New Health Restrictions Take Effect In San Diego As Hospitalizations Soar

Speaker 1: 00:00 As of midnight last night, San Diego is officially under the state's new stay at home order. Most non-essential businesses have been ordered closed with retail stores, subject to stricter restrictions and restaurants limited to take out and delivery only KPBS health reporter Taran Mentos spoke with San Diego County supervisor Nathan Fletcher, about what the shutdown means to San Diego Speaker 2: 00:24 Supervisor Fletcher. I want to start with the basics of the shutdown. What should people know? What do the stay at home orders require what's open what's Speaker 3: 00:32 Well, in essence, I think we've seen our cases go from 200 a day to 2000 a day, a tenfold increase a quadrupling in hospitalizations. And so we're in the unfortunate situation of once again, having to take action similar to what we did in March, similar to what we did in July, uh, to limit the highest risk settings and limit the interaction or mixing of folks. Um, and so we're back to a lot of personal care services, hair salons, nail, barber shops, things like that, being closed, uh, restaurants being limited to take out or delivery or pickup only. Um, and, and it just series of modifications. Again, not dissimilar from what we've done before that are designed to one more time, help us beat this thing back while we await a vaccine, Speaker 2: 01:13 There has been some confusion about what's open and what's closed. So what are you still waiting for the state to clarify, Speaker 3: 01:21 We're working to get some clarification around limited services, that things like plumbing, things like that, to get some clarification on that. Um, and a number of us are advocating. The playgrounds should be allowed to be open. I understand completely the desire to not have households and individuals mixing, but for families who have kids that are learning from home, that neighborhood playground really is a lifeline to get your kids out and get them some exercise. And so we're, we're advocating for a couple of modifications and changes, but I think in large part, uh, we generally know what the next three to four weeks, uh, will look like. And now we just have to get about one more time knocking this thing back Speaker 2: 01:56 State says the Southern California regions remaining ICU capacity is 10.9% as of today. What can you tell us about the plans for if and when ICU bed capacity is reached here in San Diego County or in other parts of the Southern California region? Speaker 3: 02:12 This really is the concern. Uh, it's not necessarily where ICU capacity is today. It's the significant increase we're seeing the ICU utilization from COVID patients. The other thing that I think is really important as a problem that we did not necessarily have in March in April. And that is a problem with staff. Uh, I speak to multiple hospital systems daily, uh, who were very concerned about the availability of ICU nurses. You have burnout, you have fatigue, you have a lot of traveling nurses that are in other parts of the country. And then you have a lot of healthcare workers who are getting infected. And so we're working to really try and understand what is the actual ICU capacity today in terms of a bed that could be staff. Um, and then that is why we're taking these actions. We have got to slow the spread, uh, and stop the injection of new ICU patients or slow it not stop it, slow it, uh, to a point where we can the, uh, the overall system capacity and certainly the integrity of our health care. Speaker 2: 03:03 Are you concerned that there will come a time when there are more people who need critical care than we have capacity and even more so than we have staff? Speaker 3: 03:11 Well, that's the nightmare scenario and that's what we've been trying to avoid all the way since March, uh, is slow, the spread to ensure the integrity of our healthcare system. Uh, if you overwhelm your, your healthcare system, you're, you're put into a number of devastatingly, bad choices around crisis care who gets a bed, you know, someone that's in a car accident, not having a place to go. Uh, I believe that if we can all take action consistent with what we did when we went in the purple tear a few weeks ago, consistent with the new regional state of home orders, uh, I believe we can slow the spread to try and mitigate and potentially get through this, but it's really important. The public understand that that prevention means you have to take action before your hospital system is overwhelmed. And that's why we're taking the really challenging actions we're taking. Now. It's not easy. We're not suggesting it is, but we do see what's on the horizon. And we're trying to get on a different trajectory. Speaker 2: 04:01 If we do have more ICU availability compared to other counties, even with changing how we count, will the County be receiving patients from elsewhere? How is the sharing of the patient load going to work? Speaker 3: 04:13 Well, the emergency medical services act outlines that the regions that outlines the distribution, the nature, and we have throughout this pandemic, uh, been, uh, willing to take patients from other regions, whether it be Imperial, primarily Imperial, um, and they would be willing to take our patients, uh, if we, if we had capacity and it's, it's very similar to what we do in fire season, where firefighters will go from one region to another, to support each other through a process of mutual aid. And so the hospitals have in place systems and processes, they follow it transport in the South what's happening. Uh, but that is the interconnected nature of, of our healthcare system. And again, something, if we are ever in need of help and assistance, we will be really glad it exists. Speaker 2: 04:53 Enforcement is a critical piece of ensuring success of this lockdown. So slow the infection rate. What grade would you give the County so far in its ability to effectively enforce COVID-19 orders? Speaker 3: 05:04 Well, it took a while to get there. The County, as a public health agency has limited ability to actually do enforcement. We can serve cease and desist or public health closure notices, but it takes on enforcement being willing to issue the citations. And then the district attorney or city attorney, depending upon the jurisdiction to be willing to enforce those through the courts. Uh, we recently did get the sheriff came around and was willing to dedicate Sheriff's deputies that could go with our public health teams to issue citations. And he made the commitment that they would be willing to do that in any jurisdiction, uh, in San Diego County, the da and city attorney, both assigned prosecutors from their offices to the team. And so I think we are in a better position in place, but as a County government, we have been limited in what we have the statutory authority to do. We need that cooperation from law enforcement, from the prosecutorial side. And I think we now have a good in place, but it certainly took a while to get there. Speaker 2: 05:59 What resources from the state are coming to San Diego. You know, the governor just mentioned that the state is asking for help from the federal government on staffing. The UT reported this morning that the national guard already helped at two local nursing facilities. What more are we expecting and what more do we need? Speaker 3: 06:15 Well, we're going to keep pushing to get everything we can. In the early days of this, we obviously had field hospitals that we were ready to set up and deploy. Uh, the real challenge is, is in order to increase healthcare system capacity, we call it the three S's. You need a structure, you need stuff, and you need staffing. Uh, the structures are pretty easy to find that's not the problem. And even this stuff, the bed or the x-ray machines or the components, uh, are, are generally available. It is staffing and staffing is, is a critical component. You have a lot of staff burned out fatigue, tired, deployed to other parts of the country where the situation is much more dire. Uh, and then a significant number of staff are becoming ill themselves or having a quarantine or isolated. So we will work with the state and the federal government in any one, uh, to get every resource that we possibly can. Uh, again, while hoping that the actions we're taking, uh, can help us stabilize our numbers and avert the crisis of overwhelming or Speaker 2: 07:08 Supervisor Fletcher. Thank you very much for your time. Absolutely. Thank you.