Kaweah Delta Chief Executive Officer answers community's COVID-19 questions
VISALIA – As the number of cases rise in Tulare County, many people
have questions about COVID-19. In a virtual video-conference call this
week, Gary Herbst, Kaweah Delta’s Chief Executive Officer, answered
questions from Tulare County residents.
Question: What are the most current numbers of COVID-19 in Tulare County?
Answer: As of Thursday, April 23, there were 453 confirmed positive cases in Tulare
County with 25 COVID-19-related deaths and 69 recovered. California has
37, 369 positive cases with 1,469 deaths. Kaweah Delta currently has 27
positive inpatients, and 17 total deaths since the beginning of March,
10 of which were residents of Redwood Springs nursing home.
Question: Any updates on when Tulare County will reach its peak?
Answer: On a very positive note, Qventus, the predictive analytical tool being
used by many hospitals across the country to help predict the patient
demands Kaweah Delta will likely experience over the next 45 days, is
now indicating that Tulare and Kern counties have actually reached their
apex. The model indicates that these counties will experience a plateau
over the next week or so and then start coming down the slope.
Question: Now that Kaweah Delta has Abbott testing, which takes minutes instead
of hours, do people get tested at the specimen collection tents and Emergency
Department or is that still only for inpatients?
Answer: Due to an initial limited supply of Abbott testing materials (chemical
reagents and test cartridges), Kaweah Delta limited the ID Now testing
to only KD inpatients, and to symptomatic employees, physicians, and residents.
As shipments and test kits increased in supply, Kaweah Delta extended
the Abbott testing to all patients coming through the ED that were to
be admitted. We would also allow the ED to test non-inpatients (those
to be discharged home from the ED) for rule-out. Kaweah Delta expanded
this testing capability to our Urgent Care Center located on Court Street
where it now has one or two Abbott analyzers to perform specimen collection
and testing for patients who arrive to the urgent care center for normal
urgent care services, but may be exhibiting COVID-19 symptoms. Kaweah
Delta decided this week that it will no longer use any commercial labs
to perform testing as results are not being returned for 7-10 days, but
will instead only use the County’s lab or its in-house lab.
Question: Do we know why Tulare County’s per capita number is so much higher
than Fresno County’s?
Answer: With Fresno County’s population of almost 1 million people, compared
to Tulare County’s population of approximately 500,000, it is hard
to understand why they have 384 positive cases and seven deaths (132 recovered)
and Tulare County has 441 positive cases and 25 deaths. “I don’t
believe they have practiced better social distancing or have sheltered-in-place
or practiced hand hygiene any differently than us. I do believe that we
have had earlier and better testing capability and capacity at our County
level and now, within Kaweah Delta,” Herbst said. “However,
I believe the single distinguishing factor is the Redwood Springs nursing
home outbreak. I have not read of a single nursing home outbreak in Fresno
County.” Kaweah Delta’s 54-bed skilled nursing facility has
had 0 positive cases among patients and staff. Without these nursing home
outbreaks, Tulare County would have had only 224 positive cases (160 fewer
than Fresno County) and only 10 deaths (still slightly higher than Fresno’s seven).
Question: What is the leadership directive regarding personal protective equipment
(PPE) for staff?
Answer: Over the past two weeks, the availability of PPE has significantly improved,
through Kaweah Delta’s conservation efforts and the stabilization
of supply channels. Kaweah Delta has continuously adjusted its PPE protocol
to reflect this changing supply condition. Most recently, on Wednesday,
April 23, Kaweah Delta began issuing new surgical masks to the 3,000 of
its 5,000 employees who do not work in the high-risk clinical areas, but
Kaweah Delta wants to protect from contracting the virus or giving it
to someone else in the event they are infected but asymptomatic. These
employees will now receive a new mask every Wednesday, unless one of these
masks becomes soiled, damp or otherwise unusable, in which case it is
On April 17, Kaweah Delta also began issuing three N95 masks to over 2,000
employees and providers who work in the higher-risk areas, including those
ancillary staff (e.g., phlebotomists, imaging techs, respiratory therapists,
housekeepers, etc.) who work on the units with our nurses and physicians.
These masks are now changed out every day allowing for the first mask
worn to be re-worn on the 4th day, free of any virus cells that would have died off.
During the initial pandemic outbreak in Tulare County, Kaweah Delta was
forced to implement pretty restrictive PPE conservation measures, although
in line with Center for Disease Control & Prevention Guidelines, as
normal supply chain distribution channels were being greatly disrupted
and our inventories were being depleted. Understand that under normal,
non-COVID conditions, our staff rarely ever wear an N95 mask, only when
taking care of patients with tuberculosis or active measles; not even
during flu season. Not knowing yet whether the coronavirus should be handled
as an airborne or droplet virus, Kaweah Delta had to be careful not to
burn through PPE before the surge hit. As such, Kaweah Delta instituted
a protocol where physicians and staff were asked to reuse and practice
extended use of masks and gowns. This is the same practice that was instituted
across the country. Kaweah Delta would always, and without hesitation,
replace an employee or physician’s mask if it became soiled, damp
or otherwise unusable.
Question: What is the current census at the hospital? Are employees being asked
to stay home due to low census because of cancelled elective surgeries,
etc. during these challenging times?
Answer: On April 23, Kaweah Delta’s adult acute inpatient census in the
downtown Kaweah Delta Medical Center was 223 patients across all medical/surgical
units, Intermediate Critical Care Units and Intensive Care Units. Kaweah
Delta had 109 empty adult acute beds and 12 empty pediatric beds (closed
for possible surge). Due to the very low inpatient census, caused largely
by the cancellation of elective surgeries, coupled with a significant
decline in Emergency Department, urgent care, and outpatient visits, Kaweah
Delta has been “docking” employees (cancelling their shifts),
reducing hours and furloughing (temporary layoff). “It’s awful,
but we have no other option as, like so many businesses and industries
out there, our revenue has plummeted. We are helping these employees as
much as possible to secure federal and state unemployment insurance benefits
and evaluating other options to potentially use sick banks or other sources
to cover lost wages,” Herbst said. #