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San Diego announced 1,091 new coronavirus cases, a new single-day record made all the more ominous by warning signs issuing from the local health care system.
South Bay hospitals reported significant recent impact on their intensive care units Friday, with 90 percent of staffed beds at at Sharp Chula Vista Medical Center now occupied, about half by patients with COVID diagnoses. Scripps Mercy Hospital Chula Vista reported an 83 percent occupancy rate in its ICU with nine of 20 beds holding COVID patients.
And the situation did not appear to be confined to those facilities situated closest to the border. Sharp and Scripps reported 82 percent and 81 percent overall system intensive care occupancy rates.
Overall COVID hospitalizations hit 76 percent of total local capacity in Friday’s report, inching close to the 80 percent level that could require reductions in the number of elective procedures that hospitals can perform. The county has said that 20 percent of capacity should be preserved to provide a buffer for treating any sudden surge in COVID cases.
A county spokesperson said Friday night that Dr. Wilma Wooten, the region’s public health officer, plans to meet with local health care systems Monday afternoon to “discuss the potential for additional action.”
The intensive care bed census included in the county health department’s most recent update, released Friday just before 5 p.m., indicates that, through Thursday, 507 out of 853 total available ICU beds were occupied for a total occupancy rate of 73 percent.
Data was not available to indicate how much that number went up on Friday. Though emergency medical service personnel track bed occupancy in near real time, no one in charge of the local EMS system was available to discuss just how quickly the vital resource is disappearing as a growing wave of positive cases generates an inevitable surge in hospitalizations.
Dr. Andres Smith, emergency director at Sharp Chula Vista, said Friday morning that the patients arriving recently represent more of a mix of COVID and non-COVID patients than in the last surge in the late spring and early summer. On Wednesday it was not clear if there would be enough special “negative pressure” rooms available to handle new patients who might end up needing significant medical help while awaiting coronavirus test results, he said.
The physician said his emergency team readied an overflow tent in the hospital’s parking lot as a location where breathing tubes could be inserted if necessary.
“We didn’t end up needing to use it that night, but it came close,” Smith said.
Dr. Kristi Koenig, medical director of the San Diego County Emergency Medical System, said Friday evening that she has also started to see signs of additional stress on local emergency rooms as patients infected by the novel coronavirus arrive at locations already busy with patients who are not infected.
“I am definitely concerned with what we see right now, because we know that, with the increases in cases we have seen, it is only a matter of time before we see that translate to more hospital impact,” Koenig said.
Her office, she said, keeps a close eye on the equipment and materials, staff and facilities needed to treat a surge of patients. At the moment, she said, staffing is of the greatest concern.
“Some people are sick, and some people are just burnt out and exhausted,” she said, noting that surging hospital admissions across the nation have also drawn experts to the east who might otherwise be available in the local workforce.
Occupancy has a very real effect not only on those with COVID but on those who have severe illnesses not related to the novel coronavirus.
In the spring, Wooten ordered all local hospitals to reduce non-emergency care as much as possible to make sure there was enough capacity to treat an expected wave of hospital admissions.
However, intense media attention on what was going on on the East Coast appeared to help avert a similar surge on the West Coast. Though some local hospitals, especially those in the South Bay and in Imperial County, did become full enough that they were forced to transfer patients out, capacity in many facilities remained unused, creating a buildup of very necessary, but yet not quite emergency, cases.
Hospitals have been working through that backlog for months, and the prospect of having to partially shut down non-emergency care again is surely not welcome. However, when it allowed hospitals to begin taking on elective work again, the county committed to keeping 20 percent of local bed capacity vacant as a buffer so that there would be enough room to cope with another surge in COVID admissions.
This story originally appeared in San Diego Union-Tribune.
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