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Frequently Asked Questions

Community Engagement Virtual Meeting

Community Engagement Virtual Meeting - Thursday, January 28

QUESTIONS FOR 1/28/2020 COMMUNITY ENGAGEMENT MEETING

  1. CURRENT NUMBERS FOR COUNTY
  • Positive cases in County
    • Of 372,000 COVID-19 tests administered throughout the County, 44,035 have tested positive for a cumulative positivity rate of 11.8%.
  • Positive cases in hospital
    • As of yesterday morning, January 27th, there were 112 COVID-positive adults in the acute medical center with two additional holding in the ER; of the 112 patients, 14 of them are in the ICU. Today, hot off the press we have 115 positive adult patients. 13 are in the ICU right now. That is a drop from 41 beds being full. All 13 are on ventilators right now. We have 52 ventilators available.
  • Deaths in County
    • As of yesterday, the County was reporting a total of 562 COVID-related deaths since the beginning of the pandemic, representing 1.28% of those who contracted the virus; equates to 116 deaths per 100,000 population.
  • Recovered Cases
    • The County is reporting that of the 44,035 that have contracted the virus, 39,994 have recovered.
  • Positive Employees
    • Since the beginning of the pandemic, 1,106 of KD’s employees have contracted the virus; 88 of them are out on a COVID-related leave of absence; 4 remain currently hospitalized and one employee has passed away. 31 providers (physicians, nurse practitioners and physician assistants) have contracted the virus and all have recovered except for one provider who passed away.
  • Positivity Rate
    • The current 14-day positivity rate for the State sits at 8.8% while the 7-day positivity rate for the County is at 16.2%.
  • Hospital Census
    • As of 7:03 this morning, KD’s adult inpatient census at its acute medical center was 90.0% with 13/41 ICU beds available, 10/54 ICCU beds available, and 15/249 medical/surgical beds available. KD also has 23 surge beds available on its 6th floor of the Acequia Wing (NICU) and 10 surge beds available in its endoscopy center.
  1. How many employees have received their vaccinations?
  • As of yesterday, January 27th, we have administered 3,184 first-dose vaccines and 2,397 second-dose vaccines to employees, members of the Medical Staff, vendor partners and chaplains who work in the hospital and contract labor; we have also given first-dose vaccines to 28 of our long-term skilled nursing patients.
    • If they decline it, what are the reasons for declining it?
      If we take out all of those employees who are currently out on a leave of absence, it appears that approximately 56.4% of our employees have received at least their first-dose vaccine; there are 966 employees who we have not heard from and about 30-35% of those we have heard from have chosen to decline the vaccine at this point in time; about half of them have decided to not take the vaccine and half are waiting to make their decision. Those that are choosing not to take the vaccine are primarily expressing anxiety, apprehension, confident in their own “young” and strong immune system, etc.
    • Do you have enough vaccine for your employees’ 1st and 2nd doses?
      Yes. We only have 787 more second-dose vaccines to administer to those who received their first-dose and we have enough Pfizer vaccine on hand to complete that. We most likely will return all unused vaccine to the County for use in mass vaccination of the community which will require employees who decide to go ahead and get the vaccine to receive it through County-sponsored vaccination events.
    • Were there any side effects worse than what you mentioned in the last webinar?
      None that I have heard.
  1. Does the hospital need lay volunteers to assist with the vaccination program?
  • If so, what are the requirements for volunteers (minimum/maximum ages, physical capabilities, etc.) and when and where to sign up?
    • Earlier this week we were informed by the County administration that they will be entering into an agreement with a company by the name of Curative. This company has operated many of the mass COVID-testing events throughout the State and has now pivoted to mass COVID-vaccination events. They are the company that has been running the vaccination event at Dodgers’ stadium and has been hired by Fresno, San Bernardino and other counties to run their vaccination programs. Curative hires all of the clinical and non-clinical staff they need to staff these events. I don’t know if they will reach out for volunteers but I will apprise all of you if we hear something.
  • Is Curative going to take over the online registration part of the vaccination as well? That has been a struggle for a lot of people in our community.
    • Yes, my understanding is that they will take over that part too.
