Update: Stanislaus County’s ICUs in critical condition due to COVID. Where will patients go?
On Saturday, the number of staffed intensive care unit beds available in Stanislaus County increased to eight of approximately 122 beds, 6.6%, up from the 4.6% the day before.
The capacity of ICU beds in the San Joaquin Valley region, Stanislaus County’s next tier for medical resources, is also stretched to its limit, has hovered around 4.5% of available staffed beds in the past few days.
The bed count fluctuates, in large part based upon the number of staff available. In comparison in the severe influenza season in 2017-2018, flu patients occupied 37 beds, and currently confirmed or suspected COVID-19 patients occupy 63 beds, more than half of all ICU beds.
With such severe shortage of ICU beds and staff to care for critically ill patients, the county’s surge plans are already in place.
“Since the pandemic began, we have been working with the hospitals to put in our surge plan,” said Kamlesh Kaur, spokesperson for county public health.
As the county approached 3,300 presumed active cases by Saturday, the surge plan, which didn’t need to be implemented earlier in the pandemic, likely will come into play soon.
Kaur said the first step is that local hospitals can ask for assistance with outside staffing, equipment or personal protective equipment. PPE has been the most common request from local hospitals.
However, one unidentified local hospital has requested and received additional staffing with this month’s influx of patients.
Representatives from the local hospitals said their facilities are seeing a lot of COVID-19 patients, and though their resources are stretched, they’re poised to take care of people..
“We have been preparing and continue to prepare for the surge of critical patients in our community. Given the recent increase in hospitalizations, we are closely monitoring the census in our hospitals and will make rapid adjustments as needed,” said Krista Deans, spokesperson for Doctors Medical Center and Emmanuel Medical Center.
A Sutter Health spokesperson said in an email, “Current case levels have required activation of the hospital surge plan, which includes adding more staff where needed. Sutter Health is using the full breadth of our integrated network to manage capacity and support patient care.”
“Everybody is seeing COVID-19,” said Joann Saporito, vice president of nursing at Oak Valley Hospital, “We’re managing just like everybody else and we’re ready to take on patients. We’re here to serve.”
Oak Valley is the smallest acute care hospital in the county, with 35 inpatient beds and five adult ICU beds, and it can surge to add 17 beds and up to 10 ICU beds, said Saporito.
A Kaiser Permanente spokesperson said in an email that their facilities are seeing about a third more COVID-19 cases than their peak in June, and they have the ability to surge hospital beds up 70%. In addition, as an integrated health care system, Kaiser can relocate patients from a heavily impacted facility to sites that are less so.
If more capacity is needed, the county can activate the county-wide surge plan, including diverting non-ICU patients to state-supported facilities outside of the region.
“As of today (Friday), our county has not sent any patients to the overflow ARCO/SleepTrain Arena in Sacramento,” said Kaur.
The former practice facility of the Sacramento Kings was set up for patients early in the pandemic but was not needed and has been in “warm-up” status. The facility was reactivated on Wednesday and can expand to accept as many as 240 non-ICU patients, with and without COVID-19, according to California Office of Emergency Services.
“There have been two patients admitted to Sleep Train,” Brian Ferguson of the CAL OES communications office said Friday afternoon. “We are in constant communication with local hospitals to see if any additional patients can be served there.”
The goal of the overflow facility is to free up health care resources in local areas to care for critically ill patients.
Infrastructure and staffing limitations
Should demand continue to outpace the infrastructure, such as actual beds available in the local hospitals, the county Office of Emergency Services can open the alternative care facility on Scenic Drive, the former county hospital, to care for non-COVID-19 patients who do not need intensive care.
Kaur said that last spring that facility was rehabilitated and equipped to function again as a hospital, but hopefully it will not be needed, as staffing it may drain the already limited pool of heath care personnel in the area.
One option to find additional health care workers is tapping into the California Health Corps instituted last spring. Initially, nearly 93,000 nurses, retired doctors, respiratory therapists, medical students and other professionals signed up. But last week, a report in The Sacramento Bee said only 1% of those volunteers are available, due to inadequate credentials and technical difficulties.
With more than 15 million infections and 290,000 deaths nationwide to date, according to the Centers for Disease Control and Prevention, recruiting health care professionals from other states, as happened last spring with New York, isn’t feasible. Health care workers are needed in their home communities.
Another possible resource is deployment of the National Guard, which has occurred in other areas of the U.S.
Last week in an attempt to stave off depletion of health care resources, Governor Gavin Newsom imposed a stay-at-home order linked to regional ICU capacity of 15%. Stanislaus and the 11 other counties in the San Joaquin Valley region went under that order last Sunday when the ICU bed capacity fell to 14.1%.
Over the past week, local ICU beds have been filled, and more than half of the patients have confirmed or suspected infection with COVID-19.
“We give our ultimate pleas for our community to heed all of the recommendations. Please stay home, it’s the single best way to avoid getting or spreading the virus,” Kaur said. “This is the time.”
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.
To help fund The Bee’s children’s health and economic development reporters with Report for America, go to bitly.com/ModbeeRFA
This story was originally published December 11, 2020 at 12:16 PM.
