Merced County hospitals near ‘Crisis Care’ status
‘People are at risk of dying due to COVID simply because we are in danger of not having the resources to care for them if we continue to see the number of COVID cases increase at the current rate. … Progressing to crisis level care means triaging medical care and ventilators so that not everyone who may need that level of care will be able to receive it.’
Dr. Joerg Schuller,
VP of Medical Affairs at Mercy Merced Medical Center
EDITOR’S NOTE: The following is a statement to Merced County residents on the “Status of hospitals in Merced County from increased demand due to the COVID-19 pandemic” by Dr. Salvador Sandoval, Merced County Health Officer.
Both hospitals in Merced County have been experiencing a surge in demand commencing in November 2020 due to the rising number of cases after Halloween and Thanksgiving, consequent illnesses, emergency room visits, and hospitalizations of Merced residents ill with Covid-19. The month of December has been the worst on record in terms of number of cases, hospitalizations, and deaths. Early indications are that we are seeing a rapid increase in cases and hospital visits due to the Christmas holiday, and likely will also after New Year’s festivities. Typically, increased case counts are followed by increased hospitalizations and ER visits at about two weeks, and deaths about a month later.
This unprecedented situation is placing tremendous strain on the capacity of both hospitals in the county to assess, treat, and process patients in a timely manner. As stated by Dr. Joerg Schuller, VP of Medical Affairs at Mercy Merced Medical Center: “People are at risk of dying due to COVID simply because we are in danger of not having the resources to care for them if we continue to see the number of COVID cases increase at the current rate.” He further adds: “Progressing to crisis level care means triaging medical care and ventilators so that not everyone who may need that level of care will be able to receive it.”
The strain on the hospital system has led to increased waiting times for patients, resources such as hospital beds and entire floors having to be dedicated to treatment of Covid-19 positive patients, cancelation of elective surgeries, and shifting of resources and personnel from usual duties to meet the demand. Added to this has been the impact on the hospital staff with personnel illness, increased work hours, and stress. Both hospitals have reported staffing shortages. Other hospitals in the region and in the state, particularly in Southern California are in a similar or worse situation.
The hospitals, in conjunction with the Merced County Department of Public Health, are closely monitoring the situation, and utilizing state resources where and when available, including the possibility of transferring some patients to alternate care sites, which are located out of the county. Already, both hospitals have been vacillating between conventional or usual care and what is referred to as “contingency care,” at times on a day-to-day basis. Primarily this has consisted in the use of step down units where patients are monitored on a floor rather than in the intensive care unit.
If the situation further deteriorates, the hospitals in the county will be forced into “crisis standards of care,” as mentioned by Dr. Schuller above. This may mean further delays in care or having to make difficult decisions about which patients will be prioritized to receive life saving interventions. It also will likely require cot-based care, further stepdown of intensive care, changes in nursing and MD ratios and responsibilities. It may require ambulance diversion with evaluation in the field, likely with telehealth by physicians complementing paramedic evaluation.