California Bay Area ERs swamped by surge in COVID-19 cases

COVID-19 continues to pummel crowded Bay Area ERs and things could only get worse

Paramedics bring a patient into the Adventist Health White Memorial hospital in Boyle Heights on Jan. 7.

Jan. 8, 2021 8:41 AM PT

Health officials in the Bay Area are warning that hospital crowding could get even worse in the coming weeks, warning that COVID-19 hospitalization could worsen so much doctors may be forced to choose who gets lifesaving care and who doesn’t.

In emergency rooms, medical staff are fatigued as they enter the 11th month of fighting this pandemic. “They are tired, they are drained physically, emotionally, in every way you can possibly imagine,” said Dr. Jeffrey Chien, emergency department medical director at Santa Clara Valley Medical Center, Silicon Valley’s flagship public hospital.

“The ER is full. Folks are waiting for beds. We are getting really creative with places to see patients, and patients are suffering,” Chien said at a news conference this week. “Folks are struggling to breathe. Folks are gasping for breath. Some folks look like they are drowning while they’re sitting there in bed in front of us. And there’s a very finite amount we can do to fight this new virus.”

Dr. Ahmad Kamal, Santa Clara County’s director of health preparedness, said patients are waiting in ambulances for hours waiting for emergency rooms to have enough room to take them in. Daniel Franklin, a duty chief with the Santa Clara County Emergency Medical Services Agency, said in one example last month, it took eight hours to offload a patient from an ambulance into a hospital.

“Every system has its limits. We are pushing that limit right now,” Kamal said. There are elements of crisis that are happening now, he added: “You’re seeing it in people waiting in ambulances for hours. You’re seeing it in people sitting in beds and gurneys in emergency rooms who do belong in an ICU bed. So we definitely have a lot of concerns about where we are.”

January is the most challenging month of the pandemic, and Kamal said, “As awful as it is, it could get worse.”

“Right now, we haven’t been in a situation where there’s two people gasping for breath, and only one of them gets a ventilator. We could get there,” Kamal warned. “This surge has been relentless. And it has not stopped. And it is straining our healthcare system to a breaking point.”

“This means that other patients who also have needs are having to go without. Hospitals are canceling surgeries. Hospitals are canceling outpatient visits,” Kamal said. “These all have effects. And we cannot have it continue. We need to all work together to contain this surge, and give the hospitals a little bit of breathing room so that they can recover and go on with other critical tasks.”

Kamal said before Thanksgiving, Santa Clara County was hovering at about 5 coronavirus cases per 100,000 people. “Now, we’re well above 50. It is 10 times worse than what we had before.”

Medical staff are constantly on a frantic pace where they’re rushing from patient to patient. “Every system has its limits. We are pushing that limit right now,” Kamal said.

There are now “less ambulances available in our 911 system because they’re currently waiting at hospitals,” Franklin said. He pleaded for people to not call 911 unless it’s a life-threatening medical emergency.

“There’s also a common misconception that if you go to the emergency room by ambulance that you’re going to get seen quicker,” Franklin said. “That’s not the case. The hospitals will triage each patient that comes in regardless if they’re a walk-in or if they’re brought in by ambulance. And then they’re going to be treated based upon the acuity of the care that they need. So some of our patients we’ve been bringing in by ambulance have gone out to the waiting room.”

James Williams, the county counsel for Santa Clara County, who has been acting as a spokesman for the county’s COVID-19 efforts, said, “There are a lot of outbreaks at worksites … all across the county. There’s a very high level of COVID transmission right now in the community. There has never been a higher level.”

Hospitals are so overcrowded that patients remain waiting in emergency rooms because there are no staffed beds they can be admitted into, Kamal said. Medical staff are being pulled in from other areas of the hospitals to provide care for critically ill patients.

Two hospitals in Santa Clara County have suffered recent outbreaks. Sixty staff members have tested positive, and one employee has died, in a cluster of infections tied to the emergency department at Kaiser Permanente San Jose Medical Center.

Officials are investigating whether that cluster of infections was linked to a staff member — who later tested positive for the virus — appearing briefly in the emergency department wearing an air-powered, holiday-themed costume on Christmas Day. Some experts say it remains possible that other reasons were a factor.

Eight people have been found to be infected among the staff at St. Louise Regional Hospital in Gilroy, Williams said.

Times staff writer Jennifer Lu contributed to this report.