Kaweah Delta braces for COVID-19 surge

Statewide, hospitals are bracing for a stark increase in coronavirus cases this month

By Kaitlin Washburn

VISALIA – As California’s health care system braces for an April surge of COVID-19 cases, Kaweah Delta is taking measures to prepare for a spike in Tulare County patients.

Last week, Gov. Gavin Newsom projected the state would require as many as 50,000 additional hospital beds to meet the coming surge this month, and more than 140,000 Californians might need a hospital bed by the end of May.

As of Monday evening, Tulare County has 135 positive COVID-19 cases and six people have died from the virus. (These numbers continue to rapidly change every day, check in with our tracking page for daily updates on cases and deaths at Tracking COVID-19)

Kaweah Delta CEO Gary Herbst said in a Friday news conference the county is forecasting an increase in cases toward the end of April.

“I cannot underscore enough how serious this disease is and how quickly it is spreading,” Herbst said. “While we are fortunate that we’ve had only a few inpatients who have tested positive, we expect that to increase significantly as the month carries out.”

Models predicting the trajectory of the coronavirus show that the Bay Area and Los Angeles will experience a spike in cases by mid-April, and Tulare County’s increase is expected to follow a week or two later, Herbst said.

Like many hospitals throughout the state and country, Kaweah Delta is facing a shortage of personal protective equipment, like masks, gloves and surgical gowns, that medical professionals wear to keep themselves safe.

On a normal day, the hospital goes through about 1,500 masks, but now Kaweah Delta is down 750 masks a day. Hospital staff is now required to wear the same gown and face mask for a full shift, Herbst said.

Kaweah Delta has placed orders for protective equipment with the county and state health agencies, the federal stockpile and its usual vendors and suppliers, Herbst said.

On Saturday, Newsom unveiled a web site, covid19supplies.ca.gov, that people and companies can use to donate, sell or offer to manufacture 13 of the most essential medical supplies, such as ventilators, N95 respirators and testing materials.

Aside from protective equipment, Kaweah Delta is also facing a shortage of ventilators. Of the 104 ventilators available at the hospital, 50 are not being used as of Friday, Herbst said.

Four out of the five patients who have COVID-19 at Kaweah are in the intensive care unit, have been intubated and are on ventilators, Herbst said.

“From everything that we are witnessing in New York and the more populated areas of California, as the disease really exacerbates an individual, the greatest difficulty that they have is breathing, that’s why they end up intubated,” Herbst said. “I am very concerned that we don’t have enough ventilators. We are trying to get more, but they are not available.”

The hospital has been running a drive-thru testing site for people who are showing symptoms of coronavirus. At the hospital’s request, the city recently closed Floral Street, which opened up nine parking spots for people to pull up and get tested from their cars, Herbst said.

As of Monday evening, 158 patients have been tested at Kaweah Delta Medical Center, and seven of those were positive for the coronavirus. At the drive-thru testing site, 852 people have been tested and 65 have come back positive. The emergency department tested 134, and had 6 positive cases. Kaweah Delta’s clinics and urgent cares have tested 13 people and only one has come back positive. (As these numbers also rapidly change, Kaweah Delta updates this web page every weekday with new figures: www.kaweahdelta.org/COVID19.aspx)

Kaweah Delta has also set up a free COVID-19 screening hotline for individuals who think they might have the virus to call and determine whether they need to get tested. Anyone can call the hotline at 559-624-4110, but the hospital encourages people with primary care physicians to call their physician for an assessment first.

‘Calm before the storm’

While the county has yet to see the overwhelming numbers that other parts of the state are experiencing, Herbst said he senses this is the calm before the storm for Tulare County. The hospital has partially emptied as people postpone visits, procedures and nonessential surgeries.

“Our hospital has more bed capacity than I’ve seen in the last 10 years. And that’s been purposeful,” Herbst said. “We are in pretty good shape right now to absorb the volume of patients coming to us … But we are not fooling ourselves, we fully expect that this situation will continue to escalate.”

The hospital’s downtown medical center has reduced its capacity to about half in anticipation of a sharp increase in patients. Currently, 228 patients remain at the hospital and the rest of the 450 total beds are empty. The hospital has also delayed elective and non-urgent surgeries and put a no-visitor policy in place.

Kaweah Delta has been converting many parts of the hospital into units dedicated to COVID-19 treatment, Herbst said. The hospital converted a 29-bed section into a dedicated inpatient unit for people who have either tested positive for COVID-19 or who are exhibiting symptoms. An 11-bed unit normally used for elective surgeries or procedures like knee replacements has also been converted.

This week, Kaweah Delta is finishing up expanding its emergency unit in preparation for the surge of coronavirus patients. The fifth and sixth floors of the hospital, which house an intermediate critical care unit and a neonatal intensive care unit, hold a total of 47 beds that will be made available, Herbst said.

If the hospital becomes overwhelmed and at capacity, Herbst said Valley Children’s Hospital is prepared to take all of Kaweah Delta’s neonatal, mother and babies, and children patients so that the hospital can free up those beds.

The Visalia Convention Center is also willing to convert to a temporary field hospital for Kaweah Delta to use, Herbst said.

As difficult as it may be, Herbst encourages people to continue practicing social and physical distancing to help curb the number of coronavirus cases in the county and protect those who don’t have the strength to fight the disease.

“I cannot overemphasize social distancing and the value of that, of washing your hands and not touching your face,” Herbst said. “It’s not just what’s happening over the next 30 days, it’s what happens next week, it’s your actions this weekend that matter.”

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