The Storm Approaches

Miller Report for the Week of December 14th, 2020

By William Miller, MD – Chief of Staff at Adventist Health – Mendocino Coast Hospital

I was on a call with health officials this morning who described what they are seeing in this current COVID outbreak as like a tsunami moving north from the southern part of the State. Many of the hospitals in the LA basin are above capacity and have no ICU beds left. Our Adventist sister hospital in Bakersfield has reported that 110 of its 256 beds are filled with COVID patients. It also reported 28 patients being boarded in the ER waiting for a hospital bed to open up so they could be admitted. San Jose Regional Medical Center, the main trauma center serving the southern end of the Bay Area recently reported that its 48 ICU beds were completely full and that it was temporarily not accepting any further transfers from other, smaller hospitals.

Yet, at the same time, there are many areas that are still relatively lightly affected. For example, in speaking with a physician colleague down in San Diego, she told me that most of the cases they are seeing are clustered in the eastern part of their county, with much less in the western part being easily manageable. Something interesting that she also told me was that US hospitals along the Mexican border are seeing a dramatic surge of cases, not from Mexican nationals, but from American expatriates who have been living down in Mexico and are now returning to the US because they are ill with COVID.

Closer to home, Mendocino County belongs in the Northern Region of eleven counties with the majority of hospital beds being located in four of those counties; Del Norte, Humboldt, Lakeside and Mendocino. As of this writing, in our three hospitals in Mendocino, we have 14 hospitalized patients with COVID out of a total of 100 beds, three are in the ICU out of 16 ICU beds. On the Coast, we have been running a steady one to two COVID patients at a time for several weeks now.

Compared with other parts of the state, I would say that we continue to have relatively few cases here on the Coast. This will likely change in the next few weeks because of our own local cases or because of transfers in to us. The reality is that at some point, we may be obliged to accept patients from afar; even intubated, ICU level patients. While this reality may worry some; that is what our surge plan has been preparing for. That decision will come from the California Department of Public Health which must look at all resources available in the state to deal with this mounting disaster. In that context, we will not be able to refuse if called upon and I am not sure we would ethically want to refuse. The only way we are going to get through this is if we all stick together. If we on the Mendocino Coast are ever hit by a real tsunami, I am sure we would appreciate help from our neighboring counties. It is simply what we must do because it is the right thing to do.