from a national registry to supplement their own healthcare workers, despite elevated numbers of infections across the country. St. Jude specialists are reportedly shifting to support roles by treating non-COVID-19 patients in the emergency room so internal medicine doctors can be free to treat COVID-19 patients.

Chart created by Harry Langenbacher.

The first hospital operated by the Sisters of St. Joseph of Carondelet, who would go on to found St. Jude in Fullerton, opened in Eureka during the great flu epidemic of 1919. A century later, all elective surgeries at St. Jude have reportedly been halted so doctors can put all their efforts into fighting the current pandemic. Although St. Jude has been able to meet the needs of patients so far, Dr. Qazi said, “It’s a real crisis here,” and urged members of the public to take preventative measures seriously to avoid spreading the coronavirus to others.