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Hospitals Across California Are Running Out Of ICU Beds

 December 18, 2020 at 10:25 AM PST

Speaker 1: 00:00 Hospital systems struggle as COVID cases, surge Speaker 2: 00:04 The rate limiting factor for all of this is staffing. And, uh, most recently we have about 30 beds that are staffed and immediately available. Speaker 1: 00:12 I'm Jade Hindman. This is KPBS mid-day edition. Why the spotlight is on the young Latino electorate in the U S during this election year, Speaker 3: 00:30 Kind of hard for me to understand how they could vote everything you've gone through to stay in this country, have your green card and stuff. How can you do that? But I've mentioned before, it just, it comes down to perspective Speaker 1: 00:42 And to look at holiday happenings in our weekend report, that's ahead on midday edition, 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: 01:33 Thank you. A happy to be here. Uh, Demetrius, Speaker 1: 01:36 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: 01:45 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 that most of our counties now are really getting impacted, uh, with IC capacity being stressed. Speaker 1: 02:03 And what does ICU capacity look like here in San Diego County specifically? Speaker 2: 02:08 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: 02:24 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: 02:46 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 plans and you get over a hundred percent by starting to 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: 03:21 And, and how about Imperial County? How are they doing in terms of ICU capacity? Speaker 2: 03:26 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, utilize other spaces to increase capacity for the demand that, uh, seems to be relentless at the moment. Speaker 1: 04:02 Does that compare to ICU capacity in other counties in the Southern California region? Speaker 2: 04:06 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 had 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: 04:53 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: 05:02 So, um, staffing is the rate limiting factor in normal times. Um, you know, you access, uh, staffing agencies, traveler nurses, 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 that will, most of the United States is also feeling these 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: 06:06 And 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: 06:13 So, 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: 06:40 And can you explain to me why there's so much fluctuation in terms of staffing right now? Speaker 2: 06:44 Um, 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: 07:09 Are there these fluctuations? Is it burnout? I mean, what's happened. Speaker 2: 07:12 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 vaccine starting to roll out and, um, that there is a light at the end of the tunnel that we will get through this. Speaker 1: 07:45 Well, the availability of the vaccine, improved staffing levels, you think, I mean, is that something you project, Speaker 2: 07:50 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, as some of our nurses and others are 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: 08:33 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. Speaker 4: 08:53 In North County Herrera, who Speaker 1: 08:56 Is Mexican American and a first-generation college student spent election night trying to keep her political opinions to herself. And this final installment of every 30 seconds, which is a collaboration with the world. Max Rivlin Adler tells us why the spotlight is on the young Latino electorate in the U S during this election year, Speaker 5: 09:15 Marlene saw her Mexican American family go both ways during the election, Speaker 6: 09:19 My dad's house, we have a very different political view than me and I spent that election week here. So while everyone was reading for the other side, I wasn't, especially my grandpa. He kept coming out while the County was still coming in and like saying Trump one inch in front of, but like in Spanish. And I was just like, no, he did it. It's not done yet. Stop listening to your news. Speaker 5: 09:41 Her father and mother split up when she was young. So she divides her time between households, her father's parents are immigrants from Mexico. They live with him and they all supported Donald Trump. Marlene's mother was pulling for Joe Biden in the days after the election. She kept in touch with her mom about the results. Speaker 6: 10:01 My mom and I, we were messaging each other. Like, have you seen the election? Did you see at the minute that Philadelphia turned, it cleared the way for Biden? My mom was the first one to call me. Did you see the election results? Did you see them like, guess I did. I just woke up by the way. Thank you. Speaker 5: 10:16 Third of Latinos usually vote Republican, but Trump was able to build on that in this year's election, which left a lot of people wondering why Marlene, who felt the impact of anti-immigrant rhetoric in her own high school was coming to terms with her grandparents support of Trump. Speaker 6: 10:33 I think my main thing that surprised me was my grandparents concern. The fact that they did come here as immigrants and the whole hate that was sparked around the community because of Trump. It's kind of hard for me to understand how they could, well, everything you've gone through to stay in this country to have your green card and stuff. How can you do that? But like I've mentioned before, it was just, it comes down to perspective, Speaker 5: 10:56 Reflecting on these choices, Marlene realizes there's so much more that impacts someone's politics than just their identity. Her own father who manages a grocery store, saw his hard work, translate to economic stability. Marlene says this has led to a more comfortable life for her brother, junior who lives full time with their father. Speaker 6: 11:16 As much as my dad helps me out, he gets me the things that I needed. I didn't grow up the same way Jr. Did. I grew up in a single mother household having to ride the bus every day. My mom being on food stamps, getting government help Speaker 5: 11:30 Marlene's own experience has influenced her politics, but changing the minds of people in her immediate family. Once they're made up has been challenging, especially during a year where they've all been stuck inside together. Speaker 6: 11:44 It's so hard as a change of perspective. I know I get frustrated and that's just a big split between both of