Scripps CEO Wants Simpler COVID-19 Vaccine Process, More Vaccines Pt. 2
Speaker 1: 00:00 Last Friday, San Diego County reported 2,695, new COVID-19 cases, 32 deaths and 337 hospitalizations. These numbers actually represent a slight decline in the new surge of cases resulting from the holidays, but conditions are still dire in local hospitals, intensive care units in the County are at or near capacity and the situation for ECM machines, which take over for the heart and lungs by removing carbon dioxide and adding oxygen is even worse. KPBS health reporter and mento spoke with script's health CEO, Chris van Gorder. Last Thursday, about how scripts is dealing with the onslaught of cases. In part two of that interview, van Gorder talks about the availability of ICU beds and ECM machines. Speaker 2: 00:51 The other big concern going on right now is ICU capacity. We've heard at the state level that hospitalizations are improving or at least stabilizing a little bit. Um, is that what you're seeing in your facilities as well? Well, our ICU is today are at 104% capacity. Um, so we are, uh, at cert, um, we are at about 200%, uh, correction, 167% capacity and Encinitas, 104 at LA Jolla, 106 at mercy San Diego. So, um, we are full, but we're opening additional capacity. Um, every day. I mean, we've got engineers that are literally converting regular floors into negative pressure isolation ward. So we've still got a little bit of capacity that we can build into, but we are bulging at the safe seems. Staffing is tight. Um, we have seen a little flattening out over the last maybe four or five days. Um, I know sharp went up today. Speaker 2: 01:50 I haven't seen their final numbers yet. We actually dropped by eight patients today. Uh, but the amount of turnover in patients is astronomical. I mean, in the last 24 hours we had, um, let me see 12, 15 deaths. Um, and we discharged 56 patients. Um, and so, you know, you can see this enormous turnover of patients that are being admitted, uh, and, uh, patients that are being discharged and sadly way too many patients who are dying this morning. Uh, when I said we are at 104% capacity, we had, I think, seven ICU beds available. And we had well in excess of 20 patients waiting for beds in our emergency departments. How do you decide who gets those first seven beds and who has to wait? That's a clinical decision made by the individual hospitals. Remember I'm talking about the discharges. So they were waiting for that group of patients that were going to get discharged to be just hard to home today. Speaker 2: 02:43 And as those beds opened up, they're obviously terminally cleaned. And then at that point we can admit the patient to a, uh, to a new bed. So it's a constant battle of, you know, holding for a while until a patient, uh, either dies or is discharged. And then we can put another patient in that bed and we keep hearing about crisis care, the crisis care continuum. We've heard Dr. Galley say that. No. Um, as of last time I heard him speak that no hospital has actually activated crisis care, but he did say that hospitals are implementing parts of crisis care. Are you implementing parts of crisis care? And if so, what is that? Um, crisis care. Obviously we put the triage teams together and they make decisions based upon, uh, both, um, um, a, an algorithm that our electronic health record gives them and, and their own clinical decisions, ethical decisions, uh, on who should receive the care versus somebody that might not get that care. Speaker 2: 03:37 Um, we have not had to do that yet. Uh, we are very close, uh, on ECMO. Um, we are pretty close. We are have, we have eight ECMO machines and basically the staff to run the eight. Um, and we have been full for the last, uh, almost week. We actually had one patient that, um, an additional patient, we, and there's a ECMO consortium, very well organized here in San Diego County. Other counties are actually looking at us to, to model, but, uh, uh, where we can actually move equipment and if necessary patients around to get the patient where the equipment is. And we were able to borrow a machine from UCLA and get a ninth patient on the ECMO machine when we needed it. So, uh, but we are, we are right maxed out and at a certain point here, I mean, literally it could be today. Speaker 2: 04:22 Uh, we may have to use crisis care protocols to decide, uh, who can get them ECMO machine, and who's going to be left off the ECMO machine. You did just say that there was, you just, just provide an example of collaboration with UC San Diego. But, you know, I talked to a lot of different people and I'm actually hearing that, um, access to ECMO from a bunch of different hospitals is difficult. I'm hearing allegations that, um, certain types of patients who have private insurance are being prioritized over other individuals, um, with little, uh, explanation. Why are you experiencing that? Have you received complaints of that happening in your own facilities? No, I have actually you're the first person I've ever heard that from, uh, economics or payer mix is not coming to play in. The decision is a clinical decision really made by the physicians at our ECMO team. And, um, and, uh, so as far as I know, economics payer mix is not coming into play at all.