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Spencer Custodio |
Sky-high hospital admissions of the coronavirus in Orange County saw a record jump on Wednesday, with an increase of 115 people in one day, with county public health officials now deploying field hospitals to ease the burden.
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On Wednesday, 1,486 residents of the county were hospitalized, including 319 people in intensive care units – the highest level this year.
On Tuesday, 1,371 people were hospitalized, including 296 in intensive care.
Gavin Newsom said in a press conference Wednesday that OC’s deteriorating situation, along with Southern California, forced him to adjust the ratios between nurses and patients in the ICU, from one nurse for two patients to one nurse for three patients.
“We have to be creative, we have to temporarily, very shortly … look a little different in terms of staffing,” Newsom said at a news conference on Tuesday. “So just stretching resources.”
But the statewide nursing association, the California Nurses Association, immediately sounded alarm bells.
“If we want to reverse those standards now, we have to exercise patience with the patient. It means that we do not have time to respond to each patient’s rapidly changing circumstances, to monitor their subtle circumstances. That could mean that they have one more day or die the next, ”said union chairman and registered nurse Zenei Cortez at a news conference on Wednesday.
Dr. Charles Bailey, the medical director of St. Joseph Hospital and the medical director of Infection Prevention at Mission Hospital, said the change in patient ratio is not ideal, but is necessary to deal with the rising hospital admissions.
“It certainly wouldn’t be recommended or allowed outside of a crisis situation. But given the limited resources, namely experienced IC nurses, it is a step that is necessary. The nurses are supported by other staff – patient care technicians and in some cases LVNs who can perform a number of tasks that do not require the RN. It is a necessary step, a temporary step. It’s something that has been done before, ”Bailey said in a telephone interview on Wednesday.
In a press release late on Tuesday, the regional health agency said they are rolling out field hospitals to ease the burden on hospitals.
“The OC Health Care Agency will deploy mobile field hospitals (MFHs) at local hospitals this week to support the Orange County (OC) health care system as it responds to an increase in COVID-19 patients. AAC hospitals can obtain emergency exemptions from the California Department of Public Health to request use of MFH facilities, ”the report reads.
A baseline report from OC Emergency Services said UCI Medical Center, St. Jude Medical Center and Fountain Valley Regional Hospital will get the field hospitals. The report indicates that Hoag Hospital in Newport and St. Joseph Hospital may also receive field hospitals.
While the County health officials are setting up field hospitals, which are essentially tents with beds, public health officials are sending additional body bags and refrigerated trucks to Southern California to brace for the impending deaths.
“We have to consider how deadly this disease, this pandemic, is. Here’s what we just did: We have orders for 60 53-foot refrigerated storage units that are currently ready in counties and hospitals. We just had 5,000 extra body bags they just bought for the state. And we’ve divided them across San Diego, Los Angeles, and Inyo counties. That should be sobering, ”Newsom said.
While it’s unclear whether body bags or refrigerated trucks will end up in the county, OC has been hit harder than San Diego County.
Orange County has 380 more people in hospitals than San Diego and about 500 more dead.
According to the county, the virus killed 1,718 county residents in 111,168 confirmed cases on Wednesday, including 23 new deaths reported today. Healthcare agency.
Due to reporting issues, the new deaths can last up to three weeks.
The province also saw a further 3,231 new virus cases reported Wednesday.
OC has recorded an average of about 2,500 new cases per day in the past week.
State public health officials estimate that 12 to 13% of new cases are hospitalized two to three weeks later.
The virus has already killed more than three times as many people in Orange County as the flu on an annual basis.
For context, Orange County has averaged about 20,000 deaths per year since 2016, including 543 annual flu deaths, according to state health data.
According to those state death statistics, more than 4,600 people die from cancer, more than 2,800 from heart disease, more than 1,400 from Alzheimer’s disease, and strokes to more than 1,300 people.
The province is on track to exceed its average annual mortality with more than 19,000 deaths since October, the latest available state health data.
