Kaweah Health calls back triage code, capacity settles around 95% as issues still loom

Kaweah Health ended their “Code Triage” last week after hospital bed capacity comes down to 95%

VISALIA – Health officials in the county, state and nation have been consistently saying that the only way to move on from the pandemic is to take the jab. Perhaps now that the Federal Drug Administration has given their full approval for the Pfizer vaccine, more needles will go in more arms. But as of right now the Tulare County vaccination rate is only creeping upward while cases and hospitalizations are taking off at a much faster rate.

As of last Friday, Aug. 20, the county’s daily case rate per 100,000 residents was 26.8. Tulare County’s positive test rate is 9.1%, while active cases are 1,867 and confirmed hospitalizations are 147. That is a change of 497 cases, and 35 more hospitalizations than the week before.

Last week’s “Code Triage” by Kaweah Health should serve as an eye-opening crisis in the community. The Kaweah Health emergency department took in a steady flood of patients last Monday, Aug. 16. In total, 161 patients entered the emergency department, and not all were seen the same day. With 99 COVID-19 hospitalizations at the time, now stands at 122, there was little space for new patients to be admitted.

Kaweah Health CEO Gary Herbst said that all 344 adult beds in the hospital were filled. After getting permission from the state Herbst said they increased the nurse-to-patient ratio from 1 to 4, to 1 to 6. But what caused the sudden influx of patients into the emergency department is still a mystery.

“We are still scratching our heads over that,” Herbst said.

He noted that the air quality has been a struggle and the heat early on last week could have been a contributing factor. Kaweah Health’s capacity stabilized last Wednesday afternoon at around 95%, which allowed them to call off the internal emergency triage code, and open their expanded portion of their emergency department. While the hospital was able to create some breathing room, capacity issues still loom.

“Our hospital capacity issues have not been fixed. We’re still going to have volume issues, but we’ve worked really hard to create capacity and for now, we can stand down,” Kaweah Health’s Chief Nursing Officer, Keri Noeske, said.

According to a press release from Kaweah Health they were caring for 16 COVID-19 positive patients in their ICU last Wednesday. As of this week they have added a new patient.

“Our two ICUs and our two Intermediate Critical Care Units (ICCUs) are both at full capacity. We are now turning another area into an intermediate critical care unit as we continue to see the number of critically-ill COVID patients climb,” said Herbst, who noted that just a month and a half ago the Medical Center had just four COVID patients compared to Kaweah Health’s all-time high of 169 COVID patients on Jan. 5, 2021.

Vaccination rate

The COVID-19 delta variant has led to a massive influx of cases, especially among the unvaccinated population. Herbst said last Tuesday that the delta variant carries a viral load 1,000 times more contagious than the original strain. And that is what led the hospital to go from single digit hospitalizations to this current explosion.

“Unfortunately, with the emergence of the delta variant, which is proving to be incredibly contagious, it’s not surprising that we’re seeing these exponentially rising numbers and find ourselves feeling like we’re right back in the middle of the pandemic,” Herbst said.

According to the county’s COVID-19 dashboard the county’s fully vaccinated residents are still a telling stat about why local hospitalizations are on the rise. Only 36.5% of county residents are vaccinated. Another 7% partially vaccinated, leaving 56.5% of the county’s population completely unvaccinated for any variety of reasons.

Fortunately, United States regulators gave their full approval to the Pfizer COVID-19 vaccine on Monday, Aug. 23. Pfizer CEO Albert Bourla called the FDA’s action, “an important milestone that I think will unlock some of the more skeptical minds.”

The Associated Press reported that Pfizer and the U.S. is the first country to grant full approval of its vaccine, in a process that required a 360,000-page application and rigorous inspections. “Never before has the FDA had so much evidence to judge a shot’s safety,” the AP report stated.

Younger cases

Tulare County Health and Human Services Agency director, Tim Lutz said that cases are by and large occurring in younger segments of the population. Among those who are in the 0- to 18-year-old range, 5 to 11-year-olds are driving the majority of cases.

Lutz said that age range is generally the hardest to wear masks consistently unlike older kids who have also returned to school.

“My wife is a high school teacher. And generally, she has a few students [who don’t want to wear the masks but], they’re pretty good about complying with their mask wearing,” Lutz said.

Valley Childrens Hospital has also warned against younger COVID-19 cases. According to a report published by Valley Children’s Hospital on Aug. 5, the hospital administered 3,440 COVID-19 tests in the month of July, 133 patients tested positive, 33 patients were hospitalized and there were 81 COVID-19 related emergency department visits. The report does not delineate age, but the delta variant is impacting younger patients much more severely than in the past.

This was a stark upward trend from June where there were 3,006 tests administered, 37 patients tested positive, 15 hospitalizations and 13 emergency department visits. And that was down from the month of May in most categories. Valley Children’s administered 4,011 tests in May, 61 patients tested positive, 27 patients were hospitalized and there were 20 COVID-19 related visits to the emergency department.

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