In the beginning of March Mayo Clinic circulated a COVID ICU protocol which virtually everybody implemented. Cleveland Clinic had something similar though NYC, Philadelphia and Baltimore hospital systems went with Mayo. It had metrics and trigger points at which point different units at hospitals were converted into COVID ICUs. Such protocols are absolutely standard for any large scale disaster scenarios. "Overwhelmed" means "handling of this event is not in a protocol". That has never happened. 2x the normal ICU beds was would not have triggered even the 2nd implementation of a second phase.