More COVID-19 patients are filling hospital beds in Stanislaus County. Will it get worse?
Hospitals are holding up as the coronavirus becomes more widespread in Stanislaus County, said representatives, who are concerned about a recent surge in COVID-19 cases.
The patient surge has put the county on the state’s watch list and threatens to reverse the reopening process in a county with a 16.1 percent unemployment rate.
According to the county Health Services Agency’s online dashboard, local hospitals were caring for 82 people with COVID-19 illness Thursday, with 27 of the sickest patients in intensive care units.
When the county asked the state for a variance in May, allowing restaurant dining and shopping centers to reopen, the five hospitals were caring for a total of 20 patients with COVID-19 per day.
The surge in new coronavirus cases, averaging 67 per day in the past week, occurred after retail stores and additional sectors were reopened in Modesto, Turlock and the seven other cities in the county. It continues to send residents to hospitals complaining of a high fever, cough and trouble breathing.
“We have seen an increase in COVID patients over the last week but this is something we have planned and prepared for,” Cheryl Harless, chief nursing officer at Doctors Medical Center, said in a statement Thursday. “We are capable and prepared to handle the increase.”
The number of hospitalizations is a key metric as county health departments in California respond to the coronavirus pandemic, which overwhelmed hospitals in New York and northern Italy.
Stanislaus officials are concerned exponential growth of the contagious disease could cause hospitalizations to double in a week or 10 days, stressing nursing staff and boosting the death toll.
One surge projection for this county, by Covid ActNow, a team of epidemiologists and health experts, predicts daily hospitalizations could reach 160 in early July and keep rising to 260 by mid-July. At that point, the county’s five hospitals would still have perhaps 300 of 1,200 total beds available, but would be suffering from impacts on staffing.
The state is keeping an eye on the surge in Stanislaus and wants to see a turn-around. Dr. Julie Vaishampayan, county health officer, summarized the state’s position in a message to a county elected official this week:
“If the county has insufficient progress, over a 14-day period, on containing their disease transmission and hospitalization rates, a county should consider reinstituting sector limitations or more general stay-at-home (orders). If the county makes insufficient or no progress, the state Public Health Officer may take action.”
So far, the impact on local hospitals is not like the chaos and heavy death toll witnessed in New York this spring, physicians said.
“The (patients) I have seen are not super sick,” said Dr. Donald Zweig, an assistant medical director at Memorial Medical Center in Modesto. “The majority of people know where they caught it. Usually, they caught it from someone in their home.”
County leaders fear if the upward curve is not flattened, the state will return to stay-home orders and closure of businesses.
Gov. Gavin Newsom at a press conference Thursday said alarm bells would ring if hospitals and intensive care units are unable to absorb additional COVID-19 patients. Capacity limitations and resource depletion are the factors that raise concern, the governor said.
About 90 percent of the 38 county residents who have died from COVID-19 are older adults, age 65 and over. But it’s more common now to see younger adults with coronavirus symptoms arriving at Memorial and Doctors Medical Center.
The significant increase in COVID-19 patients is a concern and if the numbers double again, “the county would have to start thinking about contingency plans,” said Mark Fahlen, chief of the medical staff at Doctors.
“The staff is doing a commendable job with the increased workload and stress of taking care of these patients,” Fahlen noted. “So far, the morale is good.”
Fahlen said he would like to see more social distancing and wearing of face masks by the public to help flatten the curve of hospital admissions.
Sutter Health of Sacramento released a corporate statement regarding Memorial in Modesto, saying the nonprofit health system has worked closely with state officials and health care partners “to comprehensively prepare for a surge in patients and maintain that readiness.”
Hospitals can expand capacity
Sutter said its hospitals have the ability to expand critical care capacity by two to three times if the epidemic worsens.
In response to a question about testing availability for nursing staff at Memorial, Sutter’s statement said its guidelines assign a priority to testing health care workers who have symptoms after an unexpected exposure to coronavirus.
According to Sutter and spokespeople for Doctors, testing is not provided for nurses who don’t have symptoms but might be exposed to the virus at work.
“If an employee may have been exposed to a COVID patient and are symptomatic, we provide free testing for them to rule out COVID infection,” Doctors said.
To soften the impact on the health system, the county tries to control the outbreak in the community through “non-pharmaceutical interventions”, such as social distancing, face coverings, hand-washing and isolation of infected people to keep them from spreading the illness to others.
Countries like China and South Korea have boasted success with those measures, but they have more extensive public health infrastructure than what exists in the United States.
The county is met with resistance from people who doubt the epidemic is serious and runs into language and cultural barriers in trying to track new cases in ethnic communities.
To improve access to testing in the county’s second largest city, a state and county testing site will be moved from Patterson to Turlock’s Rube Boesch Center on North Orange Avenue, effective Monday.
“It has been in Patterson for a while and we have not had a testing site in Turlock,” said Royjindar Singh, a county emergency operations center spokesman. “We have had a high number of cases in Turlock.”
Modesto, with 617 total cases, is the brightest hot spot in the county with the surge of new infections. Turlock has 263 cases, Ceres 248, Patterson 94, Riverbank 92, Newman 36, Oakdale 32, Waterford 22 and Hughson 12.
Since the reopening of retail centers and other sectors of the economy, community transmission of coronavirus has risen to 33 percent of cases, up from 25 percent in March and April.
A week ago, the county started to provide coronavirus education at the Crows Landing Road flea market. It is trying to educate groups on the proper wearing of face masks and the importance of social distancing, Singh said.
Efforts target Latino population
According to the county’s data, about 70 percent of county residents who’ve tested positive for coronavirus are Latino, a community that represents 48 percent of county population.
The county Chief Executive Office now has a liaison to organizations that work with residents in west Modesto and other neighborhoods that are hit hard by coronavirus.
Dale Butler, president of the Latino Emergency Council, a group that has advised the county on targeting coronavirus education for Latinos and migrant farmworkers, said more people need to adopt the habit of wearing face masks.
“Even though masks are required, many people are not wearing them,” Butler said. “There is a lot of education that needs to be done.”
Butler said the council’s COVID-19 team holds weekly meetings and a lot of coronavirus health information is posted in Spanish on social media sites.
“Quite a few are not taking the issue seriously,” Butler said. “Unless we take the precautions recommended by health experts, things are not going get better.”
This story was originally published June 25, 2020 at 2:49 PM.
