Covid Nurse

Yesenia Fowler, RN, prepares to enter a Covid-19 patient room wearing full personal protective equipment, including a filtered air system unit.

Doctors from three Monterey County hospitals pleaded with mayors and the county to ramp up enforcement of health orders around social distancing, face coverings and shutdowns to slow down the growing number of Covid-19 cases and hospitalizations, in a unified message during the monthly Monterey County Mayor’s Association meeting on Friday, July 10.

Even with the recent shutting down of bars and indoor dining through possibly July 23, the cases of people exposed prior to that are going to increase within the next two weeks, along with hospitalizations and patients in intensive care units. For now, hospitals can take a spike but if too much pressure comes to bear on the health care system it could lead to dire consequences for the community, they said.

“Ignoring this will be a catastrophe,” said Allen Radner, infectious disease expert at Salinas Valley Memorial Healthcare System. He appeared on the Zoom call with a fellow infectious disease expert from the Community Hospital of the Monterey Peninsula, Martha Blum, and Chief Medical Officer Craig Walls from the county’s hospital, Natividad.

“We could quickly get ourselves into a very bad spot in the next two weeks,” Blum told the mayors. She described what’s coming as potentially “pretty ugly.”

Of major concern to Blum and her colleagues is that they are now seeing more older patients who are requiring more intensive care that can last several weeks and there are concerns of growing cases from the two prisons in South County and the Monterey County Jail. (Shortly after the mayor’s meeting on Friday, the Weekly reported that there are 61 positive cases at the jail.)

Other concerns include a shortage of the only drug known to help speed up recovery and decrease hospital stays, remdesivir, as well as shortages in test supplies that lead to a serious lag time in getting results back.

The hospitals have contingency plans in place and have been putting rooms and wards into service for treating Covid-19 patients, the doctors said. They will take care of patients in coming spikes and surges, “but we need help, OK? Because this disease is not spreading in the hospitals, thank god,” said Walls, adding that it's spreading in the restaurants and other gathering spots in the community.

“Anything you can do (to enforce social distancing) you are saving the lives of your constituents,” Walls said.

Radner said that as near as they could tell, it’s been “100-percent the honor system” for following shelter-in-place and face covering orders, but now is the time for code enforcement officers, police departments and the Monterey County Sheriff’s Department to step up enforcement. He noted “frustration” that orders are not being enforced, calling them “our best shot” at preventing further spread of the disease.

Salinas Mayor Christie Cromeenes—filling in as mayor since the passing of the late mayor Joe Gunter—urged the doctors to in turn speak out more to the public about how dangerous the situation is for health care providers and the community at large. She said people see the Monterey County Health Department and the state of California as taking away their freedoms, but a message from medical professionals may be what is needed to get people to be more serious about social distancing.

One of her first acts as mayors was to ask Salinas City Manager Ray Corpuz to create the city’s new face covering order with steep fines for repeat offenders, Cromeenes said. Residents weren’t wearing masks, so something “with teeth” was necessary. (Monterey was the first city to implement a face covering order with fines.)

As the mayors were meeting, SVMHS announced that it has opened a second Covid-19 unit to meet the need after two weeks in a row of a record high number of patients with the virus. According to a press release, the hospital as of Friday is caring for 22 Covid-19 patients, three of them requiring use of a ventilator.

A month ago, on June 10, the hospital had 302 people test positive since the beginning of the pandemic. The number has doubled to 736 cases. Also a month ago, there were nine hospitalized compared to 22 currently.

“We cannot get to the dangerous point of taxing hospital capacity and that appears a very real possibility right now,” SVMHS President/CEO Pete Delgado, said in a statement. “Our team is doing an outstanding job making adjustments to safely accommodate all of our patients however I’m concerned we may see another wave of Covid patients related to recent holiday gatherings.”

SVMHS has also expanded the hours of its free, bilingual Covid-19 hotline to 7am to 11pm, seven days a week. That number is 831-755-0793.

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(1) comment

Donna Gilmore

This document provides significant evidence COVID-19 is an airborne virus and can travel long distances. It focuses on the needed for ventilation (rather than recirculation of air) in enclosed spaces. 

Together with the authors, 239 scientists support this Commentary.

A cloth or surgical mask doesn't stop these small airborne viral droplets, so provides no protection from this virus when indoors. And staying 6 feet apart is not adequate protection. 

It is Time to Address Airborne Transmission of COVID-19 

Lidia Morawska, Donald K Milton

Clinical Infectious Diseases, ciaa939,

https://doi.org/10.1093/cid/ciaa939

Published: 06 July 2020

https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa939/5867798

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