Orange County is facing record-setting coronavirus case increases and hospitalizations as intensive care units keep seeing more virus patients, which could potentially jeopardize non virus treatments.
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As of Monday, 877 OC residents were hospitalized, including 218 people in intensive care units.
During the July peak, 722 people were hospitalized, including 237 in ICUs.
Unlike the July spike, OC’s new peak comes as daily cases are increasing, not decreasing.
For the past week, OC is averaging over 1,400 new cases a day. Throughout the first half of October, the average was less than 200 new cases a day.
Over 2,000 new cases were reported Sunday and roughly 1,960 cases were reported Monday.
State public health officials estimate 12 to 13% of new cases will end up in hospitals two to three weeks down the road.
OC has 18% of its ICU beds left to handle virus patients, according to the county Health Care Agency.
Skyrocketing hospitalizations and case increases are worrying critical care doctors.
Dr. Michael Katz, a critical care doctor who treats virus patients in the ICU at St. Jude’s Medical Center, said ICU patients are usually discharged in a few days.
“Typically, we’re used to getting patients in and out. The flow of the hospital depends on that. We always have to have ICU beds available for patients coming in from the ER, heart attacks, strokes, etc. We also have to have some open for patients coming out of the operating room,” Katz said in a Monday phone interview.
But the pandemic has turned that on its head.
“The COVID patients, on average, are staying for many days to weeks. Some of them for months. Their care is too complicated and their condition is too unstable to move them to lower intensity care environments,” Katz said.
He said typically hospital staff plans for ICU staffing include an estimated number of people coming in from the emergency room, like heart attack patients, and some from the operating room.
But the pandemic has pushed planning to the limits because all the medical workers are already working, he said.
“We’re running into limitations for staffing. There might be a couple more physical beds at a facility, but there’s just no more nurses,” Katz said. “As our capacity diminishes, we have trigger points that will lead us to start pulling back on some of the procedures that aren’t absolutely necessary — hopefully for a shortest amount of time as possible.”
Dr. Paul Yost, an anesthesiologist at St. Joseph’s Hospital in Orange, said the average stay of an ICU patient is normally a couple days.
Yost also said virus patients can stay for weeks, up to months.
The increased stays create a backlog, which eventually jams up the system and could jeopardize non-COVID care like heart surgeries.
Secretary of the state Health and Human Services Agency, Dr. Mark Ghaly, said it’s critical to keep intensive care units from overflowing with virus patients.
“The peak of the summer, some of the regions dealing with COVID had roughly 35% of their ICU capacity filled up with COVID positive patients. We’ve seen that figure eclipsed … so even if you were running at 50 or 60% capacity before COVID, you might be running close to 90, 95%,” Ghaly said.
He warned that as ICU’s max out, it could shut down other vital procedures.
“You can wait only so long to put in a heart valve, or a catheter … they’re elective for a day or two, not months,” Ghaly said. “We want that capacity to be there for you when a car accident happens … or a heart attack or stroke.”
Since the pandemic began, the virus has killed 1,633 county residents out of 88,842 confirmed cases.
“I’ve been practicing 20 years now. Certainly, during my career I’ve never seen anything like this. I’ve seen several bad flu seasons — that doesn’t compare to this in any way shape or form,” Katz said.
The virus has already killed nearly three times as many people in Orange County as the flu does on an average yearly basis.
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.
And doctors have seen people battling lingering effects from the virus after they’re discharged from hospitals.
That led to the creation of a post COVID recovery program at St. Jude’s Medical Center in Fullerton.
“We’re seeing people in the ICU fighting for their lives. Really what goes untold in the story is the suffering that happens due to the severe illness. So we’re seeing people with blood clots, strokes and heart attacks related to COVID,” said Dr. Jim Keany, who treats ICU patients at Mission Hospital in Mission Viejo, in a phone interview last week.
Keany said many of the virus patients suffering from heart problems and other conditions are otherwise healthy people.
He said the hospital has seen a big spike in “cryptic strokes” during the pandemic — meaning doctors can’t pinpoint what caused the stroke.
“Cryptic strokes account for 17% of strokes on average. Since COVID started, this cryptic stroke entity accounts for 60% of strokes,” Keany said, noting that it’s an association and not a direct link.
The virus impacts organs throughout the body, Keany said.
“In autopsies, they’re showing there’s micro blood clots in organs all throughout the body,” he said.
Katz encourages people to continue treating their chronic health problems, like high blood pressure or diabetes, through their primary doctors to avoid using hospital resources.
“It will help the system maintain capacity for treating coronavirus patients.”
Here’s the latest on the virus numbers across Orange County from county data:
Infections | Hospitalizations & Deaths | City-by-City Data | Demographics
Spencer Custodio is a Voice of OC staff reporter. You can reach him at email@example.com. Follow him on Twitter @SpencerCustodio
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