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Central California begs to send COVID-19 patients to LA

The COVID-19 outbreak that still affects central California is so severe that health officials are begging state officials to facilitate the transfer of hospital patients to areas like Los Angeles County.

“We don’t have enough hospitals to meet the population and the needs,” said Dr Rais Vohra, acting health officer for Fresno County. Hospitals across the San Joaquin Valley “are often overcapacity, so they are holding dozens and dozens of emergency room patients.”

Authorities in the San Joaquin Valley expect a difficult winter. Vaccination rates are still relatively low and in Fresno County, the most populous county in the region, the hospitalization rate for COVID-19 is four times that seen in Los Angeles and Orange counties, and more than five times that of the San Francisco Bay Area.

Hospitals are constantly operating above capacity and emergency rooms are always so crowded that ambulances wait outside hospitals to drop off patients, said Dale Dotson, operations coordinator for Central California Emergency Medical Services. Agency.

Some hospitals are so overcrowded that ambulance patients with strokes or cardiac-like symptoms are referred to facilities other than the usual ones to ensure that there are enough staff available to take care of them on their own. arrival. Hospitals and paramedics continue to report staffing issues, Dotson said.

San Joaquin Valley officials are pleading with California state officials to find a way to facilitate the transfer of hospital patients to other less affected areas.

“It’s really difficult to transfer across counties in the state of California,” Vohra said. “When you look at Los Angeles … they have hundreds and hundreds of beds open in Los Angeles County.”

“If we have to transfer patients to keep our hospitals operational, we should really be able to do that with one or two phone calls. This is not the situation at the moment. And so that’s a point of frustration that we hear from several different installations, ”Vohra said. “We’re really trying to decompress as much as possible in anticipation of these winter numbers.”

It was not immediately clear why Fresno County hospitals are reporting difficulties in transferring patients to other parts of the state.

“The paperwork … it’s pretty opaque,” ​​Vohra said. “Obviously every hospital has a transfer center, and they’re very used to doing transfers. But it actually requires other hospitals to accept. “

The LA County Department of Health Services said in a statement that it “welcomes patients from other counties while ensuring that health services are readily available to residents of our county.”

The San Joaquin Valley has the worst COVID-19 hospitalization rate in all of California, with nearly 800 COVID-19 patients hospitalized in an area of ​​more than 4 million people. In contrast, the entire LA County has 558 COVID-19 patients, despite a population of over 10 million people.

Per 100,000 people, Fresno County has 22 COVID-19 patients in its hospitals; while LA and Orange counties have six and the San Francisco Bay Area four. Some experts say it’s a sign of concern when the hospitalization rate for COVID-19 is five or worse.

Only 55% of Fresno County residents are fully immunized. Statewide, the rate is about 63%; it’s 65% in LA and Ventura counties, 66% in Orange County, 69% in San Diego County, and 78% in San Francisco.

A big test of late fall and early winter will be the weeks after Thanksgiving, when officials take a close look at COVID-19 numbers to see if an increase emerges from holiday weekend gatherings.

A plausible scenario could be that the San Joaquin Valley is relatively hard hit by a winter wave, the San Francisco Bay area is much less, and Southern California is somewhere in the middle, Dr Peter said. Chin-Hong, an infectious disease. expert at UC San Francisco.

A spike in infections in the Central Valley could put a strain on local hospitals if many infected people are not vaccinated, who are much more likely to become seriously ill than those who have been vaccinated and only suffer from breakthrough infections. . .

“I think that to a large extent, [the Central Valley] will continue to suffer from pressure on hospital resources. So I think it is very wise and prescient of them to start making arrangements already ”to prepare for a winter wave, said Chin-Hong.

Vaccinating children between the ages of 5 and 11 is likely to have a major effect on the severity of the winter wave in each region. While only 7% of Fresno County children in this age group received at least one dose of the COVID-19 vaccine, about 12% of those children did so in Los Angeles, San Diego and Orange counties. .

Rates in the Bay Area are much higher: 28% in Santa Clara County, 30% in San Francisco and 46% in Marin County.

“It’s going to give the Bay Area even more force fields compared to Southern California. So I think Southern California could be like the middle zone, ”Chin-Hong said.

While some places in California with low immunization rates may not yet see a large increase, they may see one develop as the weather cools, sending people indoors, where transmission takes hold. spreads more efficiently.

Some places may “do well, but it may not last.” Once this thing starts, it becomes exponential, ”said Dr Eric Topol, director of the Scripps Research Translational Institute in La Jolla.

California’s statewide full vaccination rate, 63%, is still too low to expect we’ve created a wall of immunity, Topol said. “If we were 90% of the total population, 85%, you know, then we would have a chance to really delay that,” he said.

Nationally, the outlook looks bleak. Although cases and hospitalizations have recently stabilized in California, the country is seeing a marked increase in cases; the United States now averages about 91,000 new cases of coronavirus per day, up from 74,000 cases per day a month ago. New daily COVID-19 hospital admissions are up 8% since November 1 nationwide.

The situation of the regions during the winter will also depend on the number of adults receiving their booster injection, Topol said.

“We know their risk of serious illness is substantial” for vaccinated people over 40 who have not received a booster and are more than six months away from their initial vaccination series, he said.

For vaccinated young adults who have not received a booster, “their risk of symptomatic infection is increased. And the problem with that is, then they can go on and infect other people. This is why I firmly believe that boosters are essential in our defense.

At a press conference in San Francisco on Monday, Gov. Gavin Newsom promoted shots for kids and boosters for adults.

Newsom warned that other states with an increase in the disease, such as Michigan, Colorado and New Hampshire, are potential warning signs.

“I don’t want that to happen here in California,” Newsom said. “Get that booster shot. “

Dr Anthony Fauci, President Biden’s chief medical adviser on the pandemic, agreed that the weakening of immunity in those vaccinated is a very real problem and urged people to get their booster.

“You have waning immunity. It’s a reality. We just have to face it, ”Fauci said Monday on“ CBS Mornings ”. “When you get the vaccine you get a high degree of protection, but after several months your immunity wanes. Even if you are infected and recover, immunity wanes.

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