Merced County hospitals in danger of being overrun due to the COVID-19 pandemic  

Both hospitals in Merced County have experienced a surge in demand, starting in November, due to the rising number of cases after Halloween and Thanksgiving, consequent illnesses, emergency room visits, and hospitalizations of residents ill with COVID-19.

The month of December was the worst on record in terms of number of cases, hospitalizations, and deaths. Early indications are that we are seeing a rapid increase in cases and hospital visits due to the Christmas holiday, and likely will also after New Year’s festivities. Typically, increased case counts are followed by increased hospitalizations and ER visits at about two weeks, and deaths about a month later.

This unprecedented situation is placing tremendous strain on the capacity of both hospitals in the county to assess, treat, and process patients in a timely manner. As stated by Dr. Joerg Schuller, vice president of medical Affairs at Mercy Medical Center Merced: “People are at risk of dying due to COVID simply because we are in danger of not having the resources to care for them if we continue to see the number of COVID cases increase at the current rate.” He further adds: “Progressing to crisis level care means triaging medical care and ventilators so that not everyone who may need that level of care will be able to receive it.”

The strain on the hospital system has led to increased wait times for patients, resources such as hospital beds and entire floors having to be dedicated to treatment of COVID positive patients, cancellation of elective surgeries, and shifting of resources and personnel from usual duties to meet the demand. Added to this has been the impact on the hospital staff with personnel illness, increased work hours, and stress. Both hospitals have reported staffing shortages. Other hospitals in the region and in the state, particularly in Southern California are in a similar or worse situation.

The hospitals, in conjunction with the Merced County Department of Public Health, are closely monitoring the situation, and utilizing state resources where and when available, including the possibility of transferring some patients to alternate care sites, which are located out of the county.

Already, both hospitals have been vacillating between conventional or usual care and what is referred to as “contingency care,” at times on a day-to-day basis. Primarily this has consisted in the use of step-down units where patients are monitored on a floor rather than in the intensive care unit.

If the situation further deteriorates, the hospitals in the county will be forced into “crisis standards of care,” as mentioned by Dr. Schuller. This may mean further delays in care or having to make difficult decisions about which patients will be prioritized to receive lifesaving interventions. It also will likely require cot based care, further stepdown of intensive care, changes in nursing and doctor ratios and responsibilities. It may require ambulance diversion with evaluation in the field, likely with telehealth by physicians complementing paramedic evaluation.

The public will be notified if the situation for hospitals in Merced County further deteriorates to the level requiring crisis standards of care. In the meantime, besides the usual measures recommended of avoiding large social gatherings, sheltering in place, use of masks in public, hygiene, and distancing, please speak with your health-care provider of other treatments that may be available if you or a family member were to become positive for COVID.