Fresno-area medical leaders sound alarm as COVID-19 rise drives more hospitalizations
Across Fresno County and the Valley, the number of patients sickened by the novel coronavirus is on the rise – more than doubling in recent days and weeks at many hospitals – driven by a sharp increase in new COVID-19 cases being reported in the region.
That has medical leaders worried about the prospect of being swamped with even more patients in an already busy season.
They are particularly concerned people will fail to heed public health pleas to wear masks, practice physical distancing when in public and limit family and social gatherings for Thanksgiving.
“At this time of the year, hospitals are always challenged with capacity even without COVID,” said Dan Lynch, emergency medical services director for Fresno County, in a video call with reporters Tuesday. “COVID is just exacerbating the problem. … Even though COVID may not be an overwhelming problem at a hospital, it is pushing the problem further.”
Hospitals in the central San Joaquin Valley already went through one spike in patients requiring hospitalization for the coronavirus in the summer, when the peak number of inpatients approached 400 in Fresno County and more than 600 across Fresno, Kings, Madera, Mariposa, Merced and Tulare counties.
This time, things are different. In the summer, hospitals had access to additional staffing resources like travel-registry nurses and medical teams from the U.S. Department of Defense deployed to several facilities to help with the workload.
That came at a time when other parts of the country had already moved past their surge in hospitalizations.
Now, hospitals nationwide are seeing a second spike in cases, which will likely limit the ability of California hospitals to rely on as much out-of-state help, said David Lucchini, assistant director of the Fresno County Department of Public Health.
“If we don’t (slow this down), the holiday season and the end of December could be really ugly,” Lucchini said. “I don’t want to be doom and gloom, but we’ve been down this road before and we’re just seeing a lot more activity nationwide, and that’s what worries me.”
Hospital challenges
Not only are there more patients coming to hospitals in the area, but many are coming in sicker, said Terry Boggess, the director of infectious disease prevention for the Adventist Health Central Valley Network with hospitals in Hanford, Tulare, Reedley and Selma.
“In the last two weeks we’ve more than doubled in the number of COVID patients that we see,” said Boggess, adding that the Adventist system routes all of its coronavirus patients to its Hanford hospital. “We’re seeing a lot of very sick patients, and I think that’s being duplicated throughout the area.”
Boggess added that Adventist’s doctors report many of the new cases have been people who recently attended large gatherings such as christenings and funerals – family or social gatherings that health experts say are a prime ground for the highly contagious virus to spread.
And that’s adding to the hospital’s workload.
“We’re getting close,” Boggess said. “We’re not ‘full’ full, but we have many more patients now, and we really don’t want to go back to July when half of our hospital was COVID.”
Dr. Jorge Martinez, medical director of Saint Agnes Medical Center’s hospitalist program, said the increased caseload is being felt in his hospital as well. “I would say over the last four days, we doubled the numbers of hospitalizations,” he said. “Right now we’re running in the mid-60s. On the 18th, our hospitalizations were in the 30s.”
“What we see from the medical staff is a big concern about what’s coming,” Martinez added. “We cannot deny that. … Despite getting close to a vaccine, we know it’s not going to be available for the public until hopefully early next year. So the only option we have right now to mitigate the impact COVID-19 to make sure we continue preventing the spread of the disease.”
Serious consequences
Patients aren’t the only ones facing a danger from the coronavirus. Nurses, doctors and other medical staff are also being exposed to and contracting the virus.
At Community Medical Centers, which operates Fresno Community and Clovis Community hospitals and the Fresno Surgical Center, 249 health care workers are in self-isolation this week because of exposure to COVID-19, including 90 who have tested positive for the virus.
Saint Agnes Medical Center in Fresno has 101 staff in quarantine as of Tuesday, including 59 with confirmed coronavirus infections. Kaweah Delta Medical Center in Visalia reported that 43 of its staff were confirmed positive for the virus as of last week.
“We were fortunate in the first surge that many of our providers did not get COVID,” said Dr. Lori Weichenthal, associate program director of emergency medicine for the UC San Francisco medical education program in Fresno. “But we’ve had four positives in the last four days among our providers. That really suggests that this is going to hit our nurses, hit our techs (and) hit our physicians in a much larger way than it did in the summertime.”
“It impacts our ability to provide quality care to our patients in the Valley,” Weichenthal added. “You can have all the ventilators you want, you can have new treatments, we can understand the disease process a lot better. But if we don’t have nurses and techs and physicians to provide care, it really doesn’t matter.
There’s an emotional toll for health care providers as well, she said. “We all just experience fatigue as human beings dealing with this pandemic in our personal lives. But for our providers who go in every day and provide care to these patients – and all the other patients who normally present to a hospital – it is very fatiguing.”
“It is hard to watch people die when you feel somewhere in your heart that perhaps they didn’t need to,” Weichenthal said.
“These are your friends and neighbors and relatives … and the more we do the things we need to do – wear masks, social distancing, hand washing and everything – it not only protects us and protects the people we love, but hopefully it will also protect our health care workers in the Valley so they can continue to do their jobs.”
Public health, not limits on liberty
The chief of staff at the VA Central California Health Care System in Fresno, Dr. Cynthia Wallace, said the relatively simple measures of hand washing, mask wearing, maintaining physical distance in public and limiting social gatherings are a matter of public health rather than limitations on individual liberty.
“Nobody’s trying to control you or restrict your freedoms,” she said. “We don’t want to get to a situation where we have to allocate resources, and decide who gets a ventilator and who doesn’t get a ventilator.”
“We’re at a point now where there’s light at the end of this tunnel; we have vaccines on the horizon,” said Wallace, who is also an epidemiologist. “So we’re really asking people to hunker down just for another few months while we get through this bad phase with flu season coinciding with COVID, and get us all healthy to a vaccine so we can resume our usual activities.”
This story was originally published November 24, 2020 at 4:02 PM.
