ICU capacity was a bottleneck that never got resolved. In the US there was never a nationwide effort to mobilize ICU resources to target hot spots other than an initial aborted attempt to gather respirators for the surge in NYC and send a military floating hospital.

Regional programs were put into place to shift patients during a local surge and to mobilize hallways and other non-traditional capacity. In California once capacity dropped below 10% health orders went into effect.

At the beginning of 2023 and well after widespread vaccination the California statewide capacity was at 24% availability with 7% of beds being taken by Covid patients.

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Reg...