There are 1,200 hospital beds in Stanislaus County. Are they enough during pandemic?
Even as the Office of Emergency Services activates to the highest level, the inventory of medical resources in Stanislaus County remains unclear.
That leaves the imposing question: Is the county ready to meet a potential surge, the so-called massive healthcare demand due to the coronavirus?
One look at the county’s Pediatric Surge Plan from last year would indicate the county falls woefully short if tethered to Governor Gavin Newsom’s model of “worst case scenario,” with 56% of Californians getting COVID-19.
Following that model, 308,000 of the 550,000 Stanislaus County residents will get infected. With a predicted 1 in 5 requiring hospitalization, 61,000 beds will be needed, as well as equipment and staff to care for them.
Even a conservative 10% needing hospitalization would overwhelm the county’s roughly 1,200 beds reported in public county documents.
Despite several requests over the past two weeks to get specific information, and an answer to whether Stanislaus County would be prepared for a surge, which its top health officer said Wednesday night could be two weeks away, nobody at the county government level could shed light.
A Bee reporter was referred to Lance Doyle of Mountain Valley Emergency Medical Services Agency, which is the Medical Health Operational Area Coordinator responsible for processing all request for supplies such as personal protection equipment and ventilators.
Doyle could offer no specific numbers of available hospital beds, ventilators or other equipment.
On Wednesday, in the same Facebook Live panel discussion in which she predicted an April surge, Vaishampayan was asked if high-risk people should be concerned about a “lottery for ventilators, as rumored to be happening in Italy: “Our stay-at-home strategies were implemented early enough that I don’t think it’s going to come to that in this county. I think we are going to go through this fine. We are going to manage our surge, and we will be fine.”
Indeed, Newsom’s scenario was if no community took action, and Stanislaus County declared a “stay-at-home’ policy last week.
As of Thursday morning, 13 people in the county have been reported as testing positive for COVID-19. Nearly 500 have been tested, according to state data that does not necessarily include tests routed through private labs.
Barbara Eusebio, chief nurse executive for Modesto’s Memorial Medical Center, told The Bee Tuesday her hospital did not have a high volume of coronavirus patients and felt confident her facility was prepared. Warren Kirk, chief executive officer of Doctors Medical Center, said Tuesday his hospital has had one COVID-19 patient.
Stanislaus County health care infrastructure
To be sure, it’s virtually impossible to anticipate and stockpile every item needed for every potential crisis, but that’s exactly what disaster preparedness plans try to do.
Nationwide, OES staff work at all times, to develop preparedness plans for the plausible disasters in their respective areas, such as wildfires, earthquakes and floods seen in California, as well as global events including pandemics.
The Director of Emergency Services, or designee, can activate the medical surge. In Stanislaus County, Jody Hayes, county CEO, holds that title.
County-level OES is only one piece of the response team. Emergency preparedness and response is multi-agency and includes government and private sectors at the county, regional, state, national and even international levels.
The American Red Cross is one example of a nonprofit organization considered essential in disaster preparedness.
The “every day” shortage of the health care workforce in Stanislaus County and the Central Valley is an additional hurdle to meeting the potentially high demand for medical care, as seen in the early COVID-19 hotbed areas, including Seattle and Italy.
The existing pool of doctors, nurses, EMTs and others may be asked to work excessive hours or outside of their usual scope of practice.
Part of the surge plan includes accommodations to support the health care workforce, first responders, law enforcement and other essential personnel.
As noted in San Joaquin County’s surge plan, arrangements for caring for children, pets and other household dependents of essential personnel are part of the plan.
Local hospitals and inpatient beds
According to the county’s 2019 emergency operations plan, there are eight licensed acute care facilities and roughly 1,200 beds — Doctors Medical Center with almost 400, Memorial Medical Center with 425, Emanuel Medical Center with 219, Kaiser Permanente with 125 beds and Oak Valley Hospital with 45.
Doctors and Memorial Medical Centers are both Level 2 trauma centers, which means 24-hour emergency care, immediate coverage by general surgeons, as well as some specialty services that are likely to be needed in an emergency, such as intensive care.
The three smaller acute care facilities include Central Valley Specialty Hospital, Stanislaus Surgical Hospital, and HealthSouth Rehabilitation Hospital of Modesto.
No local facilities are designated as Level 1 trauma centers, the highest level of care, which includes services for pediatrics and more medical specialties.
Eighty-eight ICU beds designed for adults are available in Stanislaus County, according to a report from the Kaiser Family Foundation. None of the facilities have pediatric intensive care units.
These number of licensed beds does not account for the possibility to bring on board other facilities as part of the surge. Outpatient surgical care centers, doctors’ offices or clinics can be converted into make-shift hospitals.
It is not known if Stanislaus County or any of the adjacent counties will receive military-style field hospitals, called Mobile Army Surgical Hospital, or MASH units, though the federal government has listed them as part of the surge response.
In 2017, OES published the Stanislaus County Care and Shelter plan, which identified 84 shelters that could be opened under the operation of the American Red Cross to provide sheltering for displaced people, including caring for those with minimal medical needs.
There also is a disaster mutual aid system where surrounding counties or regional healthcare agencies can offer support.
Stanislaus County is part of Region IV in the Inland Region in the statewide emergency plan, which includes Sacramento, San Joaquin, Nevada, Placer, Yolo, El Dorado, Amador, Calaveras, Alpine and Tuolumne counties.
Each county has agreed to come to the aid and to maintain communications with other counties in their region, as well as statewide.
For example, since there are no pediatric intensive care beds in Stanislaus County, a child that requires ventilator support could be cared for during an emergency at Doctors Medical Center, stabilized and then transferred to UC Davis Medical Center in Sacramento for ongoing care. If UC Davis is full, the surge team would know the contact at state level and arrange for the child to go a facility with open beds, such as Oakland Children’s Hospital.
Doyle’s Mountain Valley agency plays a critical role in communicating with county hospitals.
“The EOC (emergency operations center) receives daily reporting from our Agency regarding bed availability, which is a snapshot at the time the hospitals report.,” Doyle said. “This is conducted every morning. During an event like COVID-19, hospitals conference with each other, public health, MVEMSA and OES to determine appropriate actions to take on a county-wide level.”
How to help
First and foremost, stay home and heed directives from Gov. Newsom, CDC and other public health officials.
The American Red Cross needs blood donations, but please call ahead at 1-800-733-2767.
CrossPoint Church is collecting donations, especially of PPE and disinfectant supplies, to aid health care personnel. Please visit their website for the drive-up, drop-off times at https://cpmodesto.org
The full Stanislaus County Emergency Operations Plan can be found here: http://www.stanoes.com/pdf/sc-eop.pdf
This story was produced with financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with the GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of this work.
This story was originally published March 26, 2020 at 12:28 PM.
