1,000 new COVID-19 cases in Stanislaus; short staffing, crowding lead to long ER waits
Stanislaus County recorded 1,002 cases of coronavirus infection over the weekend, signaling a growing COVID surge expected to put more pressure on local hospitals.
The updates posted on Mondays by the county Health Services Agency usually include new cases from over the weekend. The county reported six deaths in addition to the new cases, which represented a three-day total.
According to the update Monday, hospitals in the county had 283 COVID patients, including 71 in intensive care units. The COVID hospitalizations are up from 278 on Friday and the ICU admissions are the highest mark since the delta variant surge began in July.
Intensive care unit admissions for COVID-19 ranged between 54 and 58 last week. A state dashboard reported 314 hospitalized patients with COVID-19 in Stanislaus. The state number includes a few other facilities that accept COVID patients from the five regular hospitals.
The state said 13 intensive care beds were available in the county as of Sunday.
The pressure on the hospital system mounts as patients wait for hours in the Emanuel Medical Center emergency department in Turlock.
The busy emergency department is often staffed with only three nurses, when a staff of nine nurses is the norm, said Raechel Bairos, a unionized ED nurse at Emanuel who spoke with The Modesto Bee.
The short staffing has pushed the wait times for patients in the emergency department to four or five hours, she said. It can also make ambulance crews wait longer to hand over a patient to the emergency room.
“We have to make do with what we can,” Bairos said. “It is backing up the whole system.”
A spokesperson for Tenet Healthcare said administrators are working to address the problem.
“Our hospital is able to safely treat those who come to us for care and our teams’ focus, as always, remains on providing excellent patient care,” the spokesperson said. “... Like many hospitals across the country, we are facing a nursing shortage, exacerbated by the COVID-19 pandemic. To support our care teams, we have redirected some nurses who are working in other areas and we utilize them where needed. We also offer incentive pay for numerous positions including nurses, techs and respiratory therapists for those choosing to work additional shifts.”
Bairos attributed the short staffing to nurses being out with COVID illness and employees not willing to put themselves and family members at risk of exposure to coronavirus in the hospital, which she understands. But she also believes the hospital didn’t plan for the next surge, as the problem with short staffing goes back to April or May.
In Stanislaus County and elsewhere, hospitals have struggled to hire additional nurses and maintain staffing during the coronavirus emergency.
In a 12-hour shift, one nurse is in Emanuel’s emergency room lobby prioritizing the patients with the most urgent medical needs. The two other nurses each care for seven or eight patients in the emergency department rooms. Bairos said a single nurse usually takes care of four patients at full staffing.
The union representing the nurses at Emanuel said the limited staffing raises patient safety issues. The nurses in the ED fill out “Assignment Despite Objection” forms to let their director know the shift was short-staffed and not safe for patients and nurses, the union said.
A Turlock doctor said he sent a patient with chest pain and possible signs of heart disease to the emergency department for an expedited workup. The nurse in charge said there was a shortage of staff and no one could examine the patient, the doctor said.
The traffic coming to the emergency room is a combination of people with COVID symptoms and others with general medical issues who, after 17 months of the coronavirus pandemic, are no longer afraid of coming to the hospital, Bairos said.
Nurses represented by National Nurses United said they have talked with Emanuel officials about increasing staff in the emergency department. In addition, the hospital could fill gaps with travel nurses, she said. The Tenet spokesperson said hospital administrators are working to bring additional traveler nurses onboard, including in the Emergency Department.
The delta surge has been taxing for hospitals in the region, though perhaps not as severely as in December and January.
Statewide, almost 30% of ICU beds were in use for COVID patients, according to data collected by the U.S. Department of Health and Human Services from 402 hospitals in California in mid-August.
As of the week of Aug. 19, Memorial Medical Center in Modesto had 37 of 41 intensive care beds filled with patients, leaving 9.76% available, according to the HHS data. That was before COVID-19 admissions in the past week. The county Health Services Agency no longer provides daily updates on ICU availability.
Doctors Medical Center had 370 inpatient beds occupied by COVID and non-COVID patients, with 57 patients in intensive care and few ICU beds available.
Emanuel Medical Center had 124 inpatient beds occupied as of Aug. 19, with 10 of the 18 ICU beds in use, according to HHS.
Dr. Julie Vaishampayan, the county’s chief public health officer, told county supervisors Tuesday the current surge is mirroring the wave of coronavirus in summer 2020, as shown by a recent 7-day average of 47.4 cases per 100,000.
She said hospitals are stretched because of the influx of COVID patients but also wildfires leading to evacuation of communities and nursing homes.
“We get asked every day to find beds for people,” Vaishampayan said.
The county has pulled back on major efforts to vaccinate the population after the turnout dwindled at large vaccine clinics. Targeted county clinics, drugstores and community health clinics are still sources of COVID vaccine, injecting about 1,300 doses per day.
About 50 percent of eligible county residents (age 12 and over) are now fully vaccinated and 14.8 percent are partly vaccinated.
This story was originally published August 31, 2021 at 7:07 AM.