It’s a difficult healthcare virus because some people don’t show symptoms but can still spread it. Others feel mild symptoms, such as fatigue and a mild fever. Others end up in ICUs and eventually people die from the virus.
“That’s one of the differences in this virus: it appears to be more capable of transmitting before symptoms or people who don’t show symptoms. And that’s where the vaccine will come in, ”said Bailey.
He also said it is also challenging to get people to follow public health protocols.
“Those who may not be doing that as well as we have recommended keep spreading it. And once the vaccine has been administered to a large number of that group, its ability to asymptomatic spread will be blunted. But it’s a challenge, ”said Bailey.
Local epidemiologists wonder how much more the province’s hospital system can handle.
“We have some really fantastic hospital centers in Orange County – they are extremely capable and well equipped and they are on the cutting edge right now, but it’s really hard to imagine what things will be like as the numbers continue to skyrocket. , ”Said UC Irvine epidemiologist Sanghyuk Shin in a phone interview Monday.
Shin and doctors are urging residents to follow public health protocols – masks, two-meter physical distance, and avoid hanging out with people outside of immediate households – to help curb the spikes.
“I really think it’s important for the residents of Orange County to understand that we really need to start taking public health action seriously, we had to do that months ago. Unfortunately we didn’t – it’s better late than never, ‘Shin said. “We still have two weeks until Christmas and between now and then it’s all hands on deck to curb this disease, this pandemic.”
Dr. Shruti Gohil, an infectious-disease expert who treats patients at the UCI Medical Center’s ICU, said that while a vaccine is on the horizon, it won’t stop the second wave crashing into hospitals.
“We shouldn’t just think the vaccine is, okay, great now that my job is done,” Gohil said in a phone interview on Tuesday. “What we should be thinking is how to minimize the impact of the wave hitting us right now and how to get my vaccine on the road. ”
The first doses of OC vaccine were administered to health workers on Wednesday at St. Joseph’s Hospital in Orange.
County health officer Dr. Clayton Chau has said the first shipments of vaccines will not cover all Orange County health workers for whom doses are planned.
Gohil, who is also Deputy Medical Director of Epidemiology and Infection Prevention at UCI Medical Center, said public health measures should be followed because the vaccine is still new and experts are unsure how long it will take or how it can be widely distributed.
“Even once it’s known, we don’t know how long the immunity will last,” Gohil said. “About 70% of the population needs to be vaccinated before we really consider ending this thing, to really beat it. So 70% of the population is really a large number. ”
In the meantime, hospitals are being pushed to the limit.
“It’s a real challenge in terms of capacity. Our ICUs are almost full, ”said Jeremy Zoch, the CEO of St. Joseph Hospital, one of the largest hospitals in OC.
At the vaccine press conference, Zoch said he expects the situation to get worse.
“We have trouble keeping up with demand. We still see our numbers continue to increase, ”he said.
Bailey said St. Joseph Hospital and Mission Hospital are still able to accommodate the peak for now due to peak scheduling.
“I think we still have the staff and the beds to take care of it. Obviously we have the option to limit or cancel elective surgery and I think that has happened in most of the situations where that movement would aid the response to COVID, ”said Bailey. “We have the capacity to reach more than 100% of our licensed ICU capacity and it is done where it is needed.”
He also said he has never experienced anything like this in his career.
“It’s really different from anything I’ve been through. I was involved when HIV / AIDS first hit the scene, but for the most part, those people didn’t need that much IC care all at once, ”said Bailey. “Even a bad flu season will be a relatively short burst of activity (on ICUs), it won’t last, which is the challenge with COVID.”
Here is the latest news on Orange County virus numbers based on county data:
Infections | Hospital admissions and deaths | Data by city | Demographics
Spencer Custodio is a staff reporter for Voice of OC. You can reach him at [email protected] Follow him on Twitter @BuienRadarNL
Reporter Nick Gerda contributed to this story.