Record-high COVID-19 caseload at Sacramento hospitals as coronavirus surge worsens
Sacramento hospitals reported a record-high number of COVID-19 patients on Saturday, the result of a resurgent pandemic this fall that is putting the health care system under unprecedented strain, particularly in intensive care units where beds, doctors and nurses are in short supply.
In total, 284 capital region residents are being treated in Sacramento County hospitals for the coronavirus, topping the previous high of 281 in July. The patient numbers represent a dramatic increase from just 74 patients six weeks ago, and foreshadow more crowding to come.
With people gathering indoors at Thanksgiving and other holiday events, a state analysis suggests coronavirus patient numbers in Sacramento County could nearly triple to 800 in the next month. Hospitalization increases usually follow infections by about two weeks.
“This is now the third wave. This happened relatively suddenly,” said Dr. Stuart Cohen, infectious diseases chief at UC Davis Health. “About two weeks ago even, we were at a pretty low number in the hospital. Within four or five days, things almost doubled. Obviously, that’s tough. ... We have been really busy.”
Cohen and Brian Jensen, a regional vice president with the Hospital Council of Northern and Central California, said the latest surge is what health officials nationwide had feared would happen this fall as people let down their guard after 10 months of dealing with the persistent pandemic.
“We were all very optimistic and hopeful that as a community we were turning things around, but we also at the same time were very cautious,” Jensen said. “There’s COVID fatigue in our society. We’re worn out by this.
“It’s hard to stay vigilant always, and as the weather turns from hot, warm, to sometimes cold, doing things outdoors as an alternative is not as easy as it was earlier in the year.”
Statewide, COVID-19 hospitalizations are nearing a record high as well, nearing 7,000, and are projected to to hit 14,000 in a month, an amount that could overwhelm some hospitals in the state.
In Sacramento County, COVID-19 patients are spread across seven hospitals, including UC Davis Medical Center, Kaiser Permanente, and Sutter.
Sacramento County Health Officer Dr. Olivia Kasirye said she is particularly concerned that Thanksgiving family get-togethers will lead to a jump soon in cases that will require hospitalizations. Her staff is in daily contact with health care providers, she said. “We are concerned about the impact of that on the health care system. The hospitals are keenly aware of it.”
State health chief Dr. Mark Ghaly said the state calculates that 12% of people who test positive for the virus end up in the hospital.
Across the six-county Sacramento region, 469 patients were in hospitals with confirmed virus cases as of Saturday’s update: Sacramento’s 284 plus 128 in Placer, 28 in the Yuba-Sutter bi-county region, 18 in Yolo and 11 in El Dorado.
Placer’s total continues to expand on a record high: 128 is nearly double its summer peak, of 67, reached a few days in August, according to the state health department. Both Placer and Sacramento County hospitals take in patients from nearby counties.
In Placer, 128 patients works out to nearly 18% of Placer County’s hospital beds being occupied by a COVID-19 patient — almost double the statewide rate.
In an effort to slow the virus resurgence, state officials recently required most California counties to restrict businesses, including prohibiting indoor dining. The state also announced a curfew last week from 10 p.m. to 5 a.m.
By Saturday, San Francisco and San Mateo County joined much of the state in the most-restrictive purple tier due to rising infections, and would be implementing the statewide overnight curfew on Monday. On Friday night, Los Angeles went a step further, instituting a three-week stay-at-home order that’s less severe than the mandate issued in March but still prohibits most gatherings.
Kasirye said state and local health officials are watching to see if those changes make a difference in the coming week. If not, state officials are considering further undisclosed economic shutdown steps.
Sleep Train overflow site
The state plans to use the Sleep Train Arena site in Natomas as an emergency overflow field hospital for Northern California if regional hospitals and health officials determine that extra beds and healthcare teams are necessary.
The arena has been on “warm shutdown” status since spring. Brian Ferguson of the state Office of Emergency Services said it and 10 other potential field hospitals like it around the state can be activated in a matter of a day, if needed.
“It gives us flexibility if we are exceeding hospital capacity regionally,” Ferguson said. “It could be COVID or non-COVID patients, depending on the need on the ground.”
