Area hospitals are not only reaching bed capacity, sufficient staffing is also an issue. On Tuesday San Diego County reported another 1,863 COVID-19 cases, 32 deaths from the virus and hospitalizations for the virus reached a record high of 1,033 (up 231% in the last 30 days).
As San Diego hospitals cope with the demand of the virus and other medical emergencies, staff and resources are stretched thin. On Tuesday some area hospitals were forced to turn away ambulances and people seeking emergency medical care. Paramedics waited hours (some 5-7 hours) before they could deliver patients, which required San Diego County ambulance services to change procedures.
Over the weekend a new procedure was tested that allows hospitals to stop deliveries by ambulances unless the patient is suffering “uncontrollable life-threatening problems” like immediate cardiac arrest or an obstructed airway that could be fatal if not cleared in minutes.
Dr. Kristi Koenig, medical director of county Emergency Medical Services, said that when the “complete ambulance diversion” policy was tested by one local hospital, it allowed them to “decompress” within a few hours and come back online. The policy, which was announced on Tuesday, was used almost immediately and 10 hospitals reported using it the same day.
The director commended area hospitals, emergency service staff and public health planners, but is still concerned about the impact of COVID-19 infection rates throughout the county. Koenig expects the ambulance diversion policy to be used much more often, and said “The issue is going to be, of course, if we get to the point where everybody’s in a bypass situation all of the time."
The help with staffing shortages, area hospitals have contacted Sacramento for assistance as the demand is not expected to decline any time soon and in some cases facilities have reported zero staffed and available beds available. On Tuesday evening, Dimitrios Alexiou, President of the Hospital Association of San Diego and Imperial Counties said his organization asked the county Monday to request “staffing support from the state” to help hospitals meet demand. Intensive care nursing, he added, is the primary request but “wasn’t directed to any one facility” or system.
Governor Newsom has said that additional state-contracted specialists can be sent when needed, with over 500 medical personnel have already been dispatched through since pandemic began to areas where patient volume threatened to overwhelm available resources. The U.S. National Guard has already assisted nursing homes in San Diego County.
California has also loosened statewide nursing ratios, which frees up treatment capacity at the expense of quality. Typically ICU nurses are assigned no more than two patients at once, but the state ordered emergency action would increased that to three.
Cover Photo Credit: Getty Images. Chart provided by County of San Diego.