The COVID-19 wave that continues to hit Central California is so dire that health officials are urging state officials to make it easier to transfer hospitalized patients to areas such as Los Angeles County.
“We don’t have enough hospitals to serve the population and needs,” says Dr. Rais Vohra, the Fresno County interim health officer. Hospitals throughout the San Joaquin Valley “often have overcapacity, so they keep dozens and dozens of patients in the emergency department.”
Officials in the San Joaquin Valley expect a difficult winter. Vaccination rates are still relatively low, and in Fresno County, the region’s most populous county, the number of hospitalizations from COVID-19 is four times higher than in LA and Orange counties, and more than five times higher than in the United States. San Francisco Bay Area.
Hospitals consistently operate above capacity, and emergency rooms are still so full that ambulances wait outside hospitals to drop patients off, said Dale Dotson, surgery coordinator for the Central California Emergency Medical Services Agency.
Some hospitals are so busy that ambulance patients suffering from strokes or heart symptoms are being diverted to facilities other than usual to ensure there are enough staff available to care for them when they arrive. Hospitals and ambulance services continue to report problems with staff, Dotson said.
San Joaquin Valley officials are pleading with California state officials to find a way to make it easier to transfer hospitalized patients to other, less-affected areas.
“It’s really hard to transfer between counties in the state of California,” Vohra said. “If you look at Los Angeles … they have hundreds and hundreds of open beds in Los Angeles County.”
“If we need to transfer patients to keep our hospitals up and running, we really need to be able to do it in one or two phone calls. That is not the situation at the moment. And so that’s a point of frustration that we’re hearing from multiple different facilities,” Vohra said. “We’re trying to decompress as much as possible in anticipation of those winter numbers.”
It wasn’t immediately clear why hospitals in Fresno County are reporting problems transferring patients to other parts of the state.
“The bureaucracy . . . it’s kind of opaque,” Vohra said. “Of course every hospital has a transfer center and they are very used to doing transfers. But then other hospitals should actually accept it.”
The LA County Department of Health Services said in a statement that it “welcomes patients from other counties and ensures 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 a region of more than 4 million people. In contrast, all of LA County has 558 COVID-19 patients, despite a population of more than 10 million people.
For every 100,000 residents, Fresno County has 22 COVID-19 patients in its hospitals; while LA and Orange counties have six, and the San Francisco Bay Area has 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 vaccinated. Statewide, the rate is about 63%; it is 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 will scrutinize the COVID-19 numbers to see if a surge is emerging from holiday weekend gatherings.
A plausible scenario could be that the San Joaquin Valley is hit relatively hard by a winter wave, the San Francisco Bay Area is much less affected, and Southern California is somewhere in the middle, said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco.
An increase in infections in the Central Valley could put a lot of pressure on local hospitals if many people who are infected are not vaccinated, who are much more likely to become seriously ill than those who have had their injections and only suffer from breakthrough infections .
“I think for the most part [the Central Valley] will continue to suffer from an overload of hospital resources. So I think it is very wise and foresight of them to make arrangements now” to prepare for a winter wave, Chin-Hong said.
Getting children aged 5 to 11 vaccinated is likely to have a big effect on the severity of the winter wave in each region. While only 7% of Fresno County children in this age range have received at least one dose of COVID-19 vaccine, approximately 12% of these children have received it in LA, 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.
“That will give the Bay Area even more force fields compared to Southern California. So I think Southern California could be like the intermediate zone,” Chin-Hong said.
While some places in California with low vaccination rates may not see a surge yet, they can develop as the weather cools, sending people indoors, where the transmission spreads more efficiently.
In some places it might be ‘okay, but it might not last long. Once this thing takes off, it goes exponentially,” said Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla.
The statewide full vaccination rate in California, 63%, is still too low to expect that we’ve created a wall of immunity, Topol said. “If we were at 90% of the total population, 85%, you know, we’d have a chance to really stop this,” he said.
Nationally, the outlook looks discouraging. While cases and hospitalizations have recently stabilized in California, the nation is seeing a marked increase in the number of cases; the US now has an average of about 91,000 new coronavirus cases per day, up from 74,000 cases per day a month ago. New daily hospital admissions for COVID-19 have increased by 8% nationwide since November 1.
How regions fare in the winter also depends on how many adults get their booster shot, Topol said.
“We know that their risk of serious illness is significant” for vaccinated people over 40 who have not been boosted and are more than six months away from their first vaccination course, he said.
For younger vaccinated adults who have not been boosted, “their risk of symptomatic infection is increased. And the problem with that is that they can then go on and infect other people. That is why I strongly believe that boosters are essential as part of our defence.”
At a press conference in San Francisco on Monday, Governor Gavin Newsom promoted shots for children and boosters for adults.
Newsom warned that other states that are seeing an increase in the disease, such as Michigan, Colorado and New Hampshire, are possible warning signs.
“I don’t want to see that happen here in California,” Newsom said. “Get that booster shot.”
dr. Anthony Fauci, President Biden’s chief medical adviser for the pandemic, agreed that weakened immunity among vaccinated people is a very real problem, urging people to get their booster.
“You have waning immunity. It’s a reality. We just have to face it,” Fauci told CBS Mornings on Monday. “If you get vaccinated, you get a high level of protection, but after a few months the immunity decreases. Even if you are infected and recover, the immunity decreases.”