Local hospitals brace for coronavirus

  • March 21, 2020
  • Jim Johnson

UPDATE: Late Saturday afternoon, the Monterey County Health Department announced the first death of a county resident due to complications from COVID-19. The adult individual was hospitalized and had an underlying health condition. The health department also increased the number of COVID-19 cases in the county to 11.

SALINAS — As the number of local cases of the COVID-19 begins to climb, area hospital officials expressed confidence in their ability to handle an increase in patients despite limited testing capacity, and potential challenges with key medical supplies and equipment, staffing and treatment space.

Community Hospital of the Monterey Peninsula, Salinas Valley Memorial Hospital and Natividad have been planning for months with Monterey County officials for a possible local outbreak, and have already set up protocols for screening potential coronavirus cases outside their emergency departments along with making other preparations.

Most of the seven confirmed county coronavirus patients have had mild enough symptoms that they have been sent home to self-quarantine while they recover. Only one has been hospitalized in isolation.

If and when more coronavirus patients begin filling up local hospitals, though, the real test of their preparations will begin.

On Friday, Salinas Valley Memorial Hospital chief medical officer Dr. Allen Radner, an infectious disease expert with connections to all three local hospitals, said local health care officials are not anticipating large numbers of coronavirus cases largely due to measures such as shelter in place orders and social distancing.

Radner, in a teleconference on Friday, said the expectation is the outbreak will be “roughly comparable to a bad influenza year.” He noted that the flu can kill up to 40,000 people a year in the U.S. while coronavirus deaths have so far claimed about 200 lives. But he also noted the coronavirus is new so there is no immunity among the population and with the absence of medication and a vaccine it makes sense to take “mitigation measures.”

“There’s a national concern that this is frightening and there will be a large number of deaths,” Radner said. “We’re trying to avoid thousands or even tens of thousands of deaths.”

At the same time, Radner said additional testing capacity to help identify the spread of the virus among those who are not considered the highest risk would help in battling the coronavirus. However, there is currently limited commercial capability to produce more.

“Despite our desire to test more, the county is unable to accommodate that,” he said. “One of the main things we’re concerned about is supplies. It’s a local and national issue. We’re OK for now but if this goes on for months we’ll run out of supplies.”

Community Hospital of the Monterey Peninsula infection prevention medical director Dr. Martha Blum said the hospital faces the “same challenges that all health care systems throughout the country are facing at this time, namely, having enough health care workers, supplies and facilities to care for potentially larger numbers of moderately to severely ill patients.”

Blum said Community Hospital has plans in place to cross-train doctors and nurses to take on other roles in the hospital during an outbreak. He added that they are using alternative sources of supplies and equipment while “maximizing’ the use of current supplies. Other sites in the Montage Health system are also being looked at to expand patient care capacity, developing and using technologies such as telehealth and remote patient evaluation and monitoring to allow treatment of patients at home.

Community Hospital spokeswoman Brenda Moore said some supplies are currently more difficult to acquire and the hospital continues to receive new supplies but not in the volumes requested. Moore noted the hospital has not yet had to dip into its emergency supplies kept in reserve for epidemics such as the coronavirus. It has agreements with the county Health Department and the state to help secure additional supplies when needed.

Natividad chief medical officer Dr. Craig Walls said the county-owned hospital has enough supplies for now but noted that health care officials learned from Italy and Washington state that supplies can run out, which he said is a “cause for concern” for all hospitals and supplies are being closely monitored while hospital staff stays in touch with vendors.

Walls said Natividad is “prepared to handle a gradual influx or a sudden surge” in coronavirus cases, though staffing, room and supplies “may be challenges if we see a rapid surge,” noting that “some things are indeed in high demand and in short supply.”

That’s why measures such as social distancing and shelter in place orders are so important because they help “flatten the curve” of new cases, and allows the hospital and local health care system to absorb and accommodate a more gradual increase.

“This will allow us all to care for people and not get overwhelmed as we’ve seen other countries become due to this pandemic,” he said. “It’s so important to get everyone’s cooperation on this as much as possible right now so we can slow the spread of coronavirus. This will save lives and help more people who require hospitalization get the care they need.”

Combined, the three hospitals are licensed for more than 700 beds, including 43 ICU rooms, though all three hospitals are also capable of expanding isolated treatment space, including ICU capacity, if needed, according to Radner, Blum and Walls.

Blum noted that local health care officials have been preparing for months for an outbreak she said: “will inevitably occur here.”

“We have had more time to prepare for wide-spread transmission in our community than other places, like Seattle and Santa Clara County,” she said. “The more prepared we are the better the likelihood of ‘flattening the curve’ and avoiding overwhelming our local capabilities.

“But ultimately we look to our local, state and federal agencies to assist us when and if we reach a crisis point.”

Meanwhile, Community Hospital announced on Friday that it would restrict visitors to one per patient instead of two.