We read Dr. Lance Montauk’s personal experiences at the Porterville ACS during peak COVID-19 in California and thank him for volunteering to help California’s response to the COVID-19 medical surge.Reference Montauk ¹Dr. Montauk’s analysis of equipment supplies and logistics are well-intentioned, but he is uninformed of the statewide strategy. Since projections of medical surge and shortages of equipment and personnel had very wide variations, California aggressively acquired stockpiles of key medical equipment to support hospitals around the state, establish alternate care sites, and recruit volunteer personnel for patient care and logistics.

Dr. Montauk references our article published in DMPHP in September 2021Reference Devereaux, Backer and Salami ² as a reflection of an after-action report with critique of inaccurate numbers. Medical equipment and personnel support provided by the State of California began in February 2020 and extended well beyond the time period of Dr. Montauk’s deployment into 2021. Dr. Montauk’s images do not reflect the extensive usage of the equipment by many other medical systems and hospitals or repairs/replacements needed; moreover, he inaccurately assesses peak ACS patient numbers and patient turn-over. According to state data (Table 1), published in “Utilization of Alternate Care Sites During the COVID-19 Surge and Mass Care: California, 2020–2021,”Reference Christensen, Metzner and Lovett-Floom ³ Dr. Montauk’s experience occurred at one of the least active ACS sites, so his perspective does not reflect the scope of the pandemic statewide. In addition to staffing at ACSs, CAL-MAT personnel were deployed to nursing homes, vaccination and testing sites, infusion sites, oxygen supply depots, and at the Emergency Medical Services Authority warehouse where medical surge equipment was stored and distributed. Rymer et al. describe the myriad of jobs performed by personnel deployed during the pandemic period in “Rapid Expansion and Adaptability of California Medical Disaster Teams.”Reference Rymer, Breyre and Lovett-Floom ⁴ At the time of publication of “Oxygen and Ventilator Logistics During California’s COVID-19 Surge: When Oxygen Becomes a Scarce Resource,”Reference Devereaux, Backer and Salami ² hospitals throughout California, the U.S., and around the world were strained by COVID-19 medical surge without any clear forecast of the final extent of the surge. The purpose of the paper was to share information as rapidly as possible in order to help other states and countries respond to the unprecedented oxygen demands they were experiencing. While we appreciate comments, we caution readers that Dr. Montauk’s experiential evidence was formulated without the broader perspective of California’s COVID-19 response strategy or knowledge of equipment deployment to hospitals or other countries. As with every major disaster in California, a detailed analysis is performed.

Table 1.

Totals of treated patients at California CAL-MAT ACSs 2020–2021

Table 1. Long description

Beginning at the top, the table header reads COVID-19 ACS. The first row lists Asilomar Hotel with 25 patients treated from 3/10/20 to 3/29/20. Next is San Mateo with 85 patients from 3/10/20 to 6/24/20. Imperial 1 treated 213 patients from 5/18/20 to 8/22/20, followed by Imperial 2 with 356 patients from 10/30/20 to 4/23/21. Imperial Total is 569. Fairview 1 treated 114 patients from 4/18/20 to 9/30/20, Fairview 2 treated 219 patients from 12/15/20 to 3/17/21, and Fairview Infusion Clinic treated 224 patients from 1/31/21 to 3/10/21. Fairview Total is 557. Porterville 1 treated 102 patients from 6/30/20 to 9/15/20, Porterville 2 treated 104 patients from 12/14/20 to 3/17/21, Porterville Infusion Clinic treated 30 patients from 1/28/21 to 2/27/21. Porterville Total is 236. Sleep Train 1 treated 9 patients from 4/18/20 to 7/1/20, Sleep Train 2 treated 187 patients from 12/9/20 to 3/21/21, Sleep Train Infusion Clinic treated 45 patients from 2/5/21 to 3/19/21. Sleep Train Total is 241. Palomar treated 188 patients from 12/21/20 to 6/15/21. The final row shows ACS Total as 1901.