Rise of Fresno’s COVID-19 hospitalizations bring FEMA teams, possible makeshift hospital
Hospitalizations of patients diagnosed with coronavirus disease continue to rise in Fresno County and the central San Joaquin Valley, spurring the arrival of federal medical teams.
The increasing number of cases also is boosting the anticipation by emergency management leaders that they may need to activate a makeshift field hospital that’s in standby mode at the Fresno Convention Center.
Fresno County’s top doctor said that likelihood represents “in some ways a failure” by residents to take steps to blunt the pandemic’s effects in the area.
The state Department of Public Health reported that Fresno County hospitals were treating 219 confirmed COVID-19 patients as of Tuesday, and another 51 patients suspected of having the virus. Of that total caseload of 270 patients, 48 were sick enough to require treatment in intensive-care units at local hospitals.
The situation in the Fresno region and across California – where the numbers of confirmed infections and hospitalizations keep climbing – prompted the Federal Emergency Management Agency to send eight Department of Defense medical teams to the state to augment exhausted doctors and nurses, said Dan Lynch, Fresno County’s director of emergency medical services.
Two of the 20-member teams are due to begin working Thursday in the Valley, Lynch added: one at Community Regional Medical Center in Fresno, the other at Kaweah Delta Medical Center in Visalia.
The teams are focused primarily on intensive-care services and include doctors, physician assistants, nurse practitioners, intensive-care nurses and other support staff, Lynch said. “These are specialty groups that are just badly needed in the hospitals,” he said. “This is a great shot in the arm for both facilities.”
Virus adds to hospital burden
While coronavirus patients don’t represent the majority of patients in local hospitals, they add to the burden of medical staff members who are confronting the usual high number of people requiring hospitalization and intensive-care treatment for a wide range of other illnesses, injuries and other needs. Between COVID-19 and non-COVID patients, hospitals report that they and their staffs are being stretched thin.
Complicating matters is that many hospitals aren’t able to use all of the beds in their facilities because they don’t have sufficient staff available. At Community Medical Centers, which operates Community Regional Medical Center in downtown Fresno and Clovis Community Medical Center, almost 200 healthcare workers are in self-isolation because they have been exposed to the coronavirus, including 81 who have tested positive for the contagion.
At Kaweah Delta, the hospital reported that 70 employees have tested positive for the virus, while another 121 have recovered from having it.
The 30-day deployment of the FEMA/DOD medical teams, Lynch said, enables the hospitals to use a greater number of their beds before overflow needs force the county to open the state’s 250-bed “alternative care facility” set up in April at the Fresno Convention Center Exhibit Hall in downtown Fresno.
Another such alternative facility, a 50-bed setup at the Porterville Developmental Center in southeastern Tulare County, has already been opened and has 11 COVID-19 patients, Lynch said.
“Our focus is on helping the hospitals be able to staff beds that are available in their facility but the hospitals are unable to staff,” Lynch said. “This just adds to the buffer before we have to open the alternative care site at the Exhibit Hall.”
Dr. Rais Vohra, Fresno County’s interim health officer, added that the county has already been exploring how to staff the Fresno field hospital, which Lynch said can be up and running within 72 hours of the decision to activate it.
“We want to be ready when our hospitals need us,” Vohra said.
‘Failure’ by the community
But Vohra lamented the continued rise in hospitalizations – an increase of more than 57% in confirmed cases since July 1 – even as health officials implore the public to take precautions against the spread of the virus.
The growing likelihood of activating the alternative care site “is in some ways a failure that we as a community have allowed this epidemic to get this far,” Vohra said Wednesday. “We still have a chance to avert disaster, but we’ve really allowed this case count and the hospitalizations to go much higher perhaps because we weren’t as cognizant of all the preventative steps.”
“Hopefully people take that and use it as a constructive comment that the masks, social distancing and staying at home whenever absolutely possible – these are really important steps for us to take,” he said. “This is impacting the ability of our schools to safely reopen, it’s impacting how our hospitals are operating, just the sheer exhaustion and fatigue that all of our care providers are feeling on the front lines.”
In addition to being five times larger than the Porterville site, the Fresno field hospital would operate differently in terms of who would be treated there.
“Porterville only accepts COVID-positive patients who just need some recovery time before being discharged,” Lynch said. The Fresno site, “when and if it opens – probably more ‘when’ than ‘if,’ I presume – we’re only going to try to receive non-COVID patients that are in the same condition, who just need to be monitored for a couple of days or so before being discharged.”
Moving people to the field hospital, even for the last stages of recuperation, is far from ideal, he added. “It would be of much more value to the patient that we could house them in a hospital bed rather than on a cot in the Exhibit Hall,” Lynch said.
That’s why the FEMA/DOD medical teams are crucial, Vohra said. “By buttressing the staffing capacity at the hospital … that allows the hospitals to use beds that would otherwise go unused.”
Still, Vohra added, the planning continues.
“We’re playing it by ear, but we’re fully expecting that once the hospitals let us know that they’ve exceeded their surge capacity – and they’re already in their surge protocols – that’s when we’ll need to activate our convention center,” he said.
“I don’t think we’re going to be surprised whenever we have that conversation,” Vohra added. “We are actively getting ready for it.”
This story was originally published July 16, 2020 at 5:00 AM.