my sides of my family. KPBS news. Speaker 1: 12:03 You're listening to KPBS midday edition I'm Jade. Hindman get festive while also getting a little culture this weekend with plenty of options from the local art world, from jazz to short stories, to an interactive Nutcracker. Joining me is KPBS arts editor and producer Julia Dickson Evans with all the details, Julia. Well, Speaker 7: 12:24 Hi Jane. Thanks for having me. Speaker 1: 12:26 San Diego symphony has two free digital offerings this weekend, Noel Noel, and I will be jazzed for Christmas. Uh, what stands out? Speaker 7: 12:35 Yeah, it's a, it's a great weekend for a free live stream from symphony hall. And both of these events have been recorded from actually onstage at Copley. They use all sorts of safety measures like plexiglass around any of the musicians who can't wear a mask. And everyone's really spaced out sometimes using the entire hall, not just the stage and everything I've seen from the symphony in the last few months has been really well put together and worth just a little bit more screen time in the evenings. First is tonight's Noel, Noel. It's kind of a variety show with hosts, Scott, rod Brown and singer storm leaver, and also Jason morass. We'll be narrating the evening. It's going to be packed with stories, coral offerings, and a sugar plum theory, dance from city ballet, and also a sing along that's tonight at seven o'clock. Speaker 1: 13:25 Sounds nice. And then there's the symphonies virtual version of jazz at the Jacobs. Speaker 7: 13:30 Yeah. Sunday night is I'll be jazzed for Christmas with a quartet, including Gilbert kassianos on trumpet and Joshua White on piano. Gilbert kassianos is really a force to be reckoned with in the jazz scene. And I recently started listening to San Diego born Joshua White. He is absolutely brilliant on piano. Last year, he performed at the Kennedy center for the NPR music, jazz piano, Christmas music, special. Speaker 3: 14:03 [inaudible] Speaker 7: 14:12 Do some festive jazz tunes. So like Vince Guaraldi and adaptations of some pop favorites and more traditional carols, like we three Kings. And that is Sunday night at seven. Both of these events are free, but you have to register separately for each one to get your streaming link sent to you in advance. Speaker 1: 14:33 Hmm. We've been listening to Joshua White on piano at NPRs music's jazz piano, Christmas music special from 2019. He'll perform with the San Diego symphonies. I'll be jazzed for Christmas. This Sunday 7:00 PM and Noel Noel takes place tonight at 7:00 PM. So Julia for what's a good virtual Nutcracker option this year. Speaker 7: 14:54 So a standout for me is the Poway onstage partnership with Southern California ballet for their virtual field trip. Instead of just putting up the video from last year is Nutcracker online. They really put the work in, they repackaged it as this interactive educational thing. It's split up into bite-sized segments. You can tour the performing arts center. You can go through the nutcrackers history and then they have two 17 minute segments of the ballet. So individual dancers have been shortened for a young attention spans and also our digital attention spans that there's also a narrator who pops in every so often to describe what's happening and what everything means, which I have to say. It helped me even. And there's video tutorials for everything from costume design to pantomiming, to actual choreography, where you can try watered down versions of some of the Nutcracker dances. It meets the California education standards for first through seventh grade. But I really think any age will get something out of it. Speaker 1: 15:56 That's great. And parents and teachers can sign up online for the virtual Nutcracker field trip from Poway onstage, and it's viewable through January 15th. Um, moving on to literature. Now it's one thing to curl up by the fireplace with a good book, but there's a local group who wants to read stories to you. Tell us about right out loud story concert. Speaker 7: 16:17 They're a local group of literary and drama, performing artists. And they bring us things like PO Fest and for their holiday show, they're performing a series of classic short stories and poetry that you can watch or listen to from home. They're calling it a story concert. So expect some more theatrical than your standard read-a-loud voice. You're doing stories like Christmas day in the morning by Pearl S buck and Robert Lewis. Stevenson's beautiful seafaring poem Christmas at sea. And we have a little sample here of Patricia. Polacco says Hanukkah story, the trees of the dancing goats as performed by Rachel Ben warmer Speaker 8: 16:57 At our farm, just outside union city, Michigan. We didn't celebrate the same holidays as most of our neighbors, but we shared their delight and anticipation of them. Just the same such call the winter brings my babushka said, as she looked out our front window, my bones, it makes to ache. Then she slapped her chest. Then she caught my eye and winked. She wasn't fooling me. I knew how much she loved the snow. Speaker 1: 17:29 That was Rachel van warmer reading the trees of the dancing goats by Patricia Polacco from right out loud giving season the event streams on demand for free. Now through January 6th in the local music scene, Berkeley heart has a Christmas special forest. Tell us about it. Speaker 7: 17:45 Yeah. The local Americana duo are doing their holiday show and the style of a Christmas TV special. So they'll play some songs and bring in some surprise. Guests. These two have been mainstays in the San Diego music scene for so long, and it should be a nice low fi and cozy listen. They put out a Christmas album in 2014 with some new stuff, but also takes on classics. And I'll leave you with their version of silent night. Speaker 3: 18:30 [inaudible] Speaker 1: 18:35 That silent night from Berkeley heart, their Christmas special show is available to stream on demand. Now through the end of the month to find more arts events or to sign up for our weekly arts newsletter, go to I've been speaking with KPBS arts editor and producer Julia Dixon Evans. Julia. Thanks. Thank you, Jane. Have a good weekend.

As ICU bed capacity drops to 0% in the Southern California region of the state, we look at how hospitals in San Diego and Imperial counties are doing. Plus, a Mexican-American teenager comes to terms with her immigrant grandparents’ support of Donald Trump in this final installment of Every 30 Seconds. Finally, our picks for weekend arts events include jazz, a literary story concert and an updated spin on a Tchaikovsky classic.