‘Mass Casualty Plan’ prepared
Dr. Coren: ‘The next couple of months will be worse than any of us have seen’
In the same week they were expecting deliveries of the first Covid-19 vaccine doses, Mendocino County officials were also preparing to enact a “Mass Casualty Plan” to respond to what Public Health Officer Dr. Andy Coren described to the Board of Supervisors Tuesday as “the possible disaster that lies ahead.”
“I’m usually an optimistic guy, but looking at where we are now, and where the counties to the south of us are, all of our efforts so far seem too little, too late,” said Coren, who also explained that not only will it take several months for the vaccines to be distributed to a majority of the population, but it is still unknown how effectively, and for how long, the vaccines will prevent contagion. “So to respond to our current situation, we are looking into the availability of mortuary resources, and also looking into the mass casualty plans, with an eye to possibly using the fairgrounds or some other place with a medical tent to mitigate the possible disaster that lies ahead. “
When asked for the actual number of Intensive Care Unit beds that Mendocino County has, Coren said there are 16 ICU beds total across the three Adventist Health hospitals in Ukiah, Willits and Fort Bragg. “Adventist Health also has a surge plan, and within that surge plan, they can surge up to 45 ICU beds. But our concern is staffing, because these can’t just be real estate — you have to have the right number and trained people to staff those beds.”
“So the plan may be good for 45 beds, but what can happen remains to be seen,” Coren said, referring to the current situation with the virus statewide as “not getting better, but worse. The next couple of months will be worse than any of us have seen
in our lives. Especially if you need the hospital for any reason — there are not going to be the beds, there are not going to be the personnel to staff those beds.”
“Mendocino County has a 37-percent ICU capacity, but our 37-percent is five beds,” Coren said. “And where is the surge coming from (locally)? We did have a serious outbreak among the homeless at Building Bridges, and that’s being mitigated by (Redwood Community Services) who’s putting all residents in hotels at this point so they can keep people separate while they clean their facility. Also, Round Valley is suffering a fairly large outbreak, and that’s being contained.”
However, Coren said “most cases continue to be not related to outbreaks, ( but) small gatherings, break rooms, eating and drinking together that leads to community spread. And people are not telling us where they actually caught it, so we may not have a lot of the specifics” that people want to know about where and how the virus was contracted.
“Many people just don’t believe how terrible this is,” he continued. “So the problem is ‘minimal compliance.’ The more we say, the more people disbelieve. The more we order, the more people dig their heels in. This is not everybody, but it’s enough that our attempts at writing orders have been undermined.”
“What do you see this winter and spring for us, and (what will the overwhelming of the local hospital system with Covid-19 cases) mean in terms of real people’s lives in Mendocino County?” 5th District Supervisor Ted Williams asked Coren.
“I think when the hospital system truly breaks down and when all three hospitals are having trouble managing the numbers of patients, the ICU, which requires the most people to attend to those very ill patients, will be overwhelmed, and so they’ll try and manage some of those patients (in other areas of the hospitals),” he said. “And those rooms will get flooded .. and there will be a decrease in the number of staff, and quality of patient care will also suffer (as) people are discharged perhaps earlier than they should be, perhaps people are turned away from the emergency room because there just isn’t enough care available, and people will be encouraged as much as they possibly can to care for themselves at home.”
To prevent this from happening, Coren said “people really need to become compulsive about masking, social distancing and stopping gatherings,” which he said will help curb the spread of the virus in Mendocino County. “But we’re still going to have to deal with the rest of California.”