A sudden surge in COVID-19 patients has Sacramento and California hospitals on edge
A new wave of coronavirus-infected patients has hit California hospitals this month, including a particularly sharp spike in the Sacramento region. With more cases expected this winter, the surge may soon pose the biggest pandemic challenge yet to the state’s emergency healthcare system, especially if people defy safety guidelines and gather in groups indoors during the holidays.
Statewide, virus patient numbers have steady climbed over the past four weeks, according to California’s online COVID-19 dashboard, landing 3,224 people in hospitals. That’s about 1,000 more than in mid-October. The number of patients in intensive care has also increase dramatically to nearly 900.
In Sacramento, where hospitals were treating 74 virus patients a month ago, the total jumped to 158 as of numbers reported mid-week. Of those, 35 are in intensive care units, more than double the number from just two weeks ago.
The Sacramento County coronavirus patients are spread out at more than a half-dozen hospitals, including facilities run by Kaiser Permanente, Sutter Health, Dignity Health and UC Davis.
“It’s the expected (second) wave, if you will,” said Sacramento County health chief Dr. Peter Beilenson. “It is going to be a difficult few months.”
Beilenson attributed the surge locally to an increase in infections at long-term care facilities, as well as a spate of Halloween week parties in defiance of state and county safety guidelines, as well as other indoor family gatherings. State health leaders have offered similar reasons for the broader increase.
Similarly, Placer County hospitals have seen a concerning increase, with the county’s case total also growing in November at a pace not seen since July, quadrupling from 12 to 49 in the past three weeks.
The patient numbers are not yet near the peak that California experienced in late July, when a number of hospitals, notably in the Central Valley, filled beyond capacity and were forced to call on federal medical strike teams of doctors and nurses to supplement overwhelmed local staffs.
In Sacramento County, hospitals still had 69 spare ICU beds available this week.
PPE again in short supply
Hospitals may face tougher capacity issues this winter. California Hospitals Association executive Carmela Coyle said hospitals may not be able to set up triage and intake tents in parking lots like they did in summer. If patient numbers mount, hospitals may have to call on the state to relax some regulations on staffing and patient movement.
Health officials have been imploring residents to get flu vaccination shots to reduce the number of flu patients competing for hospital beds with COVID-19 patients in the next few months.
Health leaders also are warning that the combination of Thanksgiving and other indoor holiday family gatherings, along with general “pandemic fatigue,” will lead to increased virus spread.
Coyle said hospitals have remained geared up since summer with personal protective equipment, but supply lines still are not as robust as desired. “The supply chain is better than it was this summer, but it is by no means repaired,” she said. “Respirators, gowns, gloves are in short supply.”
On the upside, Coyle said, the national healthcare system learned key treatment lessons during the initial months of the pandemic, such as placing patients on their stomachs to ease breathing. Hospitals also have access to more advanced therapeutic treatments now that are proving effective in reducing the impact of infections and saving lives.
When will COVID vaccine arrive?
The biggest bonus: Federal and state officials in recent weeks have said they hope to have the first COVID-19 vaccines tested and approved for distribution among healthcare workers and first responders as early as next month.
The amount of vaccine available, however, is uncertain. That means the state’s 500,000 hospital employees, not including doctors, may not all be able to receive vaccinations in the short-term.
Because the vaccine is being developed quickly, and will likely be approved on an urgency basis, some hospital employees are wondering if it will be safe. Meredith Piggee, a nurse at Sutter Roseville Medical Center, said some nurses have expressed concern about being mandated to take the vaccine.
“Most nurses are pro-vaccine, but we want to know if it is safe,” she said. She and others are expressing concern about the shortage of protective masks as well.
Spokespeople for Sacramento-area hospital chains expressed confidence this week that they are prepared for a continued increase in COVID-19 patients.
One local hospital housekeeping employee, Edgar Allen, said he not only cleans the floors, walls and equipment between patients in test rooms, he uses a mop and disinfectant to clean the ceiling.
“We’re very educated on COVID,” he said. But, “we have to go fast when there are more patients.”
For some healthcare workers, it will be deja vu. For others, it will be a new experience.
“Some of us were here for the first surge and we are somewhat accustomed to working with the fear that comes with this,” Piggee said. “We know how to do things in a safe manner. But there are a lot of staff members who were not here for the first surge and they are sometimes scared. I remember feeling like that the first time around.”
Sacramento hospitals gear up
Michelle Gaskill-Hames, a hospital and health plan operations executive with Kaiser Permanente Northern California, said her system has maintained “a continuous state of readiness for additional COVID cases” since initial surges earlier this year.
That includes stockpiled supplies and, at the moment, capacity to handle a surge of 35% above normal capacity. The system has command centers in place that allow coordinated efforts, including moving patients among hospitals when needed.
“As a result, Kaiser Permanente facilities and staff are managing the current growth in hospitalized cases, expertly treating patients with the virus while safely caring for patients with other conditions as well,” Gaskill-Hames wrote in an email to The Sacramento Bee.
“While we wait for a vaccine, we need to embrace the public health actions that focus on social distancing measures including maintaining six feet of distance and using masks to protect each other,” she said. “Following these measures is crucial now to stop the rising tide of these infections.”
Dignity Health spokeswoman Yessenia Anderson reports her system’s hospitals also feel prepared for an increase.
“We indeed have seen an uptick in COVID-19 hospitalizations across our six Dignity Health greater Sacramento area hospitals,” she wrote to The Bee. “Our hospitals, however, have been caring for our community throughout the pandemic, and through the collective expertise and experience across our system, we better understand the disease now, how to treat it, and how to plan for a possible surge.
“The increase in hospitalizations – while something we continue to monitor – is currently not straining our care facilities. We have the resources, equipment and staffing in place to address current volumes and any additional increases.”
Dignity has been participating in pro-active steps to reduce hospital patients this winter, including flu vaccination events in diverse communities and in homeless camps.
“Our goal is to ensure everyone is protected against the flu which will also help in reducing the severity of a COVID-19 occurrence should someone contract it,” she said.
This story was originally published November 12, 2020 at 11:03 AM.
