Rising COVID-19 cases could drive Fresno-area hospitalizations. Here’s latest trend
The average number of coronavirus patients being treated in hospitals across Fresno County and neighboring counties in the central San Joaquin Valley has been on the rise in recent days, fueling concern among health officials about a strain on medical resources in the region as infection rates climb.
On Wednesday, the California Department of Public Health reported that 123 patients with confirmed COVID-19 infections were under hospitalization in Fresno County, including 33 who are sick enough to be in intensive-care units for treatment of the respiratory disease. Over the past two weeks, an average of about 104 patients were hospitalized on any given day, including almost 27 patients per day in ICU beds in the county.
Both of those are the highest daily averages since late September in Fresno County.
Across Fresno, Kings, Madera, Mariposa, Merced and Tulare counties, a total of 210 confirmed coronavirus patients were in hospitals, 51 of whom were receiving treatment in ICUs. And as in Fresno County, the two-week average of almost 177 patients per day for hospitalizations and average ICU occupancy of 40 among COVID-19 patients are higher than they’ve been in more than a month.
Dr. Rais Vohra, interim health officer for the Fresno County Department of Public Health, said that an increase in confirmed infections typically leads to a corresponding increase in hospitalizations about a week later. He acknowledged after a peak of coronavirus hospitalizations over the summer seemed to subside, the recent increase in new cases is starting to put a renewed strain on hospitals.
“Over the weekend (local hospitals) admitted about 20 new patients that had coronavirus,” Vohra said in a Tuesday briefing. “That’s a big quantity over the weekend, and I think that is going to continue.”
Between COVID-19 patients and an increase in patients requiring treatment for heart attacks, strokes and other illnesses as winter approaches, there is increasing pressure on hospital capacity.
“We actually surveyed all of our hospitals locally here and they told us they had just a very small number of ICU beds,” Vohra said. “So out of all of the ICU beds in the county, we have only about 10 open beds right now just because there’s a lot of other illnesses that are taking those beds.”
Licensing data from the state shows that Fresno County hospitals have a total of 149 licensed intensive-care beds; Valleywide, there are 312 ICU beds licensed among the region’s hospitals.
Healthcare workers affected
COVID-19 patients aren’t the only ones dealing with the virus. Two of Fresno’s largest hospital operators, Community Medical Centers and Saint Agnes Medical Center, reported this week that they have a combined total of almost 100 medical staff who have tested positive for coronavirus infection and are in isolation. They are among a total of 195 personnel who are in quarantine because of possible exposure to the virus.
“If the (case) numbers keep rising, we know that will affect healthcare workers,” Vohra said. “That’s really the paradox of this infection, is that once you know you get into a surge, the surge starts affecting your healthcare workforce.”
“And then that just makes everything worse because now you lose the ability to take care of sick people at the same time you need even more workers to take care of those people,” he added. “We don’t want to be trapped in that vicious spiral which other parts of the country frankly are experiencing right now.”
The potential threat to medical capacity underscores the importance of residents and businesses to follow the safety guidance that Vohra and other health professionals have advocated for months: Use face masks, practice social distancing, stay home when ill and wash hands often.
“The fewer number of cases there are in the community, the fewer number of hospitalizations we can expect,” Vohra said. “Whenever you choose to wear a mask, whenever you choose to keep your distance at gatherings, you’re actually helping to protect the whole community, including our healthcare workers and including the most frail members of society who may be hospitalized not even for COVID.”
Field hospital still ready
The rising numbers of new daily cases, while well below the peak levels in August, and what they portend for hospital capacity are prompting Vohra and Fresno County officials to once again contemplate the possibility of activating a 250-bed field hospital, or “alternative care site,” established in the spring at the Fresno Convention Center to handle overflow non-coronavirus patients from hospitals across the region.
The Exhibit Hall at the convention center, he added, still has beds set up inside, and more privacy screens and barriers have been added beyond what was installed in the spring.
“We don’t want to open up the convention center, but we’re already talking about if we have to, we need to have some protocols in place so that we can screen all of our staff, all of our workers and make absolutely sure that we don’t have COVID-positive staff and workers that are working any of these facilities.” Vohra said.
Vohra said there is comfort in having the field hospital in the convention center Exhibit Hall available, but opening it up “will mean that we are experiencing just a tremendous surge here in the county.”
“It will technically mean that all of our hospitals are being kind of overrun and so they will be experiencing staffing shortages at the same time that we actually need staff for the convention center,” he added.
California models with current and ‘universal’ masking
Forecasters at the University of Washington’s Institute for Health Metrics and Evaluation have produced models showing that California could see the number of new coronavirus infections, and resulting hospitalizations and deaths, climb by the thousands before Thanksgiving and grow even higher by the end of this year.
Under current conditions in California, with about 70% of residents reporting that they wear face masks every time they venture out in public, the IHME models this week predict that the number of new infections that arise in the state could reach almost 7,000 per day by Nov. 25, with a likely range of between about 2,500 and 14,000 new daily cases.
By Dec. 31, the models show case forecasts that are significantly higher – potentially ranging from about 3,500 to 28,000 new cases per day in the state, with the most likely figure at just under 13,800.
If, however, California could achieve “universal masking,” in which at least 95% of the population wears masks in public, the Thanksgiving forecasts are much lower: a range between 1,960 and 10,800 cases, with the most likely estimate at about 5,400 new daily cases.
The year-end estimate under a universal masking scenario is fewer than 7,000 new cases on Dec. 31, within a range of about 2,000 and 14,000 cases.
Since the first death attributed to the coronavirus in California in early March, the state Department of Public Health reports that 18.108 people died from COVID-19 as of Wednesday.
The IHME forecast models indicate that statewide toll could rise in the next two weeks to more than 18,600 by Thanksgiving – within a range from 18,319 to just under 19,000 – and about 20,200 by the end of the year. That would be within a range of 19,000 to 22,000 cumulative deaths in the pandemic.
