Ahead of the Thanksgiving holiday, California officials are sounding the alarm about a winter Covid rise, as hospitals in some parts of the state continue to be overwhelmed by patients despite general progress.
California’s coronavirus infection rate is one of the lowest in the country, but the burden of infection remains unevenly distributed. In Central California, a region that struggled with resistance to masks and vaccines throughout the pandemic, the strained public health system has been pushed to the brink. Hospitals this week are overcapacity, and officials are seeking to transfer more patients out of the Los Angeles area for treatment.
“We’re just running around like crazy,” said Rachel Spray, a nurse at Kaiser Hospital in Fresno. “The call lights go out, alarms go off. We just do not have the resources.” The hospital’s emergency room, intensive care unit, corona overflow zones and tent are not enough to accommodate the number of sick patients, she said. “It is not going slower.”
In Fresno County, hospitals are “consistently over 100% of capacity,” Dale Dotson, the region’s EMS operations coordinator, said at a news conference Friday. As a result, ambulances are idling outside the emergency rooms, and patients have been waiting for hours or even days for a bed.
The public health system in Fresno and the rest of California’s agricultural Central Valley has been pushed to the brink during the pandemic, though other parts of the state saw the crisis eased this summer and fall. Only 55% of Fresno residents are fully vaccinated, compared to 63% nationwide.
While visiting a vaccination clinic in San Francisco, California Gov. Gavin Newsom urged residents to get their coronavirus vaccinations ahead of the holiday weekend, urging caution despite a general decline in transmission across the state. “States are fighting because people are taking their guard down or claiming ‘mission accomplished,'” he said. “I do not want to see it happen here in California.”
California is not the only western state that sees worrying outbreaks ahead of the holiday. In Colorado, pockets of resistance to vaccinations and masking have helped boost an increase that has pushed hospitals to crisis levels. Although this state has a vaccination rate similar to California’s, its transmission rate in the community is one of the highest in the country, and 95% of ICU beds are in use. Denver and other parts of the state have reissued indoor mask requirements, which were lifted over the summer.
In Central California, opposition to public health measures, including masks, has been high throughout the pandemic, and the region experienced the highest level of support for recalling Newsom over his pandemic restrictions.
Meanwhile, agricultural workers in California’s Central Valley – many of whom lack legal status and easy access to medical care – remain the most vulnerable. The rate of Covid-19 positivity among California farm workers was four times as high as in the rest of the country, according to a report published in the journal Jama Network Open earlier this year. “The area we live in is an area of higher poverty. There is a lack of access to medical care. People have more comorbidities,” Spray said. “And that leads to a greater chance of people getting sicker.”
Staff shortages and burnout among health workers have further strained the region’s medical system. At the Doctors Hospital of Manteca, nurses have been assigned to up to nine patients at a time, “which is usually just unheard of,” said Brittany Smith, a surgical nurse at the center. State guidelines recommend one nurse for every two ICU patients and every fifth surgical patient. “We are basically in a state of crisis,” Smith said. “And we’re forced to work in conditions that are completely unsafe.”
“Because of work challenges affecting other local hospitals, we are accepting additional patients to ensure our community receives safe, uninterrupted care,” said Krista Deans, a spokeswoman for the hospital. “To support our care teams, we have used all the options we have available.”
Nurses at the hospital joined in September.
Spray said medical personnel are burnt out and “morally distressed.”
“We want to give the very best care to every patient. And we can not,” she said. Ahead of Thanksgiving and the Christmas shopping season, she added that she is preparing for the worst and begging patients to wear masks indoors and be vaccinated.
“Between now and next year, we may face a very challenging winter,” Rais Vohra, the temporary health worker in Fresno County, told a news conference. “Bent up on your turkey and your sauce, but also do not forget to fill up on your mental and spiritual resilience.”