Southern California Stay-at-Home Order Extended As COVID-19 Floods Hospitals

Speaker 1: 00:00 After Thanksgiving gatherings and holiday shopping, COVID-19 continues to spread at a fast pace. I see user filling up to capacity, and now the governor is considering extending the state. Stay at home orders. It's an effort to slow. The spread just as vaccines are being dispersed and scientists are looking into the possibility of a more contagious mutation in the virus circulating through California. So how are hospitals fairing? Joining me is Chris van Gorder, CEO of scripts health. Chris. Welcome. Thank you very much. So the Southern California region is still at 0% ICU capacity. How is scripts doing right now? Speaker 2: 00:38 Well, right now we are 89% fault. It's actually a little bit better than we were yesterday. Uh, yesterday we only had six ICU beds available in our healthcare system today. We have 12 staff beds available, but unfortunately that's as a result of, of nine deaths. Uh, COVID deaths in the last 24 hours. And, uh, the good news is we were able to discharge 48, uh COVID patients back home again. So there's a lot of turnover of patients, a lot of admissions, um, and a lot of discharges every day, but we're staying very full. Speaker 1: 01:09 Um, and how is that impacting care a little over a week ago, we began hearing about ambulances waiting outside hospitals for hours before being able to transfer patients. Is that something scripts has experienced, Speaker 2: 01:21 I'm not aware of, of ambulances having to wait hours outside of our, um, hospitals. Uh, clearly we try to clear them as soon as we possibly can, but as I said, we're full. Um, right now, um, we have 413 COVID patients, uh, in house. Um, but we have 16, uh, in the emergency rooms right now waiting for bed availability. So anytime we have regular emergencies, plus this large amount of COVID patients that are in the emergency rooms in this case, 16 more waiting for beds inside the hospital, it will have an impact on the EMS system as well. Speaker 1: 01:57 And is the Corona virus extending wait time in the ER for care? Speaker 2: 02:02 Well, we're very busy. So care probably is extended a little bit longer. I don't have the actual numbers in front of me right now, but, uh, we try to get our patients through the system as fast as we can. Obviously most of the patients that come to the emergency room are sent home the very same day. Um, but, uh, as busy as we are, and as busy as every hospital in San Diego County is, uh, I'm sure the wait times are a little bit longer Speaker 1: 02:24 And has scripts had to transfer patients to other hospitals to increase capacity at all. Speaker 2: 02:29 We transfer patients every day within our healthcare system, we have not had to transfer outside of our system. So every day we transfer non COVID patients to open up capacity, primarily at Scripps mercy, Chula Vista and scripts, mercy, San Diego. So last night, uh, we transferred three COVID patients, one to LA Jolla and two to green hospital. Speaker 1: 02:51 And are you accepting patients from other hospitals in the County? Speaker 2: 02:54 Well, we were a tertiary healthcare system with a, with a trauma center. So, uh, we accept trauma patients from other hospitals, um, every day. Uh, that's part of our, our responsibility. We are not accepting transfers. Uh, COVID transfers right now from outside of the County, uh, Imperial County, for example, but we do accept trauma cases, uh, or, uh, cases that need a higher level of care from Imperial County that happens on a regular basis Speaker 1: 03:20 At home order went into effect on December six at scripts. Have you started to see the impact of that order? Yeah, Speaker 2: 03:26 Not really. Um, we, you know, saw a big surge, uh, after Halloween. Uh, we saw an even bigger surge as a result of Thanksgiving. Um, yesterday for example, uh, we, our, our COVID census went up by 26 patients. So that's actually a very large increase in our overall census, uh, in the County there's 1,590 COVID patients in our hospitals and our County hospitals right now. And that has been increasing every day for several weeks. So we haven't really seen a flattening out yet. And unfortunately we anticipate another surge, uh, because of Christmas. And we expect a surge on a surge on a surge, uh, after new year's, which is why we're pleading with everybody out there to try to stay at home, limit your travel, follow the guidelines, uh, because we are maxing out a hospital capacity of San Diego County. Speaker 1: 04:18 I've been speaking with Chris van Gorder, CEO of Scripps health. Thank you so much for joining us, Chris. My pleasure. Thank you. Or we turn now to Scott Evans, who is the CEO of sharp Grossmont. He's joining us from the hospital's COVID vaccination clinic. Scott. Welcome. Good morning, Jane. How are you? Good, thanks. Uh, can you tell me how staffing and capacity are holding up in your ICU is right now? Speaker 2: 04:41 Sure, absolutely. Well, it certainly has been rough Jade. Uh, right now we're using 