By Shawn Raymundo
As the number of coronavirus cases continues to soar in Orange County, area hospitals are bracing for what health care professionals anticipate will be a surge of patients and hospitalizations.
At Mission Hospital in Mission Viejo, Dr. Jim Keany explained this week that—with the exception of emergencies and urgent procedures—the hospital has limited much of its inpatient care, such as postponing elective surgeries, in order to maintain capacity for coronavirus patients.
With fewer patients in the hospital right now, he said it has been eerily quiet, likening the situation to scenes in movies in which you can hear the depth of the ocean as a submarine is being stealthy before launching an attack.
“It’s quiet. Unusually, unnervingly quiet,” Keany said. “We’re about two-thirds of normal volume in both inpatients and outpatients.”
Dr. James Leo, the chief medical officer for MemorialCare, said MemorialCare’s system of hospitals and medical groups have taken similar measures to prepare for the influx of patients, while continuing to “provide care and treatment for all patients requiring inpatient admission.”
“Our emergency operations plans have been activated, and we have taken steps to prepare for the anticipated surge,” Leo said in an email to San Clemente Times.
Some of those steps, he said, include the creation of a labor pool that hospitals can deploy to specific areas if needed, obtaining equipment and supplies, as well as activating an emergency credentialing and privileging practice.
The credentialing practice, he explained, “will streamline the process of bringing in volunteer physicians or physicians from outside of our medical staffs to care for patients if necessary.”
The preparation measures come as confirmed cases of those who contracted coronavirus in Orange County have increased dramatically from 147 to 502 between March 24 and March 31—a more than 240% increase in the seven-day period.
On March 31, the Orange County Health Care Agency reported that 94 patients were hospitalized within the previous day, with 46 of those patients needing to be treated in an intensive care unit.
And since the county started reporting the number of cases by city on Friday, March 27, the number of confirmed individuals with coronavirus in San Clemente had doubled from 10 to 20 as of Tuesday.
In anticipation of the spike in hospitalizations, Keany said Mission Hospital has opened up the areas used for outpatient surgeries by turning them into inpatient areas and set up COVID-19 specific wards to help isolate patients. In turn, the wards could also help staff use less personal protective equipment (PPE), which is already in short supply like in other hospitals throughout the nation.
“Yeah, we’re in the same boat. I’ve talked to dozens of other hospitals. We’re in the same boat in the U.S. No one has the supply necessary for this type of influx,” Keany said.
“Our strategy, No. 1, is to preserve PPE as much as possible. So, developing systems that don’t require specific change” of equipment like masks and gowns, he said. “No. 2 strategy is reuse and decontamination. And the third strategy is extended use . . . they’re meant for certain hours, but we’re having people extend that use beyond recommended hourly use, and that’s done through CDC (Centers for Disease Control and Prevention) recommended guidance.”
Leo echoed that statement, noting that while MemorialCare is challenged like the rest of the nation in getting orders filled for large quantities, medical staff is “being very diligent in how we use these supplies.”
And though MemorialCare has the supplies needed to care for patients, Leo said, it is accepting donations from the community.
As for ventilators, which have been a crucial instrument needed for many patients fighting the virus, Keany said Mission does have an excess of ventilators and more are on the way.
According to Keany, the hospital is looking at other devices that can be used as ventilators, such as a BiPAP machine, which people with sleep apnea often use to help them breathe during their sleep.
“(BiPAP machines) can be reconfigured as ventilators,” he said. “I’m thinking we might have more ventilators than we’ll a have the ability to manage. So I don’t think ventilator shortage will be an issue for us.”
Leo said MemorialCare is currently assessing its stock of ventilators and augmenting the current supply.
During the current health crisis, entrance into hospitals to visit loved ones has also been restricted in an effort to limit potential exposure to COVID-19. Both Mission Hospital and MemorialCare’s facilities have suspended in-person visits while encouraging families and friends to utilize video messaging apps such as Skype, FaceTime and Zoom to interact.
Keany said there are limited exceptions such as for those visiting someone who is terminally ill, “but for the most part, no visitors.”
“We’re very sensitive to the healing nature of having a support system,” he said. “But to unnecessarily expose those loved ones to (people) feeling ill, we’re not going to do that.”
Leo notes that at MemorialCare’s facilities, women in labor are allowed to have one support person in the room with them.
For those patients who are being treated for non-coronavirus-related issues, Mission Hospital is handling them with the added layer of caution by assuming they may be COVID-19-positive. “We have to treat them like they’re COVID-positive until we work through” their case,” Keany said.
Shawn Raymundo is the city editor for the San Clemente Times. He graduated from Arizona State University with a bachelor’s degree in Global Studies. Before joining Picket Fence Media, he worked as the government accountability reporter for the Pacific Daily News in the U.S. territory of Guam. Follow him on Twitter @ShawnzyTsunami and follow San Clemente Times @SCTimesNews.