County hospitals described at near crisis level
Lutz stresses still not at crisis level
As far as county hospitals being able to treat those with COVID-19, Tulare County Health and Human Services Director Tim Lutz essential described the situation as a near crisis level.
But Lutz also stressed county hospitals haven’t reached a crisis level yet. Lutz gave that description during his report on the status of COVID-19 at Tuesday’s Tulare County Board of Supervisors meeting.
Lutz did say hospitals in the county are coming close to reaching a level he described as a “crisis standard of care” in which hospitals will have to begin prioritizing who receives treatment and how treatment is given as far as the use of ICU beds.
“To be clear we’re not there yet,” Lutz said. “We’re doing everything we can as is the state to avoid getting there.”
He stated mid-january will be the telling time as far as if the county reaches that crisis level. He said the county is past the “initial” surge of COVID-19 that came during the holidays. But he added “the surge on top of the surge” could be coming in the next 10 to 14 days.
Tulare County’s ICU availability rate as of Monday was officially listed at 0 percent. The San Joaquin Valley’s and state’s ICU availability rates have also been listed at 0 percent.
The situation continues to fluctuate as of Tuesday the health department reported there were six ICU beds, 11.5 percent, available in Tulare County.
As of Tuesday, Sierra View Medical Center reported nine of its 10 ICU beds were in use. Sierra View reported it had 47 COVID-19 patients and five patients suspected of having COVID-19.
Sierra View reported eight of its 23 ventilators were in use. Sierra View reported it now has 20 employees who have tested positive for COVID- 19, including five who have been hospitalized.
Sierra View has had 123 employees who have recovered after testing positive for COVID-19. Sierra View has had a total of 828 positive tests.
For the stay-at-home order to be lifted the en
tire Valley must reach a level in which the ICU availability is projected to be 15 percent four weeks out. The state continues to report the Valley “does not meet the criteria to exit the order.”
Central California Emergency Medical Services Agency which oversees ambulance services in the Valley, including Tulare County, has also implemented an “assess and refer” policy in which services for non-emergencies won’t be provided.
For now the rate of the spread of the virus has stabilized. But there has been a “spike” in deaths since December. And Tulare County’s positive test rates continue to increase.
Lutz reported two more deaths on Tuesday, which is considerably lower than what has been recently reported on a daily basis. There have now been 421 deaths in Tulare County due to COVID-19.
In the last three weeks there have been 89 deaths, Lutz reported, which is about 30 deaths per week. During December the county averaged 22 deaths per week, Lutz said.
He said during the summer surge the county averaged 13 deaths per week. Otherwise during the pandemic the county has averaged 10 deaths per week, he said.
The county has data on 406 deaths of which 317 have been ages 65 and older, 82 have been ages 41-64 and seven have been ages 26-40. There have been no deaths below the age of 26. Sierra View has had 96 deaths due to COVID-19.
And Tulare County’s unofficial, preliminary case rate went back up again. The rate is 73 per 100,000 over a 7-day period, an increase of 4.1 over the previous day. The state’s adjusted rate for the county is 64.3 per 100,000.
Once the stay-at-home order is lifted, Tulare County will move back into the most restrictive tier, the purple tier. For the county to move into the next least restrictive tier, the red tier, it must reduce its rate to 7 per 100,000.
Tulare County must also reduce its positive test rates. The county’s overall positive test rate has climbed from 16 to 17.2 percent.
The county’s equity metric positive test rate for its most disadvantaged areas has also climbed from 17.4 to 19 percent. For the county to move into the red tier it must reduce both those rates to 8 percent.
Tulare County’s R number which measures the rate of spread of the virus also remains the same for now at .98. That puts Tulare County in the “likely stable” category, meaning the rate of increase of the spread of the virus is expected to continue at its current level. The number .98 represents the average number of people who would be infected by one infected person.
SCHOOLS
As far as the reopening of schools, Lutz said the state has come up with another tier of sorts, the “deep purple” tier in which counties have a rate above 14 per 100,000 must test all students and staff for additional schools to reopen. But Lutz said such a requirement would be “impractical.”
Lutz added more clarity is still needed on the plan Governor Gavin Newsom announced last week to reopen more schools. “There are still more details that aren’t clear as far as what the plan details,” Lutz said.
But he did say the state is recognizing the importance of reopening schools. Even with the gravity of COVID, Lutz still said when it comes to the well-being of youth as far as schools not being reopened, “the consequences of this is greater than the risk of COVID.”
LACK OF PPE
Another issue the county is dealing with again is a shortage of personal protective equipment, especially gloves, but also gowns and masks, Lutz said.
BY THE NUMBERS
Since March 11 there have now been 35,286 cases in Tulare County. That number increased by 884 on Tuesday. That number has increased by 8,617 over the last three weeks.
But an encouraging development came on Tuesday when there was a huge decline in the number of active cases in Tulare County. After a large increase between December 30 and Monday, the number of active cases declined by 1,027 on Tuesday. There are now 4,539 people in Tulare County who have tested positive for COVID-19.
The decline in active cases was caused by a huge increase in recoveries. The number of recoveries increased by 1,909 on Tuesday. There are now 30,286 people in Tulare County who have recovered after testing positive for COVID-19.
There was also a significant decline in the number of people in self-quarantine in Tulare County. There are now 275 people in Tulare County in self-quarantine being monitored by public health officials, a decline of 240.
Since March 11 there have been 6,688 cases in the Porterville area, 467 cases in Terra Bella, 79 cases in Springville, 443 cases in Strathmore, 1,298 cases in Lindsay, 79 cases in foothillmountain communities, 6,043 cases in Tulare, 3,041 cases in Dinuba, 212 cases in Richgrove, 58 cases in Alpaugh, 583 cases in Pixley, 239 cases in Tipton, 1,080 cases in Earlimart, 832 cases in Farmersville, 576 cases in Woodlake, 33 cases in Three Rivers, 746 cases in Exeter, 543 cases in Cutler, 1,001 cases in Orosi, 70 cases in Goshen, 173 cases in Traver, 40 cases in the Reedley area and 12 cases in Orange Cove.
In Visalia there have been 3,746 cases in one region, 2,426 cases in another region and 2,953 cases in a third region.
There have been 5,030 cases ages 0-17, 5,534 cases ages 18-25, 10,087 cases ages 26-40, 10,978 cases ages 41-64 and 3,641 cases ages 65 and older.
There have been 19,501 cases who have been Hispanic, 4,552 have been Caucasian, 688 have been Asian, 222 have been African American, 190 have been Native American, 1,074 have been multirace and 9,059 are unknown.
With a population of about 470,000 people Tulare County has had a rate of 7.4 cases per 100,000 residents or 7.4 percent.