The Southern California intensive care unit (ICU) capacity has remained at 0% Friday with the region going into a “surge,” according to state public health officials.

On Friday, the California Department of Public Health announced that the ICU capacity for the Southern California region has remained at 0% with capacity in other areas in the state dropping at record levels.

The 0% ICU capacity does not necessarily mean there are no ICU beds available. State public health officials adjust the percentage if regions have a higher-than-expected ratio of COVID-19 patients in the ICU, according to the state.

The number frequently changes as new COVID-19 patients are admitted or stabilized, meaning they no longer require the level of treatment delivered in an ICU.

“You hear we’re at 0%. That doesn’t mean we have no ICU beds or staff available at all. It means we’re into a surge,” Governor Gavin Newsom said Monday, referring to the first region to reach 0% capacity, the San Joaquin Valley.

Hospitals in California are required to report the total number of all available staffed ICU beds each day as part of the regional stay-at-home order, dividing the state into five regions, according to the state.

The Southern California region includes Imperial, Inyo, Los Angeles, Mono, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara and Ventura counties.

Staffing is the main issue plaguing hospitals in Los Angeles County, not the number of physical beds.

“You can see our current need for ICU beds is quickly approaching the number of available beds that hospitals report that they immediately have available for patients who require that level of care,” said Dr. Christina Ghaly, the county health services director.

Ghaly said hospitals are “under siege” with the county’s models predicting there is “no end in sight” as COVID-19 cases continue to increase.

See Related: Southern California ICU Capacity Drops To 0% Amid Record-Breaking COVID-19 Surge

When first reported on Dec. 3, the Southern California ICU capacity was about 20%, dropping below the 15% threshold a few days later, prompting the state’s stay-at-home order.

By Dec. 9 the SoCal ICU capacity dropped to 9% later dipping to 6.2% by Dec. 11.

By Saturday, the ICU capacity available further declined to 5.3%, with a spike down on Monday to 2.7% and 0.5% on Wednesday.

On Wednesday, Los Angeles County reported the most-ever cases of COVID-19, with 22,422 coronavirus cases along with 138 deaths, according to the L.A. County Department of Public Health.

“I want to acknowledge that we’re experiencing an explosive and very deadly surge and there’s urgency in our request that everyone does all that’s in their power to slow transmission and prevent additional suffering,” said Dr. Barbara Ferrer, director of public health on Wednesday.

Within the Santa Clarita Valley, the number of COVID-19 patients hospitalized at Henry Mayo Newhall Hospital has been steadily rising since the beginning of November. As recently as Wednesday, a total of 82 COVID-19 patients were being treated at Henry Mayo, representing the highest such number since the beginning of the pandemic.

“We are definitely struggling to adequately staff all of the intensive care patients,” said Patrick Moody, spokesperson for the hospital.

“Our constraint is not the number of beds, our constraint is staffing,” Moody said. “We don’t really have a bed figure because the staffing situation is very fluid. We are not at capacity now, but it’s a constant effort to make sure we’re adequately staffed with enough intensive care nurses.”

Because L.A. County is in the Southern California region, the Los Angeles County Health Officer Order has been modified to fully align with additional safety measures across sectors and the required effective date.

The order prohibits private gatherings of any size, closes sector operations except for critical infrastructure and retail, and requires 100 percent masking and physical distancing in all others, according to the governor’s office.

Outdoor services for places of worship and outdoor protests are still permitted within the order, as long as social distancing and masking protocols are followed.

The order is set to remain in effect for at least three weeks and, after that period, will not be lifted until the region’s projected ICU capacity meets or exceeds 15 percent.

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