I think it is worth mentioning that hospitals routinely go to capacity this time of year. The cold weather causes a number of problems that cause hospitals to surge. There is the flu and other respiratory infections, COPD exacerbations, cold allergies/asthma and pneumonia. Stress related blood pressure issues, heart attacks, aneurisms, etc. There are more diabetic ulcers and necrotic complications with circulation issues because of the cold. There are more behavioral and psych issues. We see more drinking and homeless visits. I could go on.
We often have a full ICU and are holding ICU patients in the ER. We often go on "treat and transfer" or "treat and hold". Sometimes we have gone on divert. Here are a few articles talking about the bad 2018 flu season. The difference now is that these conditions are that much worse, even if flu cases are dramatically down, and non-COVID ER visits are down, and places aren't doing elective surgeries, and people are sheltering at home, wearing masks and actively avoiding healthcare facilities if they can. In spite of those things, it is bad in many places, and deaths are totally out of control compared to the norm. And what is worse, is that there is a pandemic that has the potential to rage further beyond the current levels, and there is little bandwidth to accommodate the current surge, let alone more surging. Back in 2018, we may have had full hospitals, but the hospitals hadn't exhausted all options, nor was society doing anything to modify their behavior.
I recall telling coworkers that the worst is yet to come, but few people believed it would surge worse, so I don't think there was aggressive planning at all. That would have cost more money, and hospitals didn't want to spend if they didn't have to spend. We had put up a COVID testing tent in case testing surged to our ER, but some homeless people shit in the trash can and wrecked the tent, and we had enough county support that testing didn't overwhelm our ER. Our hospital has around a quarter of the patients COVID positive, and we have expanded our COVID units, but we aren't strained like LA. We will see if it gets worse.
2018 Articles:
https://www.theguardian.com/society/...safety-concern
https://www.bizjournals.com/sanfranc...-outbreak.html