California COVID-19 Cases Foreshadow Hospital Stress

Speaker 1: 00:00 Even before the Thanksgiving holiday, San Diego hospitals are reporting a record number of COVID patients being admitted. The official County number as of yesterday is 518 beds being used by COVID patients. The hospital association has the count up to 576, although San Diego's hospital capacity is not being strained right now. And there's a better understanding of how to treat patients suffering from COVID. The concerns are growing about what may be ahead during this holiday season, Johnny muse, reporter Paul Sisson, who covers healthcare for the San Diego union Tribune. Paul, welcome back. Thanks for having me. What do public health officials think this rise in hospitalization stems from, Speaker 2: 00:46 Uh, you know, a lot of, uh, masculine activity going on, uh, you know, in the last few weeks, especially right around Halloween, uh, you know, they've said that hospitalizations usually lag infection by three to three and a half weeks. So that would put us, uh, you know, if we're seeing a spike in hospitalizations now, uh, it would stand to reason that a lot of those exposures probably occurred right around Halloween. Speaker 1: 01:13 And what were daily coronavirus diagnosis numbers like three weeks ago? And what are they now? Speaker 2: 01:21 Uh, you know, we were seeing, uh, uh, you know, hospital census numbers, uh, in the, uh, you know, 200 range. We were seeing a new case totals daily in the four to 500 range. Uh, and now I think four of the last seven days have been over 1000, including a new record of more than 1500 cases in a single day coming in yesterday. Speaker 1: 01:44 Now you spoke with, uh, chief executive officer of scripts, health, Chris van Gorder. And he told you that it's fortunate that this particular increase in COVID patients is coming on a holiday week. Why is that? Speaker 2: 01:57 Yeah. You know, if you think about it, none of us want to have an elective surgery or a schedule double surgery right before, uh, we, you know, celebrate a holiday. So, uh, you know, I, I hadn't really thought about it that way, but it does make sense that people, if they're able to schedule something might choose to, to schedule after the holiday, rather than just before it. So they're not, uh, convalescing, uh, right during the holiday itself. Speaker 1: 02:20 So even with the surge, the overall hospital bed capacity, hasn't really increased that much. Speaker 2: 02:26 What's interesting is they've been able to keep the total number of patients hospitalized in San Diego County under 80% of overall capacity. As we see a larger number of COVID patients. We're now seeing, I think about 12% of all hospitalizations dedicated to COVID compared to only about 6% on November 1st. So we've seen about a doubling in the, um, the share of COVID patients in hospitals, but it's still nowhere near, um, even 50% of all hospitalized patients. We've still got a, you know, as of yesterday, more than 4,000 hospitalized patients total and only 518 were COVID that the issue is that you need to take care of everybody. If you don't want to get into a situation where you're telling people who need surgery, that they have to stay home because you have so many COVID patients that, that you just don't have room to handle both. You want to be able to handle everybody who needs care, not just to COVID patients. That's why they're very nervous about the increasing burden of COVID as we go along, because they could eventually force them to make tough decisions about delaying non COVID care as to have to do in the spring. Speaker 1: 03:37 Now isn't there a threshold of hospital occupancy that's been set by the County and what happens if we go past it? Speaker 2: 03:46 That's right. Uh, the County has said let's reserve 20% of, of hospital capacity for COVID patients. Uh, so if we see the numbers pumping up into that, uh, you know, over 80% range of, of overall occupancy, then that's when hospitals are expected to start calling some of their elective cases and delaying surgeries and other procedures to get back down, uh, under that threshold. Um, it's a little unclear to me, uh, you know, if COVID patients are making up a certain percentage of the overall pie, uh, you know, is it okay as long as, um, non COVID cases remain below that, that 80% threshold? So that's a little unclear, it's a little unclear exactly how they're going to finesse this, uh, as we go forward. And, and it does seem like we're going to continue to see an elevated hospitalization rate. Uh, the very good news I learned from talking to an executive at sharp healthcare yesterday is that they've gotten quite a bit better at treating hospitalized patients. You said their overall length of stay in the hospital has dropped from something like an average of 13 days down to only six. Uh, so that, that allows them to clear patients through the system more quickly, which is very handy in a situation like this Speaker 1: 05:02 In a situation like this with Thanksgiving coming up this week, our hospital's preparing for another influx. Speaker 2: 05:09 Oh, absolutely. Uh, you know, they're doing everything they can to convince, uh, their, their healthcare workers to work as much as they can get them to, you know, and what a lot of the executives have told me is really, um, staffing is the biggest concern, uh, you know, hospitals in, in, in a time when you don't have a pandemic, have to flex their staff up and down based on an unpredictable number of patients coming through the door. So there is this class of healthcare workers called travelers who will work at one hospital, you know, on a short contract and then go somewhere else and work there. And a lot of those travelers have moved East as we've seen massive increases. Uh, in other States Speaker 1: 05:51 I've been speaking with Paul Sisson who covers healthcare for the San Diego union Tribune. Paul, thank you. And happy Thanksgiving. Speaker 2: 05:58 Thank you. Happy Thanksgiving to you.