  1. What is KD’s role in getting people vaccinated who come to our outpatient clinics?
  • We want to support the County in their mass testing events. We do have access to vaccines right now. We are holding back sufficient amount of Pfizer vaccine but we have made arrangements to redistribute vaccines back to the county to support them in their mass vaccinations. It is great to vaccinate established patients but it is great to target 65 and older most at risk rather than young patients. So we are supporting mass vaccination foremost. We can conduct vaccines in all our clinic sites. We will continue to receive small allocations of the vaccines, most likely modern vaccine and reach out to our patients who are in the most vulnerable patients. Older, underlying chronic conditions. We won’t have patients call in we will reach out to those patients and done to the extent vaccines are available. This will start next week on a limited basis. This is just for 4 rural health clinics, with established relationships with patients. The urgent care centers are more designed for walk ins. We hope at some point that we will be able to offer it. Don’t call the rural clinic and we will call you.
  1. Do we know when we are going to open vaccinations for teachers?
  • Teachers are in Phase 1B. I don’t have a definitive answer as to when they will be vaccinated as it has a lot to do with the scarcity of the vaccine.
  1. How reliable is our oxygen supply, and is there a significant risk of shortages if our case numbers continue to grow?
  • With respect to portable oxygen tanks, we are on an “even exchange” program where we receive a full tank for every empty tank daily out of Fresno. With respect to our bulk oxygen supplied by AirGas, we are served from their Northern Hub located in Pittsburg, CA (by San Francisco). They have sufficient factory capacity to meet our current needs and will be able to handle our needs even if our oxygen-dependent patient census exceeds 250. Our pre-COVID oxygen usage was approximating 30” of tank volume per day (downtown campus); we are currently using approximately 75” of tank volume per day (approximately 150 patients daily). AirGas has brought in trucks and drivers from Texas and Oklahoma to increase their delivery capacity. We are currently receiving deliveries every three days but are assured additional deliveries if needed.
  1. Standing down from Crisis Care.
  • Yes. With the recent sizeable drop in our COVID census and the improvement in staffing and ICU-bed availability, we have closed the Crisis Care Triage Command Center and hope to never open it up again. While we approached the brink a few weeks back, we did everything possible to keep the Crisis Care program deactivated.
  1. The hospital numbers went from 170-120 in a matter of days, yet we are still seeing high positivity rates. Why did the numbers drop so rapidly?
  • Probably a number of reasons. First and foremost, I’d like to believe that the community heard our pleas for help and resisted large gatherings and exposures over the Christmas and New Year’s holiday. Tomorrow will be five weeks out from Christmas and four weeks out from New Year’s. Unfortunately, and sadly, we experienced a lot of COVID-related death over the four-week surge period at the same time as COVID-related admissions were stabilizing. We are also seeing more patients successfully down-graded from ICU to ICCU and then med/surg and then discharge. It is also likely that our physician community is having more success in treating COVID-positive patients on an outpatient basis and keeping them from hospitalization.
  1. What are your thoughts on Dr. Fauci’s latest suggestion that people should double mask?
  • I think some of it has to do with the new COVID-19 variants we are seeing in the U.K., South Africa, Brazil and now the U.S. Scientists and others are concerned that they are much more contagious, more-easily spread and can better elude COVID vaccine antibodies. Single masks are generally made of porous layers of material that allow you to breathe but each layer is offset slightly so that the “holes” don’t line up exactly and create a web that prevents micro-molecules from reaching your mouth or nose. If you add a second mask on top of a first, usually a cloth mask over a surgical or medical mask, you create an additional barrier. While the CDC is not recommending “double masking”, Dr. Fauci is promoting it for the general public who does not have access to N95 masks or is reserving them for healthcare workers.
  1. How is KD doing with PPE supplies?
  • Our inventory is high. The gloves were our greatest challenge but we are good now thanks to our Assemblymen’s help and the work of our team.
  1. When is the new Emergency Department going to be opening?
  • We are on schedule to complete construction by March 1, 2021.
  1. When is the Tulare Clinic going to be opening?
  • We should begin seeing patients by March 1, 2021.