California Health System Buckling Under COVID-19 Pandemic

Speaker 1: 00:00 As California closes in on 2 million confirmed cases of COVID-19 in some parts of the state, patients are being treated in hallways and conference rooms because there's no more available space. Governor Gavin Newsome is warning that the state could see a once unthinkable 100,000 hospitalizations within a month here in San Diego County, the County reported 2,381 additional coronavirus infections on Monday and 28 deaths. Hospital staff are pleading with the public to help stop the spread of the virus by staying home and not celebrating Christmas with people who live outside of your household. Joining me to talk about the latest with the COVID-19 virus in San Diego is Paul Sisson who covers healthcare for the San Diego union Tribune. Paul welcome several local hospitals say they're staffed ICU bed capacity is in the single digits or no beds at all. You reported that at Scripps hospital in Chula Vista, there's only one staffed ICU bed remaining. What did you hear about the situation there? Speaker 2: 01:02 Right. I spoke with Dr. Juan Tovar, uh, there at Scripps mercy Chula Vista hospital. And, uh, he indicated that things were really tight. You know, when I was there in the spring, they had the emergency department split into two halves. One was the COVID half. The other was the non COVID half. Uh, he said when, when I talked to him yesterday that they've had to kind of gradually see the non COVID half shrink down smaller and smaller as they need to add more negative pressure rooms. And, and, uh, and they just see the crush of COVID patients coming into their ER, uh, increase and increase and increase again, in terms of the intensive care unit. Uh, you know, they've, they've done what they can to expand and add some additional beds, but, uh, you know, the staffing really is becoming a challenge. Uh, and so they're just not quite sure when it's going to be necessary to start bringing in additional workers who are trained healthcare workers, but generally don't work inside hospitals. Uh, you know, that's, I guess the next step in the surge is to bring in, uh, folks who work in the outpatient settings and doctor's offices and things, and kind of turn them into supervised hospital workers to get us through the search. Speaker 1: 02:12 Now, the County hospital association announced a slight increase in the number of staffed beds available. What's being done to prepare for large numbers of people who may have to be hospitalized in the coming days and weeks. Speaker 2: 02:25 That's right. All each hospital has a surge plan. I was talking to Patty Mason, the CEO at UCFD earlier this week, she said their plan, uh, is all about converting, uh, resources that are outside the hospital to temporarily house patients. Uh, that's outpatient, outpatient surgery centers. Uh that's uh, you know, uh, I don't know if doctor's offices are necessarily part of that, but, uh, they're looking for non-traditional locations that they can convert for temporary use, uh, you know, generally facilities that have some kind of medical capacity already. Uh, you know, if you get COVID now you may find yourself in an operating room with several other patients, uh, you know, by your side, it's still a little unclear what they're going to do with the, uh, with the medical station up at Palomar hospital. There's 200 beds in a vacant wing there that they could activate. Uh, we know that those are not capable of handling intensive care patients, and it's still a little unclear exactly how they plan to activate that, uh, that resource, Speaker 1: 03:27 The emergency medical director at sharp and Chula Vista, Dr. Andre Smith is really begging the public to stay at home. What did his hospital see as a result of gatherings from Thanksgiving? Speaker 2: 03:37 Uh, he said that that has been just a very common theme that people come in and they talk about having gone to Thanksgiving gatherings recently, uh, Dr. Tovar over at Scripps to Lavista said the same thing. Uh, you know, it seems like, uh, like a lot of what they're, what we're seeing in our hospitals now really is driven by, uh, gatherings in various places at home and elsewhere. Uh, you know, and so they, they all have a very short Christmas list this year. They just want us all to stay home and, uh, and just not, uh, not gathered for Christmas. Uh, I myself have, uh, have told my mom and dad that we're just going to come and we're going to, we're going to exchange, uh, you know, gifts curbside this year. They, they live here in San Diego and, and then we're going to go home and, uh, and cook our own Christmas dinner this year. And it's a, it's a painful, a decision to make. But, uh, one that really is starting to feel very necessary. Speaker 1: 04:29 How did doctors you spoke to describe their concern for what could happen here? If people defy, stay at home orders and attend those Christmas gatherings and new year's gatherings, Speaker 2: 04:40 They have very dire projections that they're a little queasy about sharing with us in the public, but it's pretty clear that, uh, if we see another surge for Christmas, like we saw for Thanksgiving that, uh, you know, they really don't think that capacity is going to hold it up. And it's probably going to put us in a situation where rationing is necessary. Uh, and this is a terrible, terrible, terrible, uh, eventuality where you would have have, uh, triaged directors appointed at every hospital, whose job is to look at, uh, patient conditions coming in and decide who is in good enough condition to warrant an ICU bed, to bore into a ventilator. Basically what they'll be judging is who is the most likely to benefit, uh, from the scarce resource intensive care, critical care, that kind of care who is the most likely to come out the other side and still be alive. So if you have a preexisting condition, uh, if you are, are generally, already again, tough condition with COVID, um, if your, if your blood oxygen level is already very low, if you, if you have a high, uh, level of other, uh, problems with your, with your blood supply, you just might not get a bed. Speaker 1: 05:50 So they'd actually have to start rationing that care out. Speaker 2: 05:53 Right. Right. Actually. Speaker 1: 05:56 All right. I've been speaking with Paul Sisson who covers healthcare for the San Diego union Tribune. Paul, thank you very much.