Fresno, Valley hospitals ‘in worse condition today’ than winter’s COVID pandemic peak
Hospitals in Fresno and across the central San Joaquin Valley are facing what health care leaders describe as “unprecedented” strain as serious cases COVID-19 rise and doctors struggle to find places to care for all of their patients — even those who don’t have the coronavirus.
“If I had to describe the healthcare system in the region, it’s in a state of paralysis,” said Dan Lynch, emergency medical services coordinator for Fresno County.
Lynch also oversees emergency medical operations across neighboring Kings, Madera and Tulare counties. “We’re unable to move patients for the most part” because hospitals are full with no ability to shuffle overflow patients to other nearby hospitals.
“We are in worse condition today … than we were in the highest point of December and January,” Lynch added.
Ambulances in the region are under direction to consider each patient that calls for a ride to a hospital under an “assess and refer” process.
Under the directive, ambulance operators are also asked to tell patients whose condition is not a true emergency to seek other means of care, including their family physician, health clinics or urgent-care centers. That’s because hospital emergency rooms are overflowing with patients waiting to be admitted for whom no hospital beds are available.
“We’re telling them we will not transport them to the hospital,” Lynch said. “This is unprecedented in our area.”
Overnight Thursday and into Friday, Lynch said his team organized transfers of at least five intensive-care patients at hospitals in Fresno to other parts of the state – not because more distant medical centers have a greater ability to provide care, but simply to make room for more critically ill patients.
“In my 26 years in this position, we’ve never had to transfer patients out of our area because of sheer volume,” Lynch said Friday in a video briefing with reporters. “That is the condition that we’re in right now; we need to make space in our hospitals in Fresno right now.”
Those overnight transfers, including one patient whose condition required transport by aircraft rather than ambulance, were sent to hospitals in Watsonville and Woodland. Lynch said there are also talks to transfer some other patients to medical centers at Stanford, Santa Clara and San Mateo.
“We’re sending people pretty far outside of our region,” Lynch said, “and the families then have to be able to go with these very sick individuals.”
‘Almost at a tipping point’
Within Fresno-based Community Medical Centers’ facilities – Community Regional Medical Center in downtown Fresno and Clovis Community Medical Center in Clovis – “every single bed is full,” said Dr. Tom Utecht, Community’s chief medical officer. Both hospitals, he added, have been at between 120% and 130% of their capacity.
“We are almost at a tipping point,” Utecht said. “Although our COVID numbers aren’t as high as the winter surge, our overall numbers (of patients across the board) are much higher.”
That workload is complicated by having less staff now than during the previous coronavirus surges last summer and over the winter. “We have more people, more very sick people, and less staff to take care of those people,” he added.
“That means we’re functioning in a disaster mode at this point. … We are so strained that our ability to take care of whatever you come to the hospital for – not even if it’s COVID, but a car accident or a stroke or a heart attack – is very difficult at this time.”
The situation is similar at Saint Agnes Medical Center in northeast Fresno. “We’re struggling to place patients from the emergency room up onto our floors because they are completely full,” said Ivonne Der Torosian, vice president of community health and well being for Saint Agnes.
“We’ve converted units for critical care and ICU beds,” she said. Still, Der Torosian added, “we run out of ICU beds on a daily basis.”
Fresno and the central San Joaquin Valley face a shortage of nurses and doctors even in the best of times, Der Torosian said. But that shortage has become even more acute in the pandemic as staff are exposed to or catch COVID-19 and must quarantine themselves. “Now impacted with more patients, it makes it hard to truly be able to staff accordingly,” she said.
A Visalia hospital, Kaweah Health, last week dealt with its own crisis situation for two days with an overflowing emergency room and patients waiting for hours to be admitted to an inpatient room for care before the strain let up.
Dr. Rais Vohra said the hospital situation is likely to remain under an increasing burden through September as coronavirus cases continue to climb in the region.
He expressed concern over the upcoming Labor Day holiday weekend and accompanying end-of-summer parties and family gatherings. “Be careful,” Vohra said. “Those parties, we know, can lead to superspreader events” for COVID-19.
“But even outside of COVID, God help you if you have a car crash today. … It’s really that serious right now” for hospital capacity,“ he added. “All of the care that we deserve and expect from our hospitals, whether that’s heart attacks or strokes or delivering a baby, all of that is being impacted right now.”
“The more risky activities that you partake in, the more you’re exposing yourself, your relatives and your family to tragedy which will be unavoidable if you have to seek out medical care for something serious,” he said.
‘Infodemic’ of misinformation
Vohra and Lynch expressed frustration at people in the community who express skepticism or doubt about the severity of the situation for hospitals and who dismiss calls by medical experts for people to get vaccinated to slow the spread of the coronavirus.
“It’s just another symptom of the ‘infodemic,’” Vohra said. “In the same way that COVID presents with a constellation of symptoms, this information pandemic that we’re struggling with also presents with a constellation of symptoms – people doubt the layers of protection, they doubt the efficacy of the vaccines, they seek out alternative and unproven cures, and they express skepticism whenever the leaders of the hospitals are telling them that hospitals are at or over capacity.”
“That constellation of symptoms is a sign that someone has been infected by viral misinformation,” he added. “I feel sorry for them. I wish I had a vaccine for that and a cure for that. But really it’s up to everyone to protect themselves and inoculate themselves with the truth.”
“Unfortunately, until we can convince everyone about the veracity of what we are expressing, we’re going to be losing lives,” Vohra said. “That’s what’s heartbreaking. … By the time we convince the skeptics, it may be too late for themselves or their families.”
This story was originally published August 27, 2021 at 2:32 PM.
