Two Central Valley hospitals in ‘dire’ COVID-19 situations. Do others face similar future?
Lodi Memorial Hospital, which sits in the heart of a Central Valley town framed by vineyards, suddenly has found itself front and center in the latest and perhaps most ominous phase of California’s viral epidemic — a sustained surge in coronavirus patients that is pushing some hospitals beyond the limit.
As of Monday, COVID-19 patients filled 42 of the 91 beds in use, according to county data, and all 12 of the ICU beds were in use. To worsen matters, as many as two dozen of the hospital’s own staff have tested positive.
A team of 20 Air Force doctors, nurses and respiratory therapists from Travis Air Force Base descended on the Adventist Health-managed hospital in Lodi on Wednesday to reinforce its depleted intensive care unit staff.
It will help a lot, county emergency officials say. But it’s a Band-Aid.
As hospitalizations soar statewide, it is straining health care workers whose morale and stamina have been challenged since March. And the situation at Lodi Memorial Hospital could be a warning sign to other Central Valley communities that are experiencing large increases in hospitalizations.
In a statement to The Sacramento Bee on Monday, Lodi Memorial officials said they have room to expand their ICU and that their staff is resilient. But when the state requested military medical personnel for hospitals in “hot spot” counties, Adventist was pleased to take advantage of the offer.
“The Department of Defense Medical Teams comprise clinical professionals – doctors, nurses and respiratory therapists – that will offer additional resources during the surge,” hospital leaders said. “They will also offer reinforcements for our medical professionals who have been on the front lines serving patients throughout our COVID-19 response.
“We appreciate the collaboration and support ... together, we are all playing an important role to address COVID-19.”
Jeff Costa, the coordinator for San Joaquin County’s emergency management critical care, said it’s not just Lodi Memorial, though. Hospitals throughout the county are in the throes of the epidemic. Another, Dameron Hospital, also is being aided by an Air Force health team that arrived late last week.
“The message is: hospitals are operating near capacity, and our ICUs have been routinely over capacity for several weeks,” Costa said. “It means the situation is so dire that they have to put an ICU patient in a setting that is not designed for it.”
The number of people with COVID-19 in hospitals in California has more than doubled in the last six weeks, likely the result of the state reopening its economy and individuals failing to heed guidelines to refrain from gathering in groups indoors.
Gov. Gavin Newsom has now ordered some of businesses closed again, and has instructed Californians to wear masks in public places.
Brian Jensen, regional vice president of the Hospital Council of Northern & Central California, said he believes the state and region will have the capacity to get through this.
“You’ve got a lot of really committed, dedicated people doing amazing work right now, around the clock, and as the challenges change, they are reacting to that and always planning for the next thing,” Jensen said.
COVID-19 hits Lodi hospital
The Lodi hospital has suffered a particularly harsh time in the coronavirus era.
As ambulances brought COVID-19 patients of all ages to the hospital’s emergency triage tent, tests showed hospital employees were COVID-positive as well, forcing them to quarantine at home. One, 65-year-old certified nursing assistant Donna Frey, a 30-year employee, fell ill to the virus and became a patient in her own workplace. She died July 3 after transferring to another hospital.
“We’re asking a lot of people to put themselves in situations where it’s high stakes,” Jensen said, “and it doesn’t help when there is political controversy and all the rest that surrounds the health care issues. When it comes to the front line workers, they are putting themselves in the breach.... Sometimes it’s hard for your reservoir of energy and stamina and morale to recharge as quickly as you would like.”
As a result of the staff infections, the hospital temporarily stopped admitting patients other than those afflicted with coronavirus. Those patients, instead, were diverted to a sister hospital, Dameron Hospital in Stockton, also run by Adventist Health.
That, however, led to further issues. On Thursday, the day after the Air Force sent a medical team to Lodi, officials announced the Air Force would also send a 17-person healthcare squad to Dameron hospital.
A handful of other Air Force teams are being dispatched to hospitals elsewhere in the state.
Overall, in San Joaquin County, the coronavirus surge caused intensive care units to bulge to 132% of capacity, forcing some hospitals to find other beds elsewhere in the hospital for those extra patients. The county has not, as a whole, sent COVID-19 patients out of the area, in part because neighboring counties are struggling with caseloads as well.
“We do have surge capacity within hospital walls,” said Kathy Miller, chair of the San Joaquin Board of Supervisors. “The problem is we don’t have the medical personnel to staff the extra beds.”
Coronavirus in the Central Valley
The San Joaquin Valley’s agricultural counties are now among the hardest-hit by the coronavirus in California. Miller said the county’s contact tracers are not able to keep up with all the infections popping up, but said overall it appears infections are widely spread, and not happening in one place.
Latinos are disproportionately represented among those who have tested positive, and far over-represented among the 83 recorded deaths as of last Friday.
That includes infection clusters stemming from family gatherings, she said. “People feel safer with their extended family,” she said, but that continually proves not to be true.
In fact, the county’s 13% positive test rate is now nearly triple the World Health Organizations standard of 5% as an acceptable rate for allowing businesses to reopen.
As a result, Newsom has placed San Joaquin County and the entire San Joaquin Valley on its list of counties to monitor closely.
The county had 236 COVID-19 positive patients as of Monday. That’s up from about a dozen two months ago. In total, 32% of the patients in San Joaquin hospitals had been diagnosed with COVID-19 as of Monday.
Of those, 42 were at Lodi Memorial and 30 at Dameron. The hospital carrying the biggest load is St. Joseph’s Medical Center near downtown Stockton, by far the largest hospital in the county, which had 84 patients as of late last week.
Jensen of the Hospital Council is among many healthcare officials who say the public needs to do its part by wearing masks, washing hands and maintaining social distance to reduce the strain on the hospital system. That also includes not gathering in groups.
“Anecdotal evidence has shown that those sort of gatherings, large group gatherings, where people are not social distancing, not masking, going about with the festivities in a non-pandemic way, that has really caused the numbers to jump like they have.”
“Every individual who requires care for COVID is receiving it,” he said. “However, if the conditions don’t improve, it’s going to become more difficult to keep doing that.”
This story was originally published July 21, 2020 at 5:00 AM with the headline "Two Central Valley hospitals in ‘dire’ COVID-19 situations. Do others face similar future?."
