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 and other facilities, a common practice developed to give congested medical staff time to come to terms with the devastating demand. The spike appears to be due in part to a demand for testing.
“When emergency departments are on diversion, ambulances have to travel farther and are less available to respond to 911 calls, which puts the entire system at risk,” said Dr. Kristi Koenig, medical director of San Diego County’s emergency medical system. “It’s not a good situation, one we try to avoid when we can.”
Coming a day after a last-minute Holiday Bowl cancellation attributed to COVID-19, the sudden increase in coronavirus-related emergency visits on Wednesday coincided with further evidence in the region’s weekly COVID-19 report that the local pandemic was further exacerbated. There were 3,653 new positive test results listed for Tuesday, the largest single-day number since January 7, when 4,550 positives were recorded in a single day, the peak for last winter.
Hospitals are doing much better than they did this time last year, but are still experiencing increases in admissions. There were 454 COVID-19 patients in hospital beds Tuesday, up from 387 a week earlier. The vaccine continues to deliver a significantly lower burden compared to last year when, county records show, there were 1,562 COVID-19 hospital cases on December 28, 2020.
The higher fall rates, said Dr. Joshua McCabe, director of emergency services at Sharp Memorial Hospital in San Diego, have shown quite strong in the past week.
“Just this morning, 15 patients arrived in an hour who were all seeking treatment for COVID,” McCabe said. “Between eight and nine in the morning, there were no other complaints in the ER other than flu-like symptoms that tested COVID-19 positively.”
This time, he added, patients appear to be less seriously ill than they were last year.
“When patients come in with COVID now, it’s more than a flu, and they just do not feel well,” McCabe said. “We don’t see them as often with low oxygen saturation levels as we were when COVID first started.”
This observation is consistent with observations worldwide that Omicron appears to cause less severe disease, especially when patients are vaccinated, than previous variants.
However, it is of little comfort, as the large number of cases seems to be rising faster than last year and certainly faster than it did during the recent floods in summer and early autumn.
“More people are getting sick than ever before and when people get sick with COVID, if they have other diseases or are elderly, they are certainly at a much higher risk for hospitalization and death,” McCabe said.
Rady Children’s Hospital in San Diego reported that 289 of the 1,173 tests his lab performed on Wednesday returned positive for a positivity rate of nearly 25 percent.
Rady has not only reported a high demand for coronavirus-related emergency care, but also an increase in the number of children with severe cases falling to a hospital. Since Wednesday, there have been 14 hospitalized in Rady with COVID-19. Although it was not clear if that was a record, it was quite higher than it was last winter when Rady’s hospitalized total was in single digits.
Some have believed in recent weeks that Omicron is not much of a threat, as it appears to be less effective in causing the severe respiratory symptoms that plagued intensive care units last winter.
But Koenig notes that it often takes weeks after infection for patients to become ill enough to need medical attention.
However, she said, a few percent would get sick enough to need serious help and, with the greater numbers of infections expected to rise in the coming weeks, there could still be enough volume for hospitals to press along the edge.
“Even if the percentage is lower, you can end up with a situation where the number (of hospitalizations) is higher because Omicron is just as transferable,” Koenig said.
The public is clearly very concerned about the infection, with lines to stretch tests for blocks and many waiting hours for a sample to be given. Rapid tests seem to be scarce in the county at the moment.
Some testers, Koenig said, seem to carry the current in volume seen in emergency departments, choosing to go to hospitals when test centers are unable to deliver quickly.
This trend, said the medical director, is relevant due to low staff levels at all medical facilities.
“I know it’s not easy, and the lines are long, but I would say look for another source to test whether that really is the only reason you go to the emergency department,” Koenig said.
There were 27 additional deaths listed in Wednesday’s weekly report. Most range in age from early 60s to mid 90s with other co-emerging medical conditions present. The youngest was a 47-year-old man from Inland North County, who died Dec. 21.