Orange County public health officials continue forcing hospitals to take ambulance patients, despite full emergency rooms, because skyrocketing coronavirus cases continue to rock hospitals around the county.
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It’s a move likely not before seen in OC.
“They said there’s no diversion now — we’re going to come to you and you’re going to take the patient,” said Dr. Todd Newton, an emergency care physician. “I’ve never seen that happen.
Newton, also the Orange County medical director for Kaiser Permanente, said the pandemic has produced many firsts for his career.
“I’ve never seen ambulances report having to wait two or three hours to drop patients off at hospitals in Orange County,” Newton said in a Friday phone interview. “We never had to talk to surgeons about the possibility of coming in and taking care of COVID patients. We’re not there yet, but we’re planning for it.”
OC Emergency Medical Services director Dr. Carl Schultz issued a directive last Wednesday, forcing hospitals to take ambulance patients even if they’re full.
Schultz what’s known as “diversion” — when an ambulance has to find another hospital because the first one they drove to is full.
“In the last 24 hours, we have seen EMS hospital diversion increase to extreme levels with 20 hospitals being on diversion for a total of 213. This is not sustainable,” Schultz wrote in his directive last Wednesday.
The directive was supposed to last three days.
But trends failed to improve by Friday and Schultz continued the directive until the average patient offload time for 90% of ambulance deliveries dips below 50 minutes for three days in a row.
“It is difficult to convey in words the stress you all are under and the seriousness of the situation. OCEMS will be examining the data frequently and reinstate ambulance diversion as soon as the situation permits,” Schultz wrote in Friday’s directive.
Some hospitals are having to curb non-emergency procedures in order to shuffle medical staff around to handle the tsunami of virus patients hitting hospitals.
Meanwhile, hospitalizations have been skyrocketing in OC, California and most of the country.
As of Monday, 1,709 county residents were hospitalized, including 380 people in intensive care units.
That’s a nearly 350% increase in hospitalizations from a month ago, when 380 people were hospitalized, including 91 in ICUs on Nov. 21.
The virus has now killed 1,777 OC residents out of 128,181 confirmed cases, according to the county Health Care Agency.
And OC saw another 3,753 cases reported Monday, following a record-setting 4,606 cases reported Sunday.
Orange County has averaged roughly 3,200 new cases a day for the past week.
State officials estimate roughly 12% of all new cases will end up in hospitals within two to three weeks.
OC’s positivity rate is nearly 16%, according to the latest estimates from state public health officials.
The virus has already killed more than three as many people as the flu does on a yearly average.
For context, Orange County has averaged around 20,000 deaths a year since 2016, including 543 annual flu deaths, according to state health data.
According to those state death statistics, cancer kills over 4,600 people, heart disease kills over 2,800, more than 1,400 die from Alzheimer’s disease and strokes kill over 1,300 people.
The county is on track to surpass its average yearly deaths with over 19,000 people dead as of October, the latest available state health data.
It’s a difficult virus for the medical community to tackle because some people don’t show any symptoms, yet can still spread it. Others feel slight symptoms, like fatigue and a mild fever. Others end up in ICUs for days and weeks before making it out, while other people eventually die from the virus.
State public health officials fear there could be nearly 100,000 people hospitalized in the state at some point next month.
“We are worried that certain regions could exceed their existing capacity and maybe go beyond their existing surge capacity,” said Secretary of the state Health and Human Services Agency, Dr. Mark Ghaly, at a Monday news conference.
The ICU beds in Southern California are used up, according to the state Department of Public Health.
Doctors, like Newton, aren’t worried about making new beds for patients.
They’re worried about staffing — a finite resource.
“If everything stays on the course we’re seeing now, we could be seeing 100%, 150% even 200% more cases than we’re seeing now today. And that has everyone staying up at night, planning. Because that’s going to be a problem,” Newton said.
The trends led to curbing some non-emergency procedures, he said.
“For that reason we have started ramping way down on elective surgeries and procedures because you need that staff,” Newton said. “You need to redeploy positions to help and all of those things are in place and occurring right now. We’re planning all day every day into the night.”
Here’s the latest on the virus numbers across Orange County from county data:
Spencer Custodio is a Voice of OC staff reporter. You can reach him at firstname.lastname@example.org. Follow him on Twitter @SpencerCustodio