69 of our 75 ICU beds, of course. Um, but many of those patients are extremely sick. The issue really isn't about physical beds. It's more about nursing. Uh, today actually we're doing a little bit better than yesterday, but we are running usually, uh, four or five, uh, ICU nurses short, and we tend to use nursing extenders to fill those roles, which are nurses that float in from non ICU units that cover. And so that's how we're making it work. Speaker 1: 05:15 And how does that impact patient care? Well, Speaker 2: 05:18 Um, we hope that it doesn't, but of course it could cause delays in care at any given time. And so we have, you know, a very busy emergency room here at sharp Grossmont, and we have patients that are needing to come up to beds. And so those hold times are longer in the emergency room, which I think has an impact. The other item that actually impacts that a little bit is the discharge process. And so if we have patients that are going to a skilled nursing facility, some of those skilled nursing facilities are closed to admissions at this time. And so it sort of backs up the process as you, as you might imagine, it makes it very tight. Speaker 1: 05:54 If governor Newsome's predictions of COVID cases are with 100,000 hospitalizations in the coming weeks. Do you see your hospital having to ration care at any point? Speaker 3: 06:04 Uh, well we hope not. Uh, but we certainly do, uh, have those processes in place if we need to move to a crisis level of care. Uh, San Diego County, uh, has many plans prepared in order for hospitals to do that as well as hospital and other and health systems. And so while we are hopeful that that is not the case and that we're able to continue to operate at a standard level of care we are prepared to do so if the need arises, Speaker 1: 06:33 You all been able to get any relief so far by sending patients to the Palomar field hospital, Speaker 3: 06:39 Uh, Grossmont has not, uh, sent any patients over there. Um, we are essentially monitoring our situation, you know, daily, uh, if not, uh, several times a day to see what our needs are. Uh, we are really trying to be self-sufficient to, to the extent that we can, uh, and continuing to deliver care. Um, but, but we do know, uh, that that is, uh, an available option. Uh, if we do need to use it, Speaker 1: 07:04 Have you guys had to send any patients outside of sharp? I'm Speaker 3: 07:07 Not aware of any that we have yet. Okay. Speaker 1: 07:10 Uh, you know, with scientists looking into a more contagious variant of this virus, are there ways you all can prepare for far more hospitalizations than what's being projected? Speaker 3: 07:20 Well, I think we're learning a lot right now. Um, and we're certainly learning a lot about how to manage our capacity, um, and having been doing this now for, uh, several months, I think we're actually getting better at it. Although I will say that the, um, the exhaustion level is high, uh, with, with much of our staff. Um, I think that, um, that we're, we, the things that we're learning will absolutely inform us, uh, going forward. And so, um, we, we certainly are making sure that we are always we'll have enough ventilators we'll have enough ECMO machines, uh, those type of things. And I think even as we're going forward on things like master campus planning, uh, where we're looking at, uh, capacity for, for our hospitals, I think, um, especially I know at our hospital, uh, we're certainly taking a stronger look to make sure that we're not minimizing any of the truly critical care areas, um, in, in any plans going forward. You know, um, people have thought for a long time that care is moving more outpatient, but we see that when a, a crisis and a pandemic like this develops, um, certainly that inpatient capacity is needed. And so I think that we're going to have to take a strong look at that. Speaker 1: 08:35 Is there anything you'd like for people to keep in mind, uh, as we continue in this pandemic? Speaker 3: 08:40 Yeah. I, I think, you know, people keep saying this, but it is important to reiterate. Uh, we really do have to make sure that we're doing, um, all of the things to keep ourselves healthy, uh, when vaccination is available, we certainly want make sure that folks are vaccinated. There's an order to that. And, you know, we've vaccinated, uh, literally thousands of people now at Grossmont, um, and across the sharp system, of course, and I know other health systems are doing that. I think that, uh, social distancing and masking is extremely important, um, especially around the holidays. Uh, and I know that people are getting weary of that, but that is, uh, that is what works. Um, and so we always want to, uh, uh, make sure that people are doing that so that we're here to take care of them in the event that they have non COVID related issues as well, like strokes and heart attacks. Uh, as you might imagine Speaker 1: 09:37 In speaking with Scott Evans, CEO of sharp Grossmont, Scott, thank you so much for joining us. Thank you very much, Jay. You have a great day.