Intensive care nurse Suzie Minnich has been working for weeks at the forefront of the Bay’s latest COVID-19 boom in the heart of the region’s crisis: Santa Clara County.
A staggering 154 people a day were admitted to Santa Clara County ICUs on average in January, and Minnich, the nurse manager of two ICUs at Santa Clara Valley Medical Center in San Jose, said dealing with the flood of patients’ is like working in quicksand. ”
“I’m making one bed, and two patients are already waiting for it,” she said.
The number of people in the country’s ICUs is almost seven times higher than in October before the holidays, and hospital officials estimate that at least half of the patients have COVID-19.
The deluge of people in need of critical care is causing administrators to bring in doctors from outside the ICU to help.
“Normally we would not even consider it, because these doctors are not so well trained to care for these types of patients,” said Dr. Cliff Wang, chair of the Department of Medicine at Santa Clara Valley Medical Center, said. But these are extraordinary times, he said, and those doctors are able to tackle tasks that liberate the ICU doctors, such as calling families about a patient’s condition.
Santa Clara County hospitals are by far the hardest hit in the Bay, with 37% more new patients coming into its ICU beds daily than in the next saturated province, Alameda, which sees an average of 113 new ICU patients a day. month, compared to 19 in October.
Although Santa Clara County is struggling every day with the most new ICU patients – it is the largest province in the Bay, with 2 million inhabitants – every province in the region has seen a huge jump since the holidays, with increases of nine, ten and even 17 times higher in some provinces.
The increasing numbers indicate that many people have simply ignored public health experts who have asked them to stay home during the holidays, if they did not have to save from illness, then to keep ICU beds available for emergencies, from car accidents to heart attacks.
Not everyone listened.
“Over Christmas was the worst week of nursing I’ve had in ten years,” said John Pasha, a coronary ICU nurse who works the night shift at the Good Samaritan Hospital in San Jose. A decade ago, Pasha traveled to Haiti to help after a magnitude 7.0 earthquake devastated much of the country.
In some ways, he said, this boom is even worse than that.
“I’ve never seen anyone have a faster breathing attack than someone with COVID-19,” Pasha said. ‘This person said they were struggling to breathe. I look away and turn back, and the person is dead.
“It’s COVID,” he said. “That’s what’s scary.”
Intensive care units, with their specially trained doctors and nurses, accept only the sickest of the sick. All ICU patients have their own room. Each person is surrounded by life-saving machinery, sometimes up to 15 IV pumps. Wires connect the patient to a monitor that causes a constant stream of important information about oxygen levels, heart rate, breathing rate and body temperature to flicker. And now, since families are forbidden to visit patients, the mixture of equipment contains tablets on stands so that the visits can virtually take place.
Under California law, every ICU patient can share a nurse with just one other patient. But because of the boom and because of the objection of nurses calling it unsafe, government officials are now allowing hospitals to apply for remission for these relationships. Despite the limitations, a patient’s cramped ICU room is often a busy place, as nurses and technicians work together to safely seat the patient twice a day, or as a team of doctors and other experts a patient surround and fight for the life of the person.
Minnich said at least half of ICU patients at Santa Clara Valley Medical Center have COVID, many of them in their 40s and 50s – a younger group than she saw last spring.
Pasha, Minnich and Wang all described their ICU colleagues as tired out of faith.
“People are drained. Exhausted. “Everyone is running on reserve,” said Wang. “The extra shifts mean that you are not home often – and that you do not sleep so well, because you know that you are calling at any time.”
The difference in the usual experience of canine fatigue in the ICU is that there are now “so many patients that you do not really have time to recover,” he said.
The next day, Minnich walks down the hall and sees a nurse next to the IV pump outside his patient’s room staring out somewhere, his shoulders bent.
“He looked exhausted,” Minnich said. “I said, ‘Are you okay? Do you need help? ‘ He says, “No, I’m OK.” I said, ‘You want it to be everything, don’t you?’ He said, “YES!” ‘
Five ICU beds have been added to the 40 that Minnich normally oversees, and there is no guarantee that the unit will not be expanded again. She manages about 140 nurses.
Across the city from the Good Samaritan, Pasha works 12-hour shifts “without meal breaks,” he said. “We can not leave our patients because we do not have people to replace us. There is no break nurse. We usually have one emergency room nurse who can come if a patient is getting worse. We do not have it anymore. There are no extra hands. ”
Patients can stay in the ICU for weeks, sometimes more than a month, Minnich said. It is long enough for doctors and nurses to get to know them and care for them.
“Think about it,” she said. ‘You’re with someone every day for two to six weeks. You take care of them. This is someone who has a life. They have people who care about them and love them. They have hobbies. They had a life before they came to the ICU, and now they are very sick.
“People hear about numbers. But these are not numbers. They are people. The losses were far too many. And those who survive, many will experience lifelong disabilities. It’s not going to be over for them. ”
More information
Santa Clara County hospitals are by far the hardest hit in the Bay, but in all counties, huge increases are facing ICU surveys. The numbers below compare the average daily admissions for ICUs in October and January.
Santa Clara County: Oct .: 24. Jan: 154, almost seven times higher.
Alameda County: Oct.: Jan. 19: 113, six times higher.
Contra Costa County: Oct.: 7. Jan.: 66, 10 times higher.
Napa County: Oct.: Jan. 1: 17, 17 times higher.
Solano County: Oct.: 4. Jan.: 38, nine times higher.
Marin County: Oct.: 1. Jan.: 7, seven times higher.
San Francisco County: Oct .: 10. Jan .: 57, six times higher.
San Mateo County: Oct.: 6. Jan.: 41, six times higher.
Sonoma County: Oct.: 6. Jan.: 19, three times higher.
Source: Chronicle Analysis of Hospitalization Data in California
Dr. Ahmed Kamal, director of the COVID-19 directorate of Santa Clara County for health care preparedness, warned this week that the relief from the boom after the holidays is not yet in sight, despite the advent of vaccines.
“No matter how terrible it is, things can get worse,” he said, adding that the country “has not yet been in a situation where two people are gasping for breath and only one is getting a ventilator.”
“But we can get there.”
Nanette Asimov is a staff writer for the San Francisco Chronicle. Email: [email protected] Twitter: @NanetteAsimov