Palomar Field Hospital Could Provide Relief To Overburdened Imperial County
Speaker 1: 00:00 Imperial County is one of the hardest hit by COVID-19 in the state. Nearly 21,000 people have tested positive for the coronavirus. There that's more than 10% of the population. 406 people have died. The El Centro regional medical center is bearing the brunt of the virus. It had a six bed ICU capacity in March and has increased to 49 beds today. And the hospitals can't handle many more patients. Even the parking lots are nearly at capacity. Some relief though is expected to come in the form of a field medical facility at Palomar hospital in San Diego County. Yesterday, I spoke with Adolf Edward. He is the chief executive officer for El central regional medical center. I started by asking him to describe the situation the medical center is facing Speaker 2: 00:47 Well, we've been really heavily hit this community with COVID 2.0 the second surge, uh, from the Thanksgiving wave is hitting us very much stronger than the first wave and the height of the first wave. We were at the highest number of 65. COVID positive, but now we're sitting today, uh, December 23rd at one 30. And, uh, we're anticipating probably that number to go up and the next, uh, week to one 80 and then over 200 COVID positive patients in a couple of weeks. Speaker 1: 01:22 And the governor announced that there will be a field hospital set up at Palomar. Um, will that provide any sort of relief for your hospital? Speaker 2: 01:31 Well, we have actually been pushing for that field hospital to become active and polymer, uh, starting in April. I'm glad that the governor is, um, finally getting it up and running, frankly speaking. Uh, it's going to help, uh, decamped the hospital here in Imperial County. And I know talking with Dr. Dave Duncan, the idea that we've been proposing all along, and I've been actually a very advocate of this, like I said, since April pushing for it, um, as to open that hospital and increase the ICU capability there so that I can put out some of the patients that I have here, there, because I'm going to be receiving more ICU beds. Just to give you an example of what I'm talking about. We've gone from six ICU beds. We're now sitting at close to 49 ICU beds, and we have a, what is equivalent to 69 ICU bed capability here. That's a huge increase in ICU. So the Palomar hospital, I want to thank Diane Hanson, the CEO there, and her team for working hard to opening that that's going to help us in Imperial County. Hmm. Speaker 1: 02:32 And the medical center has received assistance in the form of disaster medical teams as well. Tell us about that. Speaker 2: 02:38 Absolutely. We are now on our fourth, uh, disaster medical assistant team. Um, we've had, uh, three in the first wave. We have one today leaving today. We're B that that team is being replaced by both, uh, what we call title 32, which is a reserve a unit coming in then today at they start working tomorrow and, uh, uh, the department of health and human services, FEMA, federal team, that's coming in to help support us. Those themes are coming in at a great timing because we're not only have 10% of our, um, um, employees, uh, being affected, but by Corona, but also we're extremely tired and exhausted. We've been at this for nine months and it is nonstop. And now we are deeper into the second wave. Speaker 1: 03:31 And, and what is the medical center doing to be able to add more beds, to care for additional patients right now? Speaker 2: 03:37 So as you know, a lot of, uh, hospitals and I'm reflecting, uh, of one of those hospitals we've stopped, uh, stopped elective surgeries, um, two, three, four weeks ago into the second wave. Um, and we've converted all of the ORs into ICU capability. We've left too, of course, because we continue to have emergency surgeries that are required and we need to do those, but no elective procedures. Uh, so the areas back there have been converted to in the OARRS have been converted to overt positive, uh, rooms, uh, for, for patients that are coming in, we've taken over the PACU area. Um, we have expanded outside in the facility itself. You'll see us busting at the seam in the parking lot with dense. Uh, those have expanded our capability. We've added, um, new areas. We've we have, I think over 132 negative pressure rooms in the hospital, um, where kind of physically beyond the capability of the structure itself. And now with the last two tenths coming here and do additional tents, uh, in the emergency room side to expand my, uh, ed, uh, bays or beds there, that's going to be coming in the next week, were going to be running out of, even space in the parking lot for any more tents. So this is capacity. That's why Palomar is coming in very critical timing because we don't want to turn anybody away. Speaker 1: 05:12 Um, and with that in mind, what are your main concerns now for being able to treat the patients currently hospital, Speaker 2: 05:18 There is going to be some critical conversations that will have to happen in the emergency room. We have to make sure that the families are aware of what their loved ones are encountering and experiencing these honest conversations are difficult, especially with the fact that we can't really let the family members come in. Uh, we're trying to do everything and anything that we can to expand and extend the communication cycle. It's very hard, we're busy and we are attempting to connect with families, but at the same time, make sure that the patients are aware of their clinical circumstance and what is going to happen to them next. And that's always critical, but it's key in our conversation. And it's our responsibility to ensure that they know how their outcomes are and where they're headed Speaker 1: 06:09 In the ICU bed capacity in the County is almost non-existent or is it nonexistent at this point? Speaker 2: 06:16 Well, so I can, I can tell you that, um, every time, and I want to make sure that you guys are aware of it. Can we say that it's near zero and we've got 32 COVID positive patients sitting in ICU. We have two ICU beds left, but really if I count some of the med surge or medical surgical rooms that