COVID-19, RSV, other viruses buckling workforce in Fresno County 

Photo: Reza Estakhrian/Getty Images

With hospitals operating at between 20-40% capacity, officials in Fresno County, California, are warning of severe working conditions and are urging the public to avoid checking into the emergency room for nonemergency issues.

Calling the number of admitted patients "historic," Fresno County Emergency Medical Services Director Dan Lynch said hospitals in the county are holding admitted patients in the ER for up to four days and are using conference rooms and other non-patient areas to hold patients.

Emergency department wait times can regularly exceed 10 hours for patients not experiencing medical emergencies, officials said, and ambulances are often waiting one to two hours to turn over patients at the hospital. If conditions in the hospitals don't improve, hospitals may need to temporarily divert patients for a time until it's safe to reopen, which the county's Department of Public Health said would place significant pressure on other local hospitals that remain open.

WHAT'S THE IMPACT

Officials pinned much of the blame on the increase in hospitalizations to a sharp rise in respiratory illnesses caused by currently circulating viruses, including RSV, COVID-19 and the flu. The sharp uptick in ER utilization is straining hospital resources, officials said.

The Department of Public Health and the Emergency Medical Services Agency currently have what they call the Assess and Refer Policy in place, which is meant to reduce the impact of patients on local emergency departments and to increase the availability of ambulances. Under the policy, ambulances will respond and assess patients, and if it's determined that the patient is stable and does not require emergent transport, the ambulance personnel will provide an appropriate alternate recommendation and not transport the patient by ambulance.

The county's health departments urged a number of prevention measures, including the newly updated COVID-19 vaccine, an annual flu vaccine and a consultation with a provider for the RSV vaccine if the patient is 60 or older. 

THE LARGER TREND

Currently, the fastest-spreading COVID-19 variant in the U.S. is JN.1, representing about 21% of new cases, according to the Centers for Disease Control and Prevention.

The variant is closely related to the prior variant BA.2.86. It has just one additional change in its spike protein. This small change, the L455S mutation, may make it more apt to evade immune system responses, the CDC said.

JN.1 was first detected in the U.S. in September, and for the first month or so only accounted for 0.1% of coronavirus transmissions. The fact that it has continued to grow, and the rate at which it's growing, suggests that it's either more transmissible or is better at working around people's immune systems. Still, the CDC didn't find evidence that the variant presents an increased risk to public health compared to other current variants.

Data from August showed that COVID-19 hospitalizations and deaths were increasing at that time. For the last week of July, the number of hospital admissions in the U.S. were up 12.5%, for total admissions of 9,056. This compares to about 6,000 people hospitalized during the last week of June, the CDC's data showed.

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com