Sonoma County hospitals prepare for coronavirus patient surge; no plans to halt elective surgeries
If Santa Rosa Memorial Hospital starts moving patients from the emergency department to inside the vast white tent outside the hospital, that will indicate the dreaded coronavirus surge has begun.
It’s what county public health officials and health care workers have long feared since the pandemic arrived in Sonoma County in March. So far, Memorial Hospital — the county’s highest-level trauma center — has been able to manage its volume of COVID-19 patients, as have other local hospitals.
“When you see us panic, you’ll know,” said Scott Rocco, manager of Memorial’s emergency department, as he stood Friday outside the white tent covering six medical bays where doctors and nurses would take care of a rush of sick people. Later that day, the county would report 89 new cases of COVID-19, the highest single-day total.
Late Saturday, the county reported two more people have died of COVID-19, bringing the total to 16 since the pandemic emerged in early March. Details on the two new deaths were not available Saturday.
Rocco explained a surge occurs when the number of people showing up at a hospital exceeds its ability to treat them. It happened with recent wildfires, but it hasn’t occurred in the ongoing pandemic — at least not yet.
If it does, Rocco and other leaders at Sonoma County hospitals say they’re ready, or as ready as they can be.
In the spring, no surge of hospital patients materialized, although area medical centers had urgently prepared. Now, the county is losing a grip it had on the virus, resulting in soaring numbers of new infections, 11 deaths since late June and more residents suffering from the infectious disease needing hospital care.
To be sure, the spike in virus-related hospitalizations statewide over the past two weeks is alarming and a reminder the pathogen has not taken a summer break. California’s 416 hospitals have had a 49% increase in patient admissions with COVID-19, and a 38% boost in patients needing intensive care.
This time around, Sonoma County hospital leaders say nurses and doctors know much more about treating the highly contagious disease and have many more therapeutics like Remdesivir available.
Dr. Chad Krilich, chief medical officer for St. Joseph Health Sonoma County, operator of Santa Rosa Memorial and Petaluma Valley hospitals, said a hospital’s readiness for an inundation of virus-afflicted people depends on a number of factors, including whether there are enough health care workers and protective gear for them to take care of the influx of patients.
“Given our current volumes today and given the projections that I’m seeing today, are we ready for a surge? Yes,” Krilich said Friday. “Tomorrow will be a different day and we'll need to reevaluate everything all over again.”
The COVID-19 hospitalization rate was the one local statistic that had remained relatively stable, even as infections steadily increased. That changed a few weeks ago.
In late May, the largest number of coronavirus patients hospitalized in the county was eight. Through most of June, the average number of virus patients in a local hospital was five, and there were never more than seven.
Since June 26, though, the number of COVID-19 cases in local hospitals has jumped to 28 patients on Friday, according to the county’s hospital capacity dashboard.
As of Saturday, the average number of people hospitalized over a three-day period had increased 30%, far exceeding the 10% benchmark established by the state, signaling trouble with suppressing the virus outbreak. Therefore, Sonoma County on Friday landed on the state’s coronavirus watchlist, joining 29 other counties and triggering eventual restrictions expected Monday to halt indoor dining and drinking at restaurants, wine tasting rooms and breweries, among other pullbacks.
Expansion of beds, ICU care
As local hospitals admit more coronavirus patients, they are revamping plans to potentially add more beds as they need them, including staffing additional ICU beds as patients fill them.
In the event of an actual surge, the county’s six acute-care hospitals and its one long-term acute care hospital could add at least an additional 184 regular hospital beds, along with at least 58 beds for ICU patients to its 707 staffed beds, 67 of which are ICU beds, according to a Press Democrat survey of the seven medical centers. Sutter Santa Rosa Regional Hospital was the only one that declined a request for information about the number of extra beds it planned.
At Memorial and Petaluma Valley sister hospitals, negative pressure rooms for virus patients could be increased from 11 to 25 and 26 to 32, respectively. Memorial could add six more ICU beds to its 26 and Petaluma Valley similarly could add another five ICU beds to its nine.