The escalating number of coronavirus cases in Riverside County has raised concerns about hospitals’ ability to cope, and Riverside University Medical Center in Moreno Valley is among those working to meet increased demand, its CEO said Wednesday.
“The difference this time around is we are more prepared and ready to handle the surge,” Jennifer Cruikshank told City News Service. “But as more people come in and more people become positive, it’s more difficult for our health care team to manage, and it stretches our staff.
“The sheer volume of patients is much higher than what we saw in the summer because our winter census tends to be higher.”
Riverside County on Tuesday reached the 600-level in coronavirus-related hospitalizations, roughly matching the plateau of late July, when the first “surge” was documented, according to the Riverside University Health System.
According to Cruikshank, there are still patient beds available. The usual capacity is 439.
The medical center is the largest treatment facility available in western Riverside County.
“Currently we are working on staffing to accommodate the increase in cases, along with bed allocation and conversion to place those patients,” Cruikshank said, adding that “several patient care units are COVID-only.”
The availability of nurses has turned problematic, she said, and as a result, the county requested a “staffing program flexibility waiver” from the California Department of Public Health, “because we do not have enough nurses to take care of the patients.”
“We have exceeded our normal census for this time of year, and this past week we have had a record volume of patients,” Cruikshank said. “We have also had to begin cancelling non-urgent surgeries to ensure adequate bed space.”
The triaging process that was refined during the summer remains in place, according to Cruikshank.
“We ask all visitors to answer a questionnaire about symptoms and exposure, placing those (who) signal possible COVID positivity in negative pressure rooms and expediting their visit to see the physician,” Cruikshank said.
One oddity that’s surfaced is an “increase in the amount of asymptomatic patients” — people coming to the hospital and manifesting no outward signs of COVID-19, but coming up positive during screenings, Cruikshank said.
The issue has been raised in health studies and was recently highlighted by Beda Stadler, former director of the University of Bern Institute of Virology & Immunology, who said even “dead particles” of coronavirus turn up in diagnostic tests of people who may have had the virus but no longer pose a transmission threat.
“The concern is around staff availability to manage this newer and likely larger surge of patients,” Cruikshank said. “Our entire team has and continues to work tirelessly to ensure we can support the volume of patients coming to us to receive care while we keep our teams safe.”
Cruikshank acknowledged there are ongoing concerns about the potential for staff becoming infected or having to drop shifts to “care for ill family members.”
“RUHS, just like many hospitals across the county, does not have as many staff as we had in the summer surge because today, we are competing with hospitals nationally for those same resources that were not in such high demand across the country during the summer surge,” Cruikshank told City News Service.
On the upside, protocols have been synthesized “to reduce hospitalized length of stay,” moving people out of patient beds and back home to recover, according to Cruikshank.
“We will continue to adjust and add COVID space as the COVID volume increases, which will add an additional strain to our staff and resources,” she said.
There is a reliable stock of personal protective equipment available, and “patient flow processes” are better than four months ago, Cruikshank said.