San Diego COVID-19 Hospitalizations More Than Double From Month Ago

Speaker 1: 00:00 About 900 people confirmed or suspected to have COVID-19 or hospitalized in San Diego County, at least 600 more could be admitted in the next couple of weeks, pushing local hospitals to the brink. Joining me to talk about how the hospitals are handling the increase is KPBS health reporter Taryn Minto Taryn. Welcome. Speaker 2: 00:20 Hi Jade. Thank you. How Speaker 1: 00:22 Are local hospitals preparing for the potential, uh, of hundreds of new COVID patients expected in the coming weeks? Speaker 2: 00:30 Well, there's a lot of talk about just hoping that the current restrictions that we are recently been under are going to help with reducing that surge. But we do know that because hospitalizations lag after cases two to three weeks, um, that, that there are some that are actually, you know, going to be on their way. You said 600. Um, so that's kind of a given at this point and really they're just all looking at their surge planning. How can they add space and how can they add staff? That's something I keep hearing about is staff who also has to go with space, a bed doesn't care for a patient. So they're looking at certain things with space, such as emergency tents. Um, but they're also putting nurses on standby. We heard from the Palomar health CEO just yesterday that we have that field hospital with 202 beds up in North County. And they're putting 50 nurses on standby in case they need to activate it. Speaker 1: 01:20 And how are hospitals throughout the County communicating with each other to determine which hospitals have capacity for new patients and how to even divide that out. Speaker 2: 01:30 The County received a lot of questions about this yesterday at it's it's regular COVID-19 briefing and, you know, Dr. Wilma Wilsonart, our public health officer says that the, the County and hospitals will work collaboratively. If it reaches a point where decisions do have to be made about where resources go, you know, maybe one bed, two patients, what, what do you do? And again, hospitals and County health, uh, public health officials are saying like, we really hope that they don't have to get to that point, but the reporters were seeking information about this yesterday. And so far, what we've learned is that hospitals, um, are, are making some decisions internally within their systems, such as how in such as will end to delay a surgery and what surgeries they could delay. But everyone kept stressing again, that they just really are hopeful that there won't come a time when those difficult decisions are made. But Dr. Wooten did say that the County would woodwork again, quote, collaboratively with hospitals on that, Speaker 1: 02:22 Are there enough doctors, nurses, and other essential staff available to be able to care for all of these patients? Speaker 2: 02:28 Right. That's what a lot of healthcare leaders are actually worried about right now. And I asked this of the Dimitrios Alexio. He is the CEO of the local hospital association, and this is what he had to say. Speaker 3: 02:39 So there are some options as it relates to capacity, but again, I would still put it back on staffing that, uh, we need to figure out and continue to work at having adequate staff, whether it's the state helping us, whether it's flexing nurse staffing ratios. Speaker 1: 02:54 Hmm. So then Terran, is there a specific number of patients that hospital's, we'll put them at 100% capacity? Speaker 2: 03:02 Well, as Demetrius just mentioned, it's not just about actual capacity capacity, isn't just space. It's also individuals. It's also the people, again, a bed doesn't take care of a patient. The people do. So Dimitrios mentioned something about flexing nurse staffing ratios. California's pretty unique and has the state law that mandates a certain amount of nurses per patient. And so in an ICU, it's one nurse per two for two patients. Um, but there's, there's under the pandemic. The governor allowed flexibility with that law. And so hospitals have to apply through a waiver process and, and show it's supposed to, they're supposed to show that they exhausted all of these other efforts to expand their staffing, such as baby calling and people, um, increasing shifts, um, or reducing certain surgeries or delaying certain procedures. Um, but they are, there is a process that would allow hospitals to go beyond those ratios. And that is an option. Speaker 1: 03:58 And with that being an option, how has patient care and nurse safety impacted by potential staffing shortages? Speaker 2: 04:05 So the California nurses association is, is not on board with, with flexing ratios. Um, they say that it could affect patient care if you have one nurse responsible for more patients and also especially COVID patients, which they're seeing require just so much more, um, support. And so they're very concerned about that. They're also concerned about their own safety caring for so many COVID patients. Um, and you know, I talked to a spokeswoman at the California nurses association and she said, she's just worried that hospitals aren't really exhausting. Those other options such as maybe reducing surgeries that can be delayed. And she claims, you know, she's notes that there's even been some facilities in the state that have laid off nurses during the pandemic. So she's critical of this waiver process. Speaker 1: 04:48 Um, and you know, for the longest time we've heard regular updates from the governor, uh, about the number of ventilators in the state and the amount of PPE. What can you tell us about the amount of equipment available here locally to be able to, to care for those, uh, mostly critically ill patients, Speaker 2: 05:04 Right? So in terms of those resources, actually, I'm looking at the KPBS trigger tracker. The County has these metrics that they, they publish every single day to track certain things, including personal protective equipment and ventilators, and in San Diego County, right now, the data is showing that 44% of our ventilator supply is available. The County says it doesn't want to get less than 25%. So we still are relatively, um, pretty much above that. And then also with personal protective equipment, um, the County wants to make sure that hospitals have at least 22 days of, of personal protective equipment. Um, and they don't want half of the hospitals to have less than that. So right now, 84% of the county's reporting, 84% of the region's hospitals have at least 22 days of personal protective equipment. So that's where we are with this, but it's changing all the time. It goes up and down. If you go to the KPBS trigger tracker, you can see how these numbers have changed over time, as well as all the other metrics that the County is tracking a publishing. Speaker 1: 06:03 And what does it say about our local capacity for ICU beds? Speaker 2: 06:07 Right? So it says that, uh, out of all of our beds, 20% are available and that is the threshold the County does want, does not want to get below 20% of beds being available. But again, this brings it back to the conversation about a bed and a staff member, Dr. Wilma Wooten said yesterday that, um, of the remaining beds, only 6% of them they have staff for. So that means that there's a 14, a gap of 14% of their beds that they don't yet have staff for. So that's a situation that they would have to, if they need those beds, they have to find the staff and bring them into care for the individuals that would take them up. Speaker 1: 06:40 I mean, in short, if I need to go to the emergency room, is there enough staff, are there enough resources to treat me? Speaker 2: 06:47 That's one thing that everybody wants to be clear about is that they don't want people to fear going to the emergency room, because there has been some concerns that people earlier in the pandemic delayed going to get care. And there were some, um, you know, the outcomes that we didn't want to be seen, that you could have actually prevented such as if you like, maybe you have a stroke coming on, go to the emergency room. They want people to come in and get the care that they need. And, um, you know, I've, I've talked to Dimitrios Alexia at the hospital association. He continues to say that hospitals are very resilient. Hospitals have planned and trained and have surge, uh, surge plans in place that they can activate to take on these patients. It's constant that they do year round. Obviously this is a far more unprecedented situation where it's going on a lot longer. Dr. Wilma Wooten said short term, we can certainly handle this kind of crunch on our hospital system. Long-term is where it gets very difficult. And that's again, why she's pushing, they're pushing people to adhere to the restrictions that are in place. But again, they do not want people to not go and get care when they actually need it. Speaker 1: 07:49 I've been speaking with KPBS health reporter, Taryn, mento, Taren. Thank you. Thank you.