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SACRAMENTO, Calif. (KTXL) — As of Wednesday, California has more positive COVID-19 cases that the previous leader, New York state.

The state is fluctuating between 4,000 and 9,000 tests a day. 

The California Hospital Association says recent trends show hospitalizations follow about two weeks after a spike in positive tests.

COVID-19 patients take up 7,000 of the state’s 50,000 available beds. Two thousand patients are in intensive care.

Beds are used for other injured or sick patients besides those who have the virus. Hospitals said 5,000 available beds are not enough for a surge.

“We need to be prepared to treat as many as 25,000 COVID-positive patients. That’s about four times the level where we are today,” California Hospital Association President and CEO Carmela Coyle told FOX40.

Surge numbers are coming in from Southern California counties. Imperial County had a spike of 600 hospital cases in recent weeks, with some patients transferred to Sacramento-area facilities.

The Central Valley is a recent hotspot, especially in San Joaquin County where COVID-19 patients are straining its hospital system.

Many of the state’s hospitals have already planned for a surge.

“That is not pretty,” said Coyle. “That means beds in office buildings and conference rooms and all the rest within the hospital footprint.”

Several thousand beds are available at alternative sites, like at Sacramento’s Sleep Train Arena, but those are not ideal for the treatment of acute cases, although they can relieve the overload by taking hospital patients with more minor ailments.

Even if there are enough beds, hospitals are struggling with key shortages of personal protective equipment for their staff, testing materials and qualified nurses who are in demand from other states that must staff COVID-19 beds as well.

And the number of available beds means little if they aren’t located where the next hotspot flares up.

“Outbreaks can happen at any time and at any place,” said Coyle.

The California Hospital Association said the best way to address a shortage of beds to treat COVID-19 patients is to avoid getting the disease by using preventive measures like social distancing, using masks and washing hands.