By Angela Hart and Anna Maria Barry-Jester for Kaiser Health News
California hospitals thought they were ready for the next big disaster.
They have modernized their buildings to resist a great earthquake and forest fires. They have kept patients alive with backup generators in power outages, and have trained their staff to deal with shootings.
But nothing has prepared them for a crisis of the magnitude they face today.
“We are in a battle against an invisible enemy, and we have to fully mobilize in a way that has never been seen in our careers, “explains Stephen Parodi, infectious disease expert at Kaiser Permanente in California (unrelated to Kaiser Health News).
As California enters the most critical period of the battle against the coronavirus pandemicIts 416 hospitals, large and small, public and private, strive to build the necessary capacity for an avalanche of critically ill patients.
[California busca 37,000 nuevos trabajadores de salud]
Health centers are already seeing a steady increase in patients infected but, so far, they say they have enough space to treat them.
However, they have also issued a serious warning: What happens in the next four to six weeks will determine whether the overall California experience is more like that of New York, which has seen an explosion of hospitalizations and deaths, or that of the San Francisco Bay Area, which has so far managed to prevent a significant increase in new infections, hospitalizations and deaths. Some of his preparations are common, such as postponing elective surgeries; use more telemedicine to limit face-to-face contact; set up tents outside buildings to serve less critical patients; Or add beds, hospital by hospital, a few dozen at a time, to spaces like cafes, operating rooms, and dismantled wings. But out of necessity, because of himshortage of tests, ventilators, personal protective equipment and even doctors and nursesThey are also trying creative, and sometimes unproven, strategies to increase their readiness and ability.
In San Diego, hospitals can use university residences as alternative care sites. A large public hospital in Los Angeles is turning to 3D printing to make fan parts. And in Santa Clara County, with a population of nearly two million, public and private centers have come together to ease the pressure on local hospitals by caring for patients at the Santa Clara Convention Center. [Trump envía la Guardia Nacional a Nueva York, California y Washington para asistir en la lucha contra el coronavirus] However, some hospitals acknowledge that despite their efforts, they may end up placing patients in the hallways. “The need in this pandemic is so different, so extraordinary, and so great that a typical hospital contingency plan will be insufficient what we’re dealing with in this state and across the country, “said Carmela Coyle, head of the California Hospital Association. [Se disparan a más de 5,000 los casos de coronavirus en California] Governor Gavin Newsom predicts that mid-May, the number of critical care patients will increase to 27,000. California needs almost 70,000 more beds, bringing its total capacity to more than 140,000, both within hospitals and in alternative care centers such as convention centers. It also needs 10,000 more ventilators than the usual number for the large number of patients who need help breathing, according to the governor.
The necessary capacity increase will depend in any case on how citizens obey orders for social distancing and staying at homeNewsom has assured. “It’s not just about health care providers caring for the sick,” said Steve Lockhart, medical director of Sutter Health, which has 22 hospitals in Northern California, in that regard. While hospitals appreciate state assistance, they are also taking dramatic steps to prepare on their own. “I am really very concerned and afraid that so many people continue to do business as usual,” said Chris Van Gorder, head of Scripps Health, a system with five large hospitals in San Diego County. “It wouldn’t take much to overwhelm us,” he added. [¿Todos los mayores de 60 años necesitan tomar las mismas precauciones por el coronavirus?] Internal projections show that your hospital system may need 8,000 beds by June, he said, when he now has 1,200. In addition to taking precautions to protect his health workers, such as using baby monitors to observe patients without risk of infection, he is working with area universities to use the dormitories as hospital rooms for patients with mild cases of COVID-19, among other efforts. “I honestly think we should have been better prepared“Van Gorder said,” but hospitals cannot bear this burden on their own. “
Van Gorder and other administrators say that the Insufficient evidence for COVID-19 has hampered the responseBecause they still do not know exactly which patients have the virus, as well as the chronic lack of public health infrastructure. [[This “promising” treatment could help in the first days of infection, according to doctors] Kaiser Permanente wants to double the capacity of its 36 California hospitalsParodi said. He is also working with the garment industry to make facial masks, and looking for hotel rooms for less critical patients. Harbor-UCLA Medical Center, a hospital with a 425-bed safety net in Los Angeles, is working to increase its capacity by 200%, said Anish Mahajan, its medical director. Harbor-UCLA is using 3D printers to produce ventilation tubes equipped to serve two patients per machine. And in March, it transformed a new emergency room into an intensive care unit for patients with COVID-19. “It was kind of shocking,” Mahajan said of the unprecedented move to create additional space. He said that some measurements have not been tested, but all hospitals face extreme pressure to do everything possible to meet their greatest needs. In March, the Stanford Hospital in the San Francisco Bay Area launched a massive overhaul of its telemedicine system in emergencies to reduce the number of employees who interact with patients in person. It is the first time that the hospital uses telemedicine in this waysaid Dr. Ryan Ribeira, the emergency physician who led the project. Stanford also did a soul-searching, thinking about who among its staff might be most at risk if they detected COVID-19, and assigned them to parts of the hospital with no coronavirus patients or areas dedicated to telemedicine. Very close, Several previously competing San Francisco hospitals have joined together to create a dedicated COVID-19 floor at Saint Francis Memorial Hospital, with four dozen critical care beds. The city currently has 1,300 beds, including 200 intensive care beds. If the number of patients increases, as happened in New York, officials anticipate they will need 5,000 additional beds. [California es el cuarto estado del país con el mayor número de infectados] While hospital officials are cautiously optimistic that state and local orders to stay home have worked to slow the spread of the virus, there are still they are preparing for what could be a major increase in admissions. ANDThis story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation unrelated to Kaiser Permanente. [Sigue toda la información sobre la pandemia del coronavirus]
See also: In California 50% of those infected with coronavirus are young California reports arrests for violating quarantine Indignation in California over death of teenager with coronavirus who was rejected from a hospital for not having insurance –
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