San Diego County recorded enough new coronavirus cases over the weekend to exceed the combined populations of Lemon Grove and Coronado, according to the county health department’s latest update on the pandemic Monday.
There were a total of 19,009 new cases on Friday alone, with 17,507 more on Saturday and 12,563 on Sunday. Any of those days was enough to demolish the previous single-day record of 8,313 set on Jan. 2.
Those three days total 49,079 cases, slightly more than the 26,525 people estimated to reside in Lemon Grove and the 21,381 in Coronado.
For a moment there, it looked like the winter surge might have peaked in the 8,000s, but Monday’s results made it obvious the community is only now beginning to get a true sense of what the Omicron variant is capable of in an environment where social activities remained open through Thanksgiving, Christmas and New Year’s Eve.
As local businesses, municipal governments and schools begin to pull back on indoor activities, the most critical question remains: What are so many cases likely to deliver to the doorsteps of the region’s already beleaguered hospitals?
It generally takes weeks for a surge in new cases to translate into a surge in additional hospitalizations. It often takes days or weeks for a new infection to worsen to the point where significant medical attention is necessary.
If the virus behaves as it has in other places, the percentage hospitalized should be much lower than it was last winter. However, with so many more people testing positive daily, and lines for additional testing continuing to stretch for blocks, it seems clear that even a much-lower percentage headed for hospital beds could still end up producing a significant impact.
Last week, a crush of patients arriving at emergency departments, combined with a simultaneous rash of health care workers staying home after testing positive, conspired to tie the region’s emergency medical system in knots.
The situation seemed to be marginally better at the start of the new week. Scripps Health, which saw several of its facilities inundated last week, reported that it had 562 employees on unscheduled leave Monday, compared with about 700 last week.
Low staffing levels continue to pinch the hospital’s ability to admit patients from their own ERs, with Chris Van Gorder, chief executive officer at Scripps, saying that Scripps Memorial Hospital Encinitas had 30 patients stalled in emergency beds waiting for admission.
Total hospitalizations are also continuing to mount.
“We had 250 COVID inpatients on Saturday morning, and today we have 291,” Van Gorder said. “We had an increase of 31 COVID inpatients just from yesterday to today.”
So far, though, local medical providers do not appear desperate enough on the staffing front to pull a new emergency lever added to their pandemic-response toolboxes Saturday.
New guidance for the quarantine of infected health care personnel, published in a letter to all hospitals and skilled nursing facilities on Jan. 8, scraps previous return-to-work criteria that allowed health care workers to head back to their jobs five days after testing positive, even if a subsequent test had not yet proven that they were no longer infected. Those returning after five days with minor symptoms were to remain masked and work only with patients who had themselves tested positive.
But, citing critical staffing shortages, the CDPH says that positive workers who have no symptoms “may return to work immediately without isolation and without testing, and (health care providers) who have been exposed and are asymptomatic may return to work immediately without quarantine and without testing.”
While all efforts to bring additional personnel in should be exhausted before a provider takes such steps, and efforts should be made to make sure that infected workers care for infected patients, the state acknowledged that such groupings “may not always be possible,” especially in very-busy emergency departments “in which you may not know which patients are COVID-19 positive or in areas where you may be experiencing extreme staffing shortages.”
The idea of bringing back workers before they test negative is so far not being embraced by San Diego’s large providers.
Scripps, Sharp Health Care, Kaiser Permanente and UC San Diego Health all said in emails Monday that they have no current plans to follow the new guidelines to their maximum extent.
John Cihomsky, vice president of communications at Sharp, the region’s largest health care provider, said that Omicron’s ability to spread rapidly influenced the decision.
“We have around 700 workers off work, and most are symptomatic,” Cihomsky said in an email. “Only around 45 are asymptomatic.”
Van Gorder said the medical experts he consulted were concerned that those who are asymptomatic remain infectious.
“We try not to have someone knowingly working who could infect a colleague or patient,” Van Gorder said. “Yes, everyone must wear the appropriate mask — in this case, an N95 — but during the course of a shift, that mask will likely come off, even if it’s just in a breakroom.
“We know Omicron is highly contagious, and we can’t afford to have one employee infect another or, worse yet, a patient.”
For now, he said, Scripps will bring positive workers back after seven days in quarantine. UCSD and Sharp said they are following the U.S. Centers for Disease Control and Prevention’s latest return-to-work guidance, which allows asymptomatic health care workers to return after five days of quarantine, though both are requiring a negative antigen test. Kaiser said in a statement that it’s following CDC guidance, but did not elaborate on the particulars of its program. The CDC technically allows workers to return to facilities in crisis without work restrictions or testing.
Source: This post first appeared on sandiegouniontribune.com