CA deploys nurses to Kaweah Health as Visalia hospital sits at 106% capacity, driven by unvaccinated COVID patients

Kaweah Health called off its Code Triage after reinforcements from the California Department of Public Health arrived to bolster the struggling hospital's staffing woes in the wake of a surge of COVID-19 patients.

The hospital had declared an "internal disaster" on Nov. 3 after its emergency department saw more than 100 patients waiting for treatment and hospital beds. It was the second time in three months Kaweah had initiated an emergency response due to a shortage of beds and staff.

The relatively small Visalia hospital is treating more COVID-19 patients than any other in California, stretching Tulare County's healthcare infrastructure thin as nurses and medical staff contend with burnout and low morale amid an ongoing delta variant surge that has no end in sight.

While three federally-authorized COVID-19 vaccines have brought relief to hospitals in other regions of the state, vaccine hesitancy remains high in Central California. Tulare County ranks 45 out of the state's 58 counties with just 47% of residents vaccinated.

More populous regions of the state with higher vaccination rates have seen far lower COVID hospitalizations.

As of Tuesday, Kaweah Health was treating 366 patients and was at 106% capacity. Of those, 93 were COVID patients and 24 were in the ICU.

Once COVID patients reach the hospital's ICU and require intubation, survival rates are low, ranging from 30% to 40%, according to Keri Noeske, Kaweah Health vice president and chief nursing officer. Tulare County recently surpassed a thousand COVID-related deaths.

"That's not normal for a critical care area, where more than half your patients pass away. Those things take a toll. There's really not much they can do because it really does damage and cause a lot of problems for patients," Noeske said. "I admire the people who get up and do this everyday because they know if they don't, then who will?"

While COVID cases account for just a third of the hospital's admitted patients, they require a much higher level of care and physician attention than typical patients due to the severity of the more contagious delta variant of the virus.

“While patients with COVID represent less than a third of our total patients they are having a tremendous impact on the healthcare system and it’s something that really could be avoided,” CEO Gary Herbst said in a statement. “We’ve seen how effective vaccinations are in keeping patients out of the hospital and 90 to 95 percent of our inpatients with COVID are unvaccinated.

"I just imagine what our condition would be like if we did not have those 105 patients with COVID needing hospitalized care right now.”

While the hospital remains full or above capacity, Herbst said additional staffing from the state will help relieve the stressed hospital, especially in the ICU.

“We are feeling some relief as we welcome the first of 16 registered nurses that the state is sending to help us care for patients,” Noeske said, adding that the nurses will stay at Kaweah until December and the state is paying their wages. “With these additional nurses, we’ll have staffing so that we can use surge beds as high volumes continue.”

State health officials said they are committed to ensuring that hospitals have the resouces needed to serve patients in the San Joaquin Valley and across the California.

"Throughout the COVID-19 pandemic, the state’s top priority has always been to ensure all Californians have access to top-quality health care in order to help save lives," a CDPH spokesperson said in an email to the Times-Delta. "Throughout the COVID-19 pandemic, the state’s top priority has always been to ensure all Californians have access to top-quality health care in order to help save lives"

Kaweah staff said they are concerned about a possible influx of patients as the holiday season approaches. While COVID hospitalizations have been on the decline, influenza and RSV cases could be much worse than last winter, when much of the country was masking and social distancing and children were not in schools.

"We've already been seeing RSV in our pediatric patients needing hospitalization, and this is much earlier than usual. Last year, we had no RSV cases," Noeske said. "That's what really concerns me."

Hospital leaders are looking to shore up staff, either through traveling nurses or by extending contracts with the state's nurses at the hospital's expense. At the same time, Kaweah is working with Tulare County Health and Human Services Agency to target zip codes with the lowest vaccination rates, in an effort to boost vaccinations countywide.

"I recognize the challenge people are faced with right now with all of the focus on the vaccine and vaccine choices," Noeske said. "But the reason I need people to be vaccinated or to mask and distance, is because there's too many people getting severely ill with COVID and overwhelming the healthcare system.

"Resources including people resources are drying out."

Those who wish to get a COVID-19 vaccine can schedule a same-day appointment on MyTurn.ca.gov, or visit participating CVS or Rite Aid pharmacies in Visalia, Porterville and Dinuba.

The public is urged to visit their primary care physicians or an urgent care clinic for non-life-threatening illness and injuries.

Joshua Yeager is a reporter with the Visalia Times-Delta and a Report for America corps member. He covers Tulare County news deserts with a focus on the environment and local governments.

Follow him on Twitter @VTD_Joshy. Get alerts and keep up on all things Tulare County for as little as $1 a month. Subscribe today.

This article originally appeared on Visalia Times-Delta: CA sends nurses to Kaweah Health as Visalia hospital remains full