Pandemic Life: The Impact On Health Care In San Diego County
Tuesday, March 16, 2021
Credit: UC San Diego
This story is part of a series, Pandemic Life: One Year On. Click here for more.
They are the places we go when we’re sick. From broken bones to heart attacks, hospitals and the health care professionals that work in them are there for us 24/7.
But last spring, something new emerged, a novel coronavirus that outside of research labs, no one had ever seen before.
Scripps Health President and CEO Chris Van Gorder remembers the early days when people were just starting to come to grips with the enormity of the COVID-19 challenge.
“It got our attention big time when it was announced that the US refugees were gonna be flown from Wuhan, China to the Miramar Air Station,” Van Gorder said.
That was last year, on Feb. 7. Van Gorder realized back then his institution would play an important role in what was to come. At that point, there were 76,000 cases of COVID-19 worldwide and more than 2,100 deaths.
“Shortly thereafter, it was March 9th ... that San Diego had its first positive case and that was at Scripps Green Hospital,” he said.
A chaotic response
As Scripps, along with other local health care providers and San Diego County officials began to gear up for what they were quickly realizing was going to be a major health challenge, guidance coming from the federal government was anything but helpful.
Speaking at the White House on Feb. 27, former President Donald Trump said "it’s going to disappear, one day it’s like a miracle, it will disappear.”
Early on, the CDC was telling Americans not to buy N95 masks — the surgical ones that have now become so familiar. The concern being there wouldn’t be enough for doctors, nurses and other health care professionals.
That guidance from the CDC didn’t change until April, when the agency recommended people start wearing cloth facial coverings. The WHO eventually followed suit in June.
Yet, despite all of that, Trump was still refusing to wear a mask in public.
“We have a committee called the HID, highly infectious disease committee," he said. In late February, the committee began meeting every day, constantly assessing the fluid situation.
“Throughout the entire pandemic, we dealt with all the things around the right medications, and you know vent utilization and staffing and all that,” McClain said.
As a sign of just how much things have improved, that committee is now meeting once every two weeks.
Vaccines in record time
Masking, hand washing and physical distancing were all we had to prevent getting infected for most of this pandemic. But then came the vaccines.
Important work on the science behind them was done right here, with the Johnson & Johnson vaccine tested in National City.
Key research was also going on at the La Jolla Institute for Immunology.
“All vaccines function based on immune responses,” said Dr. Shane Crotty, a professor at the Institute. Crotty added that he and his colleagues at the Institute knew early on that COVID-19 was going to be a major challenge.
“Within a single calendar year, we had, there was a phase three clinical trial for a vaccine. That’s phenomenal, that’s never happened before in human history and then instead, it became three successful clinical trials within a single calendar year," Crotty said.
He was talking about not only Pfizer and Moderna, but also the Johnson & Johnson vaccine. That vaccine uses a different technology, but one thing they all share in common is how fast they can be made.
Now, the vaccine supply is rising fast. President Joe Biden said in his address to the nation last week that every American adult will be eligible to get a vaccine by May 1. And, he said, every adult who wants a vaccine should be able to have gotten one by the end of May.
But getting those vaccines into people’s arms has been easier said than done.
In collaboration with health care providers, San Diego County has opened vaccination pods and super stations throughout the region. However, program has been disrupted by problems ranging from difficulties in getting appointments to vaccine shortages and bad weather.
That means a lot of work on the ground for organizations administering those vaccines. For Sharp Healthcare, it means having enough vaccine to supply five super sites throughout the county.
“We are committing to being able to vaccinate within those five super sites, a total of about a hundred thousand vaccinations a week," McClain said.
Late last month, the state designated the health insurance giant Blue Shield to transition the state’s existing provider network to a new enhanced network which is supposed to take the amount of vaccines administered per week from one to four million by the end of March.
Van Gorder of Scripps Health said things are not going well so far and that’s caused problems for them at their Del Mar Fairgrounds super vaccination station.
“It’s the most flawed supply chain process I’ve ever seen," he said. "We have no idea how much we’re gonna get any particular week … it’s very flawed and that’s what happened the other day is we scheduled out our week and then somebody in the MyTurn system scheduled an extra 1,300 doses the next day. We didn’t plan for that, we didn’t have the doses for that."
That forced Scripps Health to close the Del Mar site for a day and then this past weekend they had to close the site again, once again due to scheduling snafus, leading to a shortage of vaccine, but this time the closure lasted three days.
A better future
Still, COVID-19 has brought some silver linings to health care. We know a lot more about how to treat it now than a year ago, and innovations made necessary by the pandemic are likely to have a lasting, positive impact.
Van Gorder pointed to the meteoric rise of telemedicine. He said before the pandemic Scripps Health had done maybe two dozen telemedicine visits. Then, within weeks, "we were doing tens of thousands," he said.
It was the same case at Sharp. "That has taught us all sorts of things about what appropriate use of telehealth is," McClain said.
So now, we as a society can say "what a difference a year makes."
The vaccine supply is ramping up fast. And what everyone from the president on down to local health care folks are hoping for, pleading with all of us to do, is stick with the non-medicinal safety measures.
Combined with vaccines, they amount to different paths, forged together to finally get us all out of this once-in-a-century collective crisis.
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