have been converted to accommodate ICU level care, then my number really is 69 beds. So we are doing everything and anything we can do, but the critical factor today is the ICU staffing. And I'm grateful to hear or have heard that we're going to be getting 10 more ICU nurses. If that does happen in the next 48 hours, I'm going to expand my ICU capability to be able to accommodate the wave because unfortunately, the patients that are coming now are coming in with higher co-morbidities much sicker. And I'm sure you guys are hearing that the Mexicali hospitals have closed down. Even the private hospitals are closed down. A lot of the folks that have the right paperwork to cross the borders and, or our us citizens that can come back here are coming to us and they're driving directly to our EDS. So we don't know what impact that's going to be, but our ICU capability all is dependent today. And our ICU nursing a man, Speaker 1: 07:46 What happens when you reach your, your expansion capacity, Speaker 2: 07:52 Um, Palomar kicks in. That's why if I'm able to have fellow Mar, as I talked with Dave Duncan this morning, we're very clear. I'm so grateful that the governor is putting in the resources to open Palomar. We can move, uh, 10 patients out of a hospital here that immediately freeze me for 10 ICU capabilities. Um, and that is actually the level of conversations we're having. We are asking to have priority to move patients out of here. As soon as Palomar opens, we were told this morning that it's within 24 to 48 hours. Speaker 1: 08:26 Do you foresee a situation where you'll have to ration care, Speaker 2: 08:30 Ration care has been discussed all along crisis. Standards of care are very key and critical to understanding what conversations we have to have. They are key in moving forward on what we need to do, but the reality is rationing of healthcare resources in communities like mine that are predominantly Hispanic as a well known fact across not just us across border cities. What we need to do now is worry about who gets the last event, but the state is promised by the way, I just received good news right before the call, and we're going to be receiving 10 additional comprehensive vents. So imagine if you will, today, I have a total of 78 patients on vents. All of those are COVID positive. I have 22 available vents that are comprehensive and I've just added another, um, uh, 10 that's coming from the States. So I'm going to have 32 comprehensive vents. I have a total of 105 other types of events like high flow, nasal cannulas, and BiPAPs. So I've got the ability technically to take care of them. Now, will I have the staff and the beds to be able to put the patient in the, in the bed and take care of them? That is the next ethics question that we're going to be dealing with. Speaker 1: 09:52 Mm. And so how does the Corona virus complicate your ability to then do the expansions that you need, um, without further spreading the virus? Speaker 2: 10:01 Well, so the good news is we have believe it or not vaccinated 328 out of our 1,100, uh, staff members so far in a matter of 24 hours. And the vaccine is the Pfizer vaccine. We've received that through the distribution from the state. I came down through the County to us. Uh, today we have another clinic that we're setting up at five o'clock and we're going to be vaccinating another 150. So we'll be climbing closer to 550 hearing for our staff first because we don't want them to, um, get COVID-19. Uh, we have been doing a lot of work on their mental health and my mental health. So it's everybody that's involved. Every single individual's mental health has been looked at because it's very key and critical. And then the last piece to all of this is to ensure that those teams that come in actually are rotated in areas where our team has been working nonstop. Speaker 2: 11:00 So we can give them just a little bit of a break, and I'm not talking about a break so that they can travel in a van or a bus or a truck or on a plane for, you know, two weeks. I'm talking about just a 24 hour rest period. I'm talking about 48 days, so that maybe get a meal at home, relax, watch some TV and come back, uh, and be put on the, uh, the schedule. Again, those are kinds of the things that we're looking forward to doing, just to give ourselves a little bit of a break, but I'm going to tell you, we have a very resilient staff here. They've done phenomenal. And I can't thank them enough. Speaker 1: 11:37 And going into the Christmas holiday, we're hearing pleas from doctors across the state for people to stay home, not together with family and friends, what would happen in the Imperial Valley? If the governor's prediction of nearly 100,000 hospitalizations came to be, Speaker 2: 11:54 It's going to be extremely dark winter. I think I'm quoting Dr. Fowchee, right? It's going to be difficult. I, we don't have the space for the numbers that you're talking about. I'm really hopeful. And by the way, I love for you to put out there that we've put a video that I made with my marketing team that says, don't be this dummy. We show a dummy. We show him connected to all of the vents and all of whatever we need to do to care for them. We ask people to be careful. Um, we ask people to think about their loved ones for 2021, make sure that they're there for next Christmas. Not this Christmas. We ask people to care for them, loved ones, not to want to have the meal this year and forget the fact that they won't have Mel next year, because there's going to be one or two missing chairs from their family dining room. We ask people to think twice about traveling, uh, uselessly for something that is not going to help them, but will hurt them. I don't know what else we can do, frankly speaking, but we would love for you to put out the word, because I know you guys have been active pushing people, listen to you more than they would ever listen to us. Um, the stay at home, these wash your hands and please keep the mask on. Okay. Speaker 3: 13:12 Been speaking with Adolf Edward chief executive officer for El Centro, regional medical center. Thank you so much for joining Speaker 2: 13:19 Us. Thank you very much, KPBS.