The Sleep Train site can house nearly 250 patients. Medical supplies are available, and the state can call on both state and federal healthcare teams to assist.
In total, the state has 1,800 beds at the pop-up facilities.
California hospital numbers
California Hospitals Association executive Carmela 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.”
Hospitals may have to call on the state to relax some regulations on staffing and patient movement, she said.
The state dashboard as of Saturday showed a little over 2,000 ICU beds still available, close to its lowest point of the pandemic. That figure fluctuates near-constantly, not just from coronavirus admissions and releases, but as other intensive care patients come and go, and also as hospitals adjust staffing levels.
But those available ICU beds are far from evenly spread. Nearly 650 of them as of Wednesday were in Los Angeles County — a spare bed for one in every 16,000 people who reside there. Adventist Health/Rideout in rural Northern California, the only hospital serving the Yuba-Sutter bi-county area, had just three available ICU beds — one for every 60,000 residents — with six already being treated in intensive care.
Coyle said the national health care system has 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.
UC Davis’ Cohen also noted that, at his medical center, “it seems like the ratios of people who are hospitalized in the ICUs versus the people who are hospitalized on regular floor beds seems to be a little bit lower, so there was a higher percentage of patients who were in critical care units (in the spring), though that may also reflect changing demographics of the coronavirus pandemic.”
The best news involves potential arrival of COVID-19 vaccines. The first vaccines are expected to arrive in mid-December, but initially will be in limited supply, and will be given to healthcare employees. The general public is unlikely to have access to vaccine shots until the middle of 2021, although vaccines will be available earlier than that for more at-risk people.
State surge continues
As of Saturday, the death toll across the state from COVID-19 had surpassed another bleak milestone with more than 19,000 deaths reported. In total, California now has 1,183,320 confirmed cases, the highest of any state in the U.S.
Those numbers may be slightly lower than the true totals, partly because some counties have not reported new cases during Thanksgiving weekend, and because some test result reports may be delayed.
Overall, though, the numbers reflect a continued COVID-19 surge that has hit California, as it has much of the country, in the last month, prompting serious concerns about the coming months.
Most new cases by far are among the 18-to-49 age group, a group that has proven to be more physically resilient in handling the virus. But health officials warn that those people can pass the virus on to older friends and relatives who tend to suffer more negative health consequences when infected.
California has seen its seven-day average virus test positivity rate rise to 6.2%, a notable increase from a lot of 2.4% last month, according to Johns Hopkins University.
California now ranks 11th nationally among states, and is among 44 states whose positivity rates now are higher than the 5% level the World Health Organization advises is the level above which it is unsafe for businesses and other group gathering places to be open.
Sutter Health and UC Davis prepped
Sutter Health, which operates in 22 Northern California counties, reported in the last week that it continues to have capacity to handle COVID-19 cases.
“Over the past few weeks, like other areas in the state, Sutter’s network has seen an increase in cases of COVID-19, including hospitalizations in some of its service areas,” the company said in a statement. “While we are monitoring these increases closely, our network hospitals have capacity to care for patients who require care for COVID-19 and those seeking care for other clinical needs.”
Sutter is also laying plans for the expected arrival in the next few weeks of a COVID-19 vaccine, to be administered to healthcare employees.
“Sutter Health is working on plans for COVID-19 vaccine distribution, which includes infrastructure, staffing, equipment and supplies,” the company said. “Currently, we have been in the process of putting the necessary cold storage and transportation infrastructure in place. This is a foundational first step that will support the safe distribution of the vaccine throughout our footprint.”
UC Davis Health officials called the current caseloads manageable, in a statement to The Bee. Only 5% of the Sacramento medical center’s patients are being treated for COVID-19.
“UC Davis Health remains well prepared, with its clinical teams continuing to provide very effective patient care. The increases we’re seeing in COVID-19 case are manageable.
“Our facility is flexible, so we can increase COVID-dedicated space and ICU capacity if we need to do so. But right now, almost all of our hospital space is needed for non-COVID health care needs.”
This story was originally published November 28, 2020 at 12:42 PM.
