ICU Staffing Shortfalls

ICU capacity continues to fall in the southern California region, while the number of covid-19 cases continue to rise. San Diego county health officials reported 15 deaths and about 2100 new infections on Wednesday. But health officials are concerned about staffing to handle patients. While the county has 20 percent of its beds available... it can only staff six percent of them. County public health officer dr Wilma Wooten says hospitals have to determine how to staff those beds. THAT’S THE ISSUE AND KIND OF CHESS GAME THAT HAS TO BE PLAYED IF WE REACH THAT POINT. AND THE HOSPITALS HAVE A PLAN FOR THAT. (:10) Dimitrios Alexiou (uh-lex-ee-ooh) leads the Hospital Association of San diego and Imperial counties. He says hospitals can add space with emergency tents. But to meet staffing needs, they may seek relief from a state law that mandates certain nurse to patient ratios. there are some options as it relates to capacity. but again, i would still put it back on staffing that we need to figure out and continue to work at having adequate staff, whether it's state helping us, whether it's flexing nurse staffing ratios But the california nurses association told kpbs operating outside the ratios can affect patient care and nurse safety. A spokeswoman says she’s worried the state’s hospitals aren’t first exhausting other options, such as canceling elective surgeries. She also noted that some healthcare providers in the state have even laid off nurses during the pandemic. County Healthcare officials say they’ve faced situations in some flu seasons when icu capacity has been very low--- but they say the challenge with coronavirus is the long recovery time for infected healthcare workers. They say they cannot sustain long term operations when ICU beds are 85 to 95 percent full. It’s Thursday, December 10th. This is San Diego News Matters from KPBS News. I’m Anica Colbert. Stay with me for more of the local news you need to start your day. Governor Gavin Newsom has reversed course on last week’s order to close playgrounds due to the statewide surge in COVID-19 cases. KPBS metro reporter Andrew Bowen says many parents are relieved. AB: Parents and kids wasted no time in taking advantage of the reopened playground at Trolley Barn Park in University Heights. When ICU capacity in Southern California fell below 15% last week, the state ordered playgrounds closed. But parents and lawmakers pushed back, and the governor relented on Wednesday. Nickolas Estrada was glad to get out of the house with his 3-year-old daughter, Amora. NE: I'm a single father, so I'm trying to do the best I can to keep her engaged as well as myself with everything going on. It's definitely been difficult. Just trying to take it day by day and wake up and find new things to explore to keep her engaged and myself. AB: The state is still advising parents and children to social distance and wear masks, even outside. Andrew Bowen, KPBS news. Not surprisingly, THE SAN DIEGO ZOO AND SAFARI PARK ARE CLOSED TO VISITORS. Its the THE SECOND TIME THIS YEAR they’ve shut down BECAUSE OF THE RAPID SPREAD OF THE COVID 19 VIRUS. KPBS ENVIRONMENT REPORTER ERIK ANDERSON HAS DETAILS. The visitor attractions are following state orders to shutter their operations to help slow the spread of the coronavirus. The parks will continue to have essential workers on site to make sure that the animals living there get the care they need. Zoo officials released a statement this week saying the urgent work of saving endangered species around the globe will continue unchanged in the face of the pandemic. The statement went on to say that zoo officials are thinking of their dedicated employees and volunteers who make the parks special places to visit. They say they look forward to the day when they can welcome guests to the facilities again. Erik Anderson KPBS News Stater Brothers Markets are once again giving employees hazard pay due to the srurge in covid-19 cases. KPBS reporter Jacob Aere says a grocery workers’ union is trying to get other stores to follow suit. The United Food and Commercial Workers International Union, or UFCW, came to an agreement with Stater Brothers Markets to reinstate the company’s $2 per hour hazard pay. President of UFCW Union, Local 135, Todd Walters says Stater Brothers is among the minority of grocery stores to give bonus pay to their employees. “Kroger which is Ralphs, Food4Less, they are not doing it. They were the first company to pull out from doing it. We’ve asked them continually to please reinstate the hazard pay.” The UFCW is demanding that retailers and grocery companies also provide free personal protective equipment, paid sick leave and COVID-19 tests to all employees, in addition to hazard pay. Jacob Aere, KPBS News. A new report finds veterans are struggling to file claims for VA benefits during the pandemic. KPBS Military Reporter Steve Walsh says many vets