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California Sets New Daily Record Of 379 Virus Deaths

 December 18, 2020 at 10:16 AM PST

Speaker 1: 00:00 Hospitals across the state are running out of ICU beds for COVID patients, ambulances are backed up waiting outside emergency rooms and triaged tents are going up. California is seeing some of its highest rates of infection. And now ICU capacity is at 0% in the Southern region while it's at 3% statewide. So how are hospitals coping with the surge Demetrius Alexio, who is president and CEO of the hospital association of San Diego and Imperial counties joins us now. Demetrius welcome. Speaker 2: 00:33 Thank you. Uh, happy to be here. Uh, Speaker 1: 00:35 Demetrius, when we hear that ICU capacity is at 0% in the Southern California region, what exactly does that mean on the ground? And in hospitals? Speaker 2: 00:44 It means, uh, several things to me, one, uh, that we're all busy because Southern California region is more than just any one County. It's a number of different counties. And for us collectively to be at zero, it means, uh, that most of our counties now are really getting impacted, uh, with IC capacity being strained. Speaker 1: 01:03 And what does ICU capacity look like here in San Diego County specifically? Speaker 2: 01:07 So, uh, latest numbers I saw we have about 84 beds that are open and available. Um, but the rate limiting factor for all of this is staffing. And most recently we have about 30 beds that are staffed and immediately available. Speaker 1: 01:23 And, you know, we're hearing that, you know, again, there is 0% or below 1% availability of ICU beds in regions across the state. And at least one local facility has reported that they are over capacity at 109% full. Does that mean we have zero beds in some places and how can a facility be more than 100% full? Speaker 2: 01:45 So, um, no, it doesn't mean that we don't have any beds. Our hospitals are definitely resourceful. Um, so you have a number of licensed beds available and as you start to push those limits, uh, what a hospital will do is activate their surge plans and you get over a hundred percent by starting use other spaces that you normally wouldn't use that are safe to use, but in normal times you wouldn't use those spaces. So that's where our hospitals will continue to activate some of those other spaces as needed. But, you know, frankly, we'd all love to be in a better place where we have plenty of beds available, but right now that's just not the case. Speaker 1: 02:20 Mm. And, and how about Imperial County? How are they doing in terms of ICU capacity? Speaker 2: 02:25 They are pretty much full as well. Uh, this is something, uh, where the challenge this time around is the first time when we hit our surge. Uh, San Diego County in normal times is a relief valve in normal transfer patterns, uh, through mutual aid. And the challenge this go round is that, uh, San Diego is pretty impacted. So Imperial County is starting to activate their surgical plans as well, starting to use their alternative care site, uh, popping up tents, uh, in front of the hospitals, et cetera, to utilize other spaces, to increase capacity for the demand. That seems to be relentless at the moment. Speaker 1: 03:01 How does that compare to ICU capacity in other counties in the Southern California region? Speaker 2: 03:06 My understanding and obviously, uh, with our, with our association, my focus is primarily saying they're going to Imperial, but what I hear anecdotally is other counties are really feeling the same crunch. Uh, just the number of cases coming in. Um, the number of hospitalizations continues to increase. I can say specifically here in San Diego, you know, we're averaging about 30 to 40 more hospitalizations each day. And what's interesting is if you go back to October 25th, uh, when we sort of hit a bottom level, we at 178 hospitalizations. And as of yesterday, we were at 1,221 COVID positive patients hospitalized. So you can see, you know, you're talking over a 400% increase, uh, which, you know, creates some significant challenges. Speaker 1: 03:52 And as you mentioned, one of the main concerns right now is a lack of, of doctors and nurses. What's the plan to address that need in our area. Speaker 2: 04:01 So, um, staffing is the rate limiting factor in normal times. Um, you know, you access, uh, staffing agencies, traveler nurses, uh, et cetera. And the challenge right now is we're not the only County that's feeling this, the whole state is feeling this pinch. And in fact, uh, many parts and most of the United States is also feeling the surges. So literally you're competing with the whole country for staffing. So we did get some relief, uh, with some nurse staffing ratios, uh, potentially, uh, some relaxation there, which can expand staffing, but then some of our hospitals are utilizing other resources. Uh, nurses are picking up extra shifts. You know, that's the real challenge in all of this is it's not about the beds. It's really about the staffing and with the nurses and doctors and other clinicians. I mean, they've been at this for nine to 10 months, so folks are exhausted, but they're continuing to push forward. And that's where, you know, we continue to hope that folks will stay home and do all the right things so that we can start to bend this curve and create some relief with vaccines on the horizon. Speaker 1: 05:05 You mentioned that we're competing for travel nurses with the rest of the U S are there any other pools of workers that we can tap into? Speaker 2: 05:13 Well, you know, I mean, potentially you could look at other countries where there may be some opportunities. And I know some of those discussions are probably in the preliminary phases happening, but you know, that takes time too, because you have to sort through pieces as well as, um, ensuring competency, et cetera. So, you know, those are real challenges. So in the short term, it really is sort of buckle up and continue to push forward and push through this and ensure that everybody gets the access to care that they need. Speaker 1: 05:39 And can you explain to me why there's so much fluctuation in terms of staffing right now? Speaker 2: 05:44 Well, the challenge is, is that, you know, in normal times, uh, we had shortages of physicians. Uh, nurses can be a challenge, but you know, again, normally you have other opportunities to backfill and bring in other nurses. And that just isn't the case right now, because there's so much demand throughout the country that a lot of those normal resource pools aren't readily available, like they normally would be, Speaker 1: 06:08 Why are there these fluctuations? Is it burnout? I mean, what's happening. Speaker 2: 06:12 So yes, uh, burnout is a challenge. I mean, you're talking 10 months of continuous shifts, continuing challenges, the stress, um, on top of it, you know, many schools aren't necessarily back in order full time. So that creates other challenges, especially for households where two people are working. So there is just, you know, the resiliency of the workforce is something I am concerned with as we continue to move forward. And that's where, again, we're hopeful with vaccines starting to roll out and that there is a light at the end of the tunnel that we will get through this. Speaker 1: 06:44 Uh, well, the availability of the vaccine improves staffing levels. You think, I mean, is that something you project, Speaker 2: 06:50 Uh, from the, what we've heard from the vaccines is, you know, there is an opportunity there to add some immunity to folks to start to help our workforce, because that's the other challenge as well, is that early on, um, most of the people who were catching COVID cases, um, were more in the community. It wasn't so much impact in the workforce, but we're hearing more and more of that spread impacting the workforce is, uh, uh, some of our nurses and others are, you know, feeling the same pressures and taking a moment. And that's where, unfortunately it is impacting our workforce as well. So yes, the vaccine will provide some hope, but in the short-term we've just got to continue to do the right things, social distance wear masks, stay home. And we can't, Speaker 1: 07:32 I've been speaking with Demetrius Alexio president and CEO of the hospital association of San Diego and Imperial counties. Demetrius, thank you so much for joining us. Thank you.

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The staggering new figures released Thursday mean California has seen more than 1,000 deaths in the last five days and nearly 106,000 cases in just two days.
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