Authorities in Fresno County are fighting for machines that produce oxygen to handle the rising tide of people sick with COVID-19, as the number of bodies has put greater pressure on funeral homes.
Officials in California’s tenth most populous county say the situation is not as dire as that in Los Angeles County. But health officials are trying to ease the pressure on hospitals by sending home COVID-19 patients who would normally stay in the hospital – and to do that, they are looking for machines that can generate oxygen for patients at home.
“It is a very serious scenario to make that decision,” said Fresno County interim health officer, Dr. Rais Vohra. “Because under normal conditions, under ideal conditions, everyone who needs oxygen would be admitted to the hospital. Unfortunately, we are operating in a disaster and therefore we don’t have that luxury, and we have to make very difficult choices and do the best we can. “
Vohra said he was hunting for some oxygen concentrators – machines that can create oxygen from the air. “We are trying to do as much as we can to track the supplies that will be needed just to prepare for an even greater number of patient volumes in the coming weeks.”
The demand for oxygen is critical.
“Many people just need oxygen to get over it,” said Vohra. These are patients who have pneumonia and are able to walk, but need an oxygen tube flowing at high speed connected to the nose to avoid becoming seriously ill.
At the moment, it is difficult to expand a program that can accommodate perhaps hundreds of patients a day to be configured for oxygen treatment at home. But that is what they are trying to do, said Vohra.
Fresno County is the most populous municipality in the San Joaquin Valley, one of the most productive agricultural areas in the country. But like Southern California, the San Joaquin Valley has been hit hard by the pandemic and its capacity for available intensive care unit is 0%.
And in this county of nearly 1 million people, there were only 11 beds in the intensive care unit available on Tuesday. That means that many critically ill patients had to stay in the emergency room when they were supposed to be in the ICU, said Vohra.
“There are other places within the hospital where they are trying to make space for patients in intensive care,” said Vohra. Less serious patients may need to be cared for outdoors, in tents set up in the parking lot.
The next few weeks are a cause for concern. There are already intermittent times when patients in ambulances wait several hours before being allowed to enter the emergency department. The ambulance team is trying to redirect people who do not have a real emergency to a primary care physician or urgent care center.
“I am very concerned that we will see an increase in the number of hospitalizations and deaths,” considering the large gatherings that occurred during the holidays, said Vohra. “We haven’t really seen a decrease in the increase that we’ve already seen. … There really was no postponement. And so, we’re certainly just waiting and getting ready to see what the next few weeks will bring. ”
Within Fresno County hospitals, officials report that they are still able to adequately supply oxygen through existing infrastructure; they received help from American Ambulance, a company that provides ambulance services in the municipality, which has machines to generate oxygen and refill tanks.
But Vohra said that what is happening in LA is a cautionary tale about how easily infrastructure can be overwhelmed.
“We know – because Los Angeles is going through this – that demand can … overwhelm our ability to meet people’s demands,” said Vohra. Some hospitals are under pressure because of the significant volume of patients, “the inability to find places for them” and limited staff.
Funeral homes in Fresno County are also under pressure. Mortuaries had to find ways to maximize storage space for the growing death toll, Vohra said, and mobile refrigeration units were called in to store some bodies.
“This is a mass accident, a mass fatality event that our county is experiencing. And we had to expand the corpse storage areas here in Fresno County beyond normal, ”said Vohra.
Whether the county will have to resort to the use of two refrigerated trailers sent by state officials depends on how quickly funeral homes and mortuaries can process the bodies, Vohra said.
“It will take the entire ecosystem to try to find the best way to work with this really large number of bodies that they need to care for,” said Vohra. “I’m happy that these two trucks are coming and I hope we don’t need them.”
Fresno County had one of the highest per capita mortality rates in the last week of any California municipality in the past seven days, ranked 12th out of 58 counties. Since December 1, 230 COVID-19 deaths have been reported in Fresno County, almost a third of the cumulative total of 711 deaths recorded in the past 10 months.