are being improperly denied health benefits because they can’t get in to see a doctor. Marc Session got a late start. He was 34 when he entered Navy bootcamp. Like many vets, he has lingering issues from his time in the service, especially with his back. He’s been wrestling with the VA benefit’s process since he retired in 2017. This year, during the pandemic, the real issue for the Chula Vista vet has been getting in to see a doctor. “I was initially scheduled in February, then it was rescheduled until September, then in October they said it would be scheduled in November.” Even in a normal year, Session says the VA claims process is long and exhausting. “It’s very frustrating. I want this whole situation to be over. Finally not have to worry about any more exams...I just want to be done with it. Get it out of the way so i can move on.” Beginning in April, the VA shut down all in-person appointments. Everything moved on line, including doctor’s appointments. The backlog of exams ballooned to 1.5 million during the pandemic. A new report by the VA’s inspector general also says thousands of claims were improperly denied. (pop) This after VA leadership declared that NO Vet should have their claim denied because it wasn’t safe to see a doctor. “They didn't get the memo, because there was so much happening.” Session’s attorney Attorney Casey Walker once worked for the VA. As he put it, some VA employees just didn’t get the memo. “A lot of these employees worked from home for the first time, ever. A lot of them not being too capable with their technology at home. They always worked at the regional office, their entire lives.” The VA made the backlog worse, Walker says, by telling outside mental health providers they could not evaluate their patients remotely when it came to filing VA benefit claims. At the same time, VA was telling its own doctors and contractors to only see patients using telehealth. “Almost in the same month, they said you must do all mental health exams by telehealth means. Then I thought, what gives here?” The VA’s website shows nearly all of the country is open for in person exams to some degree, to chip away at the backlog of 1.5 million exams. Maura Clancy handles veteran benefits appeals for Chisholm Chisholm & Kilpatrick, a national firm based in Rhode Island, which has clients in San Diego. “I have noticed more examination reports coming in. So I know they are working on some of the exams that were pending throughout the pandemic. So that’s a start.” Instead of scheduling new visits, she says the VA could also lean more heavily on using existing medical records -- at least for now. The VA told their inspector general they are looking at cases denied during the pandemic. Vet’s shouldn’t count on their cases being reopened, Clancy says. Instead, vets should assume they’ll have to step up on their own and file an appeal. “It only helps to be able to point to what VA’s guidance was in the beginning of the pandemic, which was those denials weren’t supposed to happen. And hopefully, they will take some corrective action.” The VA has been trying to clear away its backlog of benefit claims for years. A new law went into effect a year before the pandemic, designed to speed up the process. According to advocates who help guide veterans through the process, juggling a new system and a pandemic, probably created even more cracks in the system. Steve Walsh KPBS News. That was KPBS Military Reporter Steve Walsh….. Coming up on the podcast….a new book of historical photographs gives a behind-the-scenes look at the history of San Diego during the 1960s and 1970s, and also explores how one man shaped the look of the city today. “In the seventies he made redevelopment a number one priority, and out of that came Horton Plaza shopping center, the convention center, the trolley, downtown offices, office towers and housing.” We hear from retired San Diego Union-Tribune journalist Roger Showley on how pictures from the archives of the San Diego History Center and the Union Tribune shine a light on how San Diego came to be. If you go back 50 years ago in San Diego. Things were really different... UC San Diego and the Salk Institute were in their infancies, San Diego State was a college, not yet a university. The Padres didn’t join the Major leagues till 1969, when they had a brand new stadium a few miles east of the brand new Sports Arena. And if you wanted to go to LA in the early ‘60s, good luck … Interstate 5 was yet to be completed. These milestones and much more are included in San Diego Memories: “A Time of Change: The 1960s and 1970s.” KPBS Midday Edition Co-Host Mark Suer spoke with its author, longtime San Diego journalist Roger Showley. Here’s that interview…. That was long time San Diego journalist Roger Showley speaking with KPBS Midday Edition Co-Host Mark Sauer. That’s it for the podcast today, thanks for listening and have a great day.