Hospital’s virus cases double
Nurses are being recruited by San Fernando Valley facilities
LANCASTER — Antelope Valley Hospital’s total number of positive COVID-19 patients doubled over the past month while staffing levels remain a concern, according to the most recent data presented during the City’s COVID-19 update.
AV Hospital had 154 positive cases on Thursday, up from 68 cases a month ago. Palmdale Regional Medical Center had 83 cases, up from 53 cases a month ago. AV Hospital also has 24 COVID-19 patients on a ventilator in the intensive care unit, compared to 15 patients last month. Palmdale Regional had 17 ICU patients on a ventilator.
AV Hospital has 20 ventilators on standby, and 80 disposable ventilators. Palmdale Regional has 32 ventilators on standby, and 20 disposable ventilators.
“Our disposable vents have also not been activated yet,” Deputy Mayor Dr. Jonathan Truong said during a presentation Thursday morning on Facebook Live. “But remember, for us, it’s not the vents, it’s not the disposable vents (and) it’s not the beds; it’s the staffing. We’re still struggling with staffing. Our staff do get sick of COVID and they’re out 10, 14 days at a time.”
Truong added the hospital’s nurses are being recruited by hospitals in the San Fernando Valley with an extra $500 a day incentive.
Lancaster’s adjusted positive COVID-19 case rate is 8,441 cases per 100,000 people, compared to 7,305 cases per 100,000 for Los Angeles County. Lancaster’s adjusted death rate 87 deaths per 100,000, compared to 91 deaths per 100,000 for LA County. Palmdale’s adjusted case rate is 9,568 per 100,000; the city’s adjusted death rate is 101 cases per 100,000 people.
“We’ve been hearing that there are hospitals that will be rationing care,” Lancaster Mayor R. Rex Parris said. “Would you explain to people precisely what that means without sugar-coating it?”
Truong replied that some hospitals are asking patient’s families whether their loved one, for example an elderly patient in their 90s with dementia who said she did not want to be on a ventilator, should remain on a ventilator.
“Those tough questions are being raised more frequently, and it’s painful for family and distressing for the staff,” Truong said.
The doctor added they are asking those tough questions not to ration care but to make room for beds and ventilators to be available.
Deputy Mayor Tiffany Tanner the biggest issue she sees hospitals facing is with patients who have been admitted waiting in the emergency room to get a bed.
“When those heart attacks, strokes, traumas, diabetic crises come in, there’s nowhere for them to go to be treated, and so they’re going to have to wait,” Tanner said. “And unfortunately, that is going to lead to some people losing their lives, I think, because there’s nowhere to treat them.”
Truong said when he in the hospital doing rounds he hears about one or two “code blues” or urgent medical emergency, a day. These days Truong hears two or three code blues an hour.
“People are dying; people are being coded,” Truong said.
Those emergencies do not happen in the ICU but on the floor due to a lack of beds. Truong recalled how a few days ago they had 14 patients in the Emergency Department including 10 patients on a ventilator waiting for a bed in the emergency room.
“They’re coding while they’re waiting on the vent,” Truong said. “And the reason there’s no bed is because we have beds upstairs just no nursing staff.”
For the COVID-19 pandemic, the average ratio of nurses to patients on the floor is one to four; they are now at one to six. ICU nurses are typically one to two; they are now at one to three. Telemetry nurses went from one nurse to two patients to one nurse for every three patients.
“Ventilators are the worst,” Truong said. “Our respiratory therapists used to manage one to four, one to five, now they’re at one to nine. Human resources in terms of trained professionals are just not there.”
Tanner added that while AV Hospital’s COVID deaths are not as bad as LA County, deaths from other causes are likely to start rising as the hospital stays overwhelmed.
Truong added both hospitals canceled elective surgeries because there is not enough staff to cover it.
Parris asked, for the benefit of people watching the update, when they should go to the hospital or when they should just call their doctor to potentially ease the load on the emergency rooms. He also asked Truong and Tanner to tell people what to expect when they do go to the emergency room.
Tanner urged people who exhibit any symptoms to call their primary doctor and set up a tele-medicine visit or video chat. Patients can check their vitals at home.
Patients who do need to go to the emergency room will have to wait alone.
City Manager Jason Caudle took questions from the audience. One persona asked if the city had the National Guard in to help.
“We don’t have the National Guard, but we do have FEMA,” Parris said.
AV Hospital got one of three medical teams sent to California thanks to the intervention of Rep. Mike Garcia, R-Santa Clarita; House Minority Leader Kevin McCarthy, R-Bakersfield; and former Rep. Howard P. “Buck” McKeon.
“We owe a tremendous debt to those three people,” Parris said.
Parris praised the nurses who have stayed at AV Hospital as heroic when they could get an additional $500 a day by working a hospital in Los Angeles or the San Fernando Valley. AV Hospital was about 160 healthcare workers down.
“The ones who are leaving are tyrannous cowards that I can’t say enough bad about them to abandon the hospital they worked in all these years,” Parris said.
Parris added he could not believe why Gov. Gavin Newsom has not used his authority to put a stop to it.
“The rich hospitals are staffed; the rest of us are not; that means the rest of us are dying when we don’t need to,” Parris said.
Parris cautioned the worst is yet to come.
“We need everybody’s cooperation at this point.” Parris said,