Fresno County hospitals are almost full. What does the new high in hospitalizations mean?
The steady climb in the number of people hospitalized for COVID-19 in Fresno County is higher now than at any point since the first local cases of the global pandemic were reported in early March.
As of Thursday, 103 people confirmed to be infected with the novel coronavirus were being treated in hospitals across Fresno County, including 23 in intensive-care units. That’s in addition to 47 other patients suspected of having the virus but for whom test results had not yet confirmed a diagnosis.
That’s a 61% increase in confirmed COVID-19 hospitalizations over the past week, and that kind of rapid increase is a growing worry for Dr. Rais Vohra, Fresno County’s interim health officer. “That is reflecting that we are really still battling this pandemic,” Vohra said in a media briefing Friday. “It’s a concern. It means we don’t have any room to absorb a very much larger number of (coronavirus) patients.”
That’s the problem that prompted Vohra to repeat a warning that he’s mentioned several times over the past week: if the situation worsens, and the number of patients outpaces the available medical staffing, beds and critical resources such as ventilators, “it could trigger more drastic measures” such as requiring businesses — many of which have just been allowed to reopen from virus-prevention measures over the past few weeks — to once again shut down.
“I saw more saw more COVID patients (Thursday) night than in any of my shifts previously,” said Vohra, who also works as an emergency room physician at Community Regional Medical Center in downtown Fresno. “All of our hospital partners are telling us the pandemic is really being seen in our emergency departments.”
“All our hospitals are really messaging to us that they are at capacity, and even over capacity, in how many patients they are able to treat given staffing and bed resources,” Vohra added. “Other than COVID, there are other more silent demands on the medical community that really keep going and persist. All of those taken together are keeping hospitals at their capacity.”
In Fresno County, the total of 147 confirmed and suspected coronavirus patients rose by 10 between Wednesday and Thursday, according to information from the California Department of Public Health.
A marked increase in the percentage of positive tests — from 8.1% on Thursday to 8.7% on Friday — added to Vohra’s concern.
What hospitals are experiencing at this stage of the pandemic is different than a couple of months ago, when hospitals and doctors put off many scheduled surgeries and procedures except for emergencies to brace for an expected rapid increase in coronavirus cases that never really materialized. An auxiliary medical treatment facility was also established at the Fresno Convention Center to handle a possible overflow of patients after hospitals in other parts of the United States and around the world found themselves overwhelmed with cases.
“This pandemic is unprecedented. We emptied out hospitals. Some had to furlough workers,” Vohra said. “Shifts got cut, just because not enough patients were seeking medical care at that time.”
“Now the pendulum has swung in almost the opposite direction. People are flooding the emergency rooms,” he added. “The flow is now so steady it’s as if the pandemic never happened.”
But with state medical models suggesting a peak demand for hospital beds, services and supplies as early as mid-July or as late as mid-September, Vohra said, hospital occupancy and capacity is a foremost consideration for how the county and the Valley cope.
“It really depends on our medical providers’ capacity to really take good care of our patients,” he said. “Right now they’re letting us know they’re at their full capacity but they are managing.”
“I think that if we go into more a urgent phase of this crisis where we start to have to use surge protocols, or where our supply lines are getting used up and we don’t have enough ventilators, say, or hospital beds, then that would trigger more drastic measures including locking things back down,” Vohra added.
Across the Valley
The number of people hospitalized for coronavirus in the central San Joaquin Valley climbed about 24% in the past seven days, and almost 90% over the past two weeks, driving concern over the region’s lack of progress in stemming the spread of COVID-19.
Across Fresno, Kings, Madera, Mariposa, Merced and Tulare counties, 237 patients with confirmed COVID-19 diagnoses were being treated in hospitals as of Thursday, according to the most recent data available from the state Department of Public Health. That’s more than eight times as many as required hospitalization on April 1, in the early stages of the pandemic in the region.
The figures include 48 people whose bouts with the disease are serious enough to land them in hospital intensive-care units.
Another 53 people who are suspected COVID-19 victims — patients whose symptoms are consistent with the respiratory disease caused by the virus but for whom test results are pending — are also hospitalized across the six counties.
Many people who contract the virus suffer only mild symptoms including fever, a cough or breathing difficulty, and some show few if any symptoms; they get past it simply by staying isolated at home and resting.
But in Fresno County, 8% of all patients who have tested positive for the virus have required hospitalization at some point since early March.
In Fresno County, about one out of every six intensive-care unit beds in hospitals were occupied by suspected or confirmed COVID-19 patients on Thursday. That’s approximately the same ratio as the larger central San Joaquin Valley region, but it varies from one county to another. In Kings County, for example, eight of the county’s 22 ICU beds were being used Thursday to treat coronavirus patients. In Madera County, by contrast, only three of the county’s 52 ICU beds held COVID-19 patients.
“Knowing that coronavirus is out there and … that you can get a rapid surge of patients that have severe pneumonia, that have life-threatening complications like blood clots and strokes, … that’s a little concerning,” Vohra said. “You’re always kind of preoccupied with the sense that today might be the day when we have this huge uptick and all of our hospital beds will be occupied” and require expanding intensive-care units into other parts of hospitals to make room.
This story was originally published June 26, 2020 at 6:19 PM.
