San Diego County emergency departments saw such a significant increase in traffic Wednesday that the region’s emergency medical director issued a special alert just after 1 p.m.
About half of the 22 hospitals across the region were so busy that they had to divert some ambulances to other facilities, a common practice designed to give overburdened medical staffs time to catch up with crushing demand. The spike appeared to be due in part to a demand for testing.
“If emergency departments are on diversion, then ambulances have to drive farther away and they’re less available to respond to 911 calls, which puts the whole system at risk,” said Dr. Kristi Koenig, medical director of San Diego County’s emergency medical system. “It’s not a good situation, one that we try to prevent whenever we can.”
Coming one day after a last-minute Holiday Bowl cancellation attributed to COVID-19, the sudden increase in coronavirus-related emergency visits Wednesday coincided with further evidence in the region’s weekly COVID-19 report that the local pandemic continues to worsen. There were 3,653 new positive test results listed for Tuesday, the largest single-day number published since Jan. 7, when 4,550 positives were recorded in a single day, the peak for last winter’s surge.
Hospitals are faring much better than they did this time last year but are nonetheless still experiencing increases in admissions. There were 454 COVID-19 patients in hospital beds Tuesday, up from 387 one week earlier. Vaccination continues to deliver a significantly-lower burden compared to last year when, county records show, there were 1,562 COVID-19 hospital cases on Dec. 28, 2020.
Those higher case numbers, said Dr. Joshua McCabe, director of emergency services at Sharp Memorial Hospital in San Diego, have shown themselves quite starkly in the past week.
“Just this morning, 15 patients arrived in one hour that were all seeking treatment for COVID,” McCabe said. “Between eight and nine in the morning, there was no other complaint in the ER except influenza-like symptoms that tested COVID-19 positive.”
This time around, he added, the patients seem to be less seriously sick than they were last year.
“When patients come in now with COVID, it’s more like a flu, and they’re just not feeling well,” McCabe said. “We’re not seeing them as often with low oxygen saturation levels like we were when COVID first started.”
That observation tracks with observations worldwide that Omicron seems to cause less-severe illness, especially if patients are vaccinated, than previous variants did.
It’s of little comfort, though, as the sheer number of cases appears to be increasing more rapidly than it did last year and certainly more quickly that it did during the recent surge in the summer and early fall.
“More people are getting sick than ever before and, when people get sick with COVID, if they have any other diseases or are elderly, they certainly run a much higher risk of hospitalization and death,” McCabe said.
Rady Children’s Hospital in San Diego reported that 289 of the 1,173 tests its lab performed Wednesday came back positive for a positivity rate of nearly 25 percent.
Rady reported not just high demand for coronavirus-related emergency care but also an increase in the number of kids with severe-enough cases to need a hospital stay. As of Wednesday, there were 14 hospitalized at Rady with COVID-19. While it was not clear whether that was a record, it is quite a bit higher than it was last winter when Rady’s hospitalized total was in the single digits.
Some have opined in recent weeks that Omicron is not much of a threat because it appears to be less effective at causing the severe respiratory symptoms that filled intensive care units last winter.
But Koenig noted that it often takes weeks after infection for patients to get sick enough to need medical attention.
However, she said, some percentage will get sick enough to need serious help and, with the larger numbers of infections expected to occur in the next few weeks, there could still be enough sheer volume to push hospitals past the brink.
“Even though the percentage is lower, you can end up with a situation where the number (of hospitalizations) is higher because Omicron is just so transmissible,” Koenig said.
The public is clearly very concerned about infection, with lines for testing stretching for blocks and many waiting hours to give a sample. Rapid tests seem to be scarce across the county at the moment.
Some test seekers, Koenig said, appear to be driving the surge in volume being seen at emergency departments, choosing to head to hospitals when testing centers can’t deliver quickly.
This trend, the medical director said, is concerning due to low staffing levels at all medical facilities.
“I know it’s not easy, and the lines are long, but I would say look for another source for testing if that’s truly the only reason you’re going to the emergency department,” Koenig said.
There were 27 additional deaths listed in Wednesday’s weekly report. Most ranged in age from their early 60s to mid-90s with other co-occurring medical conditions present. The youngest was a 47-year-old man from inland North County who died on Dec. 21.
