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Sharp Still Bracing For Possible Surge Of COVID-19 Patients

 April 16, 2020 at 11:11 AM PDT

Speaker 1: 00:00 Hospitals across the region have geared up converting more rooms to handle the very sick stockpiling personal protective equipment, postponing elective surgeries. But so far the expected surge and the COBIT 19 patients, which has overwhelmed medical facilities in New York, Michigan and other hot spots hasn't really hit hospitals in San Diego County. Joining me to discuss the situation here is Scott Evans, CEO of sharp Grossmont hospital in LA Mesa. Welcome to midday edition. Speaker 2: 00:30 Thank you. Speaker 1: 00:31 Well, as of Wednesday, 488 people have been hospitalized with coronavirus in San Diego County since mid February. That's far below what it would take to inundate the hospital system in the region. How would you describe the experience at sharp Grossmont so far in terms of the volume of coronavirus patients you're seeing? Speaker 2: 00:50 Sure. So, uh, certainly the, the number at this point has not been overwhelming. Uh, to date we have about 83 patients that have been admitted, uh, to sharp Grossmont hospital with a positive COBIT diagnosis. A lot of these patients are in fact, uh, treated in the intensive care unit, which does require some additional resources. But our overall census in the hospital has been somewhat suppressed. And so, uh, obviously you, you mentioned we, we have not had elective surgeries, et cetera. And so that certainly, uh, increases our ability to care for patients, but the overall census has been much lower than what it normally is. Speaker 1: 01:33 Now, given that local public health officials are saying there's signs, San Diego's curve is flattening. Does that mean the surge is passed or sharp still preparing for a possible surge of COBIT 19 patients? Speaker 2: 01:44 No, we are absolutely, uh, gearing up for a, a possible surge. I think that, uh, we're starting to see some of those numbers increase in the South Bay region and not necessarily here in East County, San Diego, but we have been asked to create an additional 40% over our normal licensed, uh, acute care bed capacity. And so that's, uh, we are working diligently and in order to do that, most recently we have added additional ICU beds. And so normally we operate with about 48 ICU beds. Today we are operating with 75 and I can tell you that we are already, uh, overflowing into those, uh, additional ICU beds. Speaker 1: 02:27 And why do you think some of those worst case scenarios aren't panning out? Speaker 2: 02:32 So I think that, um, they, they may still pan out in terms of, uh, coming in the future. Uh, we're not seeing it right now. I do think that, uh, we're not seeing necessarily that surge today, uh, as was previously predicted because San Diego in general is doing a reasonably good job at complying with a stay at home orders as well as social distancing. And, uh, obviously we're seeing a lot of people masking, which is, which has been, which has been helpful and, and I think that's why we haven't seen that curve, uh, explode yet. But, uh, we certainly do worry about that curve. Uh, uh, certainly increasing. I think we are concerned with, uh, border cities, uh, as well and, and starting to see, uh, some activity, uh, related to what might be happening, uh, in Mexico. Um, and will that indeed spill over into, into the United States? We do. Uh, there are lots of people that go back and forth between Mexico and the United States even for work. And so that remains a concern for us. Speaker 1: 03:39 I wanted to ask about emergency room visits overall had been some reports that they're down significantly in some facilities is they're concerned some patients with, with perhaps serious conditions are just not coming in. They assume the hospitals are getting slammed. Speaker 2: 03:54 Yeah, I think that certainly is a concern. I will validate that for you in that Grossmont hospital typically sees a more than 300 patients in a day. We're currently seeing just a little bit less than 200, so essentially one third less visits. Uh, we still are obviously seeing, uh, the, the very sick patients, uh, the patients that are coming in to our comprehensive stroke center or, uh, to our, um, our heart center. Uh, those patients obviously are still coming in, but we're, we're, we are about a hundred down, uh, from, from what's normal now. This week in particular, we are seeing a slight pickup and so normally our hospital would have more than 400 patients in it. Uh, we have been functioning really more around the 320, uh, Mark. Uh, but this morning we are above 360. And so, uh, we are starting to see some patients come through again. Speaker 1: 04:52 Now the governor has laid out six principles this week to help guide the state. When it comes to lifting coronavirus restrictions as the head of a hospital, do you think it's appropriate to maybe start having those conversations? Speaker 2: 05:04 I think we can have those conversations, but I, I definitely think that, uh, there, there needs to be some safeguards in place, uh, in case. Um, we do see more widespread, uh, of Corona following this sort of stand down of any of the measures that we have in place to prevent the disease from spreading. So I would certainly like to see a more robust stockpiles of personal protective equipment. I would like to make sure that we are, uh, set in terms of the number of ventilators that we have. Uh, and that we are, uh, very ready for surge capacity in case, uh, any sort of stand down on some of these restrictions does stimulate more of a surge generation. Speaker 1: 05:46 And of course, one of the six conditions the governor said must be met before easing restrictions is more testing. Our understanding is that sharp healthcare's testing capacity is around 950 per day. Currently you're a averaging far less than that 125 or so. Why is sharp not testing at full capacity? Speaker 2: 06:05 We have been testing obviously for, for some time we are ramping up on the testing. I think that as that testing capacity becomes available, then we start filling that testing capacity. So, uh, I'll just, uh, say that a couple of weeks ago our capacity was only 300 a day. Uh, and so, you know, the fact that we were doing now, uh, much more than that, uh, is significant. And we're starting to expand our definition of, of what would be tested in terms of some of the outpatient environment. So, uh, when we did have some issues as it relates to capacity, uh, we were having people from the emergency department, et cetera, that that had mild symptoms would go home and self isolate. Uh, we're expanding that testing now to make sure that we are able to, uh, to test those patients. And so I think, uh, while there's always a few days lag, I think you'll absolutely see those numbers increase and we are seeing them increase. Uh, certainly at Grossmont, uh, we've, we've already tested more than, uh, I think 1100 patients and I'm seeing that rise every day. Speaker 1: 07:08 So you are, as you say, easing, um, uh, the testing criteria a bit. What's required now to get a test Speaker 2: 07:15 clinician makes that decision, uh, based on, on certain guidance. But if the patient has signs and symptoms and they have a known exposures, the physician invariably is, is recommending testing for that. Certainly if they're admitted to the hospital, uh, and they have any signs and symptoms or, uh, they, uh, possibly have come from a nursing home, uh, that has had, uh, an outbreak or are clustering of patients, then they will get tested in the emergency department as well as sharp Grossmont hospital's care clinic, uh, which is a, an outpatient department of the hospital. Or we are seeing, uh, patients that are being tested more frequently, uh, just based on their presentation of, of mild, uh, symptoms. And so we're starting to see that, that rise. Now. Uh, I also would like to see the capacity for rapid testing, uh, go up so that we can get rapid results and that is seen in some health systems now, uh, as, as that technology is allowed to be introduced. And we are very hopeful that we will have that technology soon. But if we can get a test back in 45 minutes or an hour, uh, I think obviously that rapid testing will, will help increase. And, and I would support doing that so that we could certainly make sure that we are then putting patients or, uh, that test positive into isolation to stop the further spread. Speaker 1: 08:37 All right. Well, I've been speaking with Scott Evans, CEO of sharp Grossmont hospital. Thanks very much. Speaker 2: 08:43 Thank you very much. Have a great day.

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Sharp Grossmont CEO Scott Evans says while they're not currently seeing the patient surge that was previously predicted, they're still standing by for a possible influx of patients.
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