Kaweah Health forced into code triage, COVID cases eating up capacity

Kaweah Health continues to treats COVID-19 hospitalizations while counties with high vaccination rates move past the pandemic; the hospital ended their code triage on Friday, two days after initiating it

VISALIA – Kaweah Health Medical Center was forced to call a “code triage” for the second time in three months last week. This put hospital executives and directors on high alert to manage care and free up hospital beds for a surge of incoming patients. And according to CEO Gary Herbst, much of this was due to the consistent onslaught of COVID-19 hospitalizations.

Kaweah Health notified the public on Wednesday, Nov. 3 that the hospital admitted 51 patients who were waiting for a bed, and were treating 60 patients in the emergency department, all while operating at full capacity with 368 inpatients. Over 100 of those patients are there for COVID-19, and 24 of those were in the intensive care unit.

“We live in an area where normally there are a high number of hospitalizations due to chronic illness and high medical needs. Additionally, we have the highest number of COVID-19 patients in the state and there just isn’t enough room for everyone,” Keri Noeske, Kaweah Health vice president and chief nursing officer, said.

A Kaweah Health press release added that hospitalizations for COVID-19 are “very different” in other counties in the state. According to federal Health and Human Services data Tulare County is among the highest in terms of COVID hospitalizations throughout California. Kaweah Health made the particular mention that counties with higher vaccinations rates have much lower hospitalizations. “Tulare County has one of the lowest vaccination rates in the state, with 46.40% of the population fully vaccinated. In areas where there are high vaccination rates, hospitalizations are much lower.”

During a press conference on Thursday, Nov. 4, Herbst said that 30% of the hospital’s capacity is treating COVID-19 patients and added that some commentary on social media has indicated that the public has taken that to mean that COVID in Tulare County is “not that bad.”

However, if the hospital could reclaim that 30% capacity there wouldn’t be backups in the emergency department and elective procedures would be at “full steam.” Herbst added during his press conference that hospital administrators from other hospitals around the state are “slack jawed” when they hear the number of COVID cases and hospitalizations at Kaweah Health.

For comparison there were 20 COVID patients at University of San Francisco in a county whose vaccination rate is 76%. In Santa Clara County, 73.3% of the population is vaccinated and there are only 29 hospitalizations at the Sanford Medical Center. In Los Angeles County, where 72% of the population is vaccinated, University of California Los Angeles has only nine COVID patients while Cedars-Sinai Medical Center had only 13 COVID patients.

The lack of capacity for Kaweah Health has delayed admissions or deterred patients from seeking care at all. Herbst recognized that some patients fighting infections have come to the hospital suffering from sepsis because they were not treated early enough, when an antibiotic could have managed their illness. He added that cancer diagnoses have come later and later as well, giving patients less hope of beating an aggressive form of it.

Tulare County Health and Human Services director, Tim Lutz, said during an update to the board of supervisors late last month, that the COVID delta variant has been particularly fierce when it comes to hospitalizations.

“Hospitalizations are the really frustrating piece…We’ve seen a plateau but it’s really a plateau at a much higher admission rate than we saw last summer for instance,” Lutz said during a presentation at the Oct. 22 board meeting.

The peak of the summer surge last year was 114 hospitalizations on Aug. 14, 2020. The summer surge this year has been far steeper and sustaining. There were 164 COVID-19 hospitalizations on Sept. 1 this year, and while the number has ebbed and flowed, it has largely stayed between 155 and 170 for almost two months now, “And it continues to put a lot of strain on our hospital system,” Lutz said.

Lo and behold Tulare County broke the 1,000 death mark last Thursday, Nov. 4 when the 1,002nd COVID-19-related death was recorded within the county. Over 751,000 lives have been taken nationwide, and more than 5 million deaths have been registered globally.

“Our hearts, our thoughts and our prayers go out to the families who have lost someone to COVID,” Herbst said.

Kaweah Health have lost four of their own employees over the last 20 months, and one provider, due to COVID, according to Herbst.

Kaweah Health stated that they called off their code on Friday, Nov. 5 at 4 p.m. The hospital stated that there were 350 adult inpatients being cared for with 87 patients seeking care in its emergency department (ED) and 24 of those waiting for inpatient admission. Of its inpatients, 105 patients were positive for COVID-19.

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