New York health officials are moving forward with a plan meant to free up bed space in hospitals across the state amid a resurgent coronavirus pandemic that is affecting virtually every corner of the country. 

The strategy is aimed at ensuring there are enough beds to handle an expected wave of patients through the middle of next month, Health Commissioner Howard Zucker wrote to hospital leaders in a letter sent on Wednesday. At its heart is ensuring New York's hospitals are not overwhelmed during the upswing in COVID-19 cases. 

"We are assuming a continued increase of hospitalizations throughout mid-January," Zucker wrote in the letter. 'Hospital capacity will be a major battle. We learned many lessons through the spring. Hospitals can now reasonably predict their expected demand by observing the infection rate increase and hospitalization rate increase in the zip codes in their area. The data is published daily. Unlike the surprise in the spring, we know when and where numbers will increase."

There are now more than 6,000 people hospitalized in New York with COVID-19; there are more than 18,000 patients in hospitals at the height of the pandemic's spring surge. 

Hospitals are being asked to implement a three-part plan for boosting capacity. That includes having a strategy in place for "load balancing" at hospitals within a regional health care network and having a place to transfer patients prior to admission. 

Meanwhile, health officials are also focusing on independent hospitals that could be located in communities with high COVID positive rates or smaller isolated hospitals that could be under the greatest risk of being overwhelmed by new patients, Zucker wrote. Health officials want them to have transfer agreements with neighboring hospitals and health care systems now. 

And, amid concerns there could be a sudden spike in COVID-19 cases, hospitals must be ready to reach a 15% bed capacity grwoth within 72 hours. If they can't expand bed capacity, elective surgeries must be cancelled or bed capacity is expanded so they can always ensure they have the added 15% staffed beds in case of a surge, Zucker wrote. 

"This will be a difficult period through the holidays and until the vaccine hits critical mass," Zucker wrote. "It will test all of us. However, we learned much from the spring and if we follow those lessons, we will affirm our reputation as the best health system on the globe."