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Health and Medicine

California hospitals strained for staff and bracing for omicron uptick, including among kids

Image of a line outside a COVID testing center in California
Andrew Nixon / Capitol Public Radio
/
A COVID-19 testing center runs at the Serna Center in Sacramento, Calif, on Monday, Jan. 3, 2022.

As the Omicron variant of COVID-19 spreads rapidly in California, hospitals are filling up and expecting even more patients, including pediatric cases.

Hospitals statewide have seen a 165% increase in COVID-19 admissions in the last month, according to Jan. 6 state data. Case numbers are still less than half of what they were at the peak of last winter’s surge, but that’s expected to change.

“We are on track to exceed last winter’s peak of hospitalizations,” said Kiyomi Burchill, group vice president for policy with the California Hospital Association.

State models predict that by Feb. 5 hospitalizations will surpass 23,000 — nearly four times what we’re seeing now and greater than last winter’s peak of roughly 22,000.

As cases climb, hospitals across the country are grappling with staffing shortages due to health workers calling in after COVID-19 infections or exposures.

In Sacramento County, public health officer Dr. Olivia Kasirye is urging people not to go to the hospital for COVID-19 testing.

“The hospitals are full, and that is why we are asking that individuals that do not need to access the emergency room leave those services for people that do have true
emergencies,” she said.

Meanwhile, physicians and state health officials are continuing to urge people to get vaccinated, wear masks in public and avoid gatherings.

“Nurses are caring for more and sicker patients at the same time,” said Dr. Anne Liu, immunologist at Stanford University. “It’s really worth it to try to avoid stressing our
system if we can.”

Unvaccinated Children Are At Risk

With the surge expected to worsen, health officials worry that California’s unvaccinated children will be turning up at hospitals in higher numbers.

California Health and Human Services Secretary Dr. Mark Ghaly said at a Wednesday press conference that hospitals are admitting more pediatric patients “on a day-to-day basis over the last few days than we did even at the peak of last winter surge.” The state has not provided CapRadio with hospitalization numbers specifically for children.

State epidemiologist Dr. Erica Pan tweeted her concerns about pediatric cases on Christmas Day, asking parents to “please give your children the gift of vaccine protection as soon as possible.”

Unfortunately NY is seeing an increase in pediatric hospitalizations (primarily amongst the unvaccinated), and they have similar 5-11yo vaccination rates. Please give your children the gift of vaccine protection as soon as possible as our case #s are increasing rapidly.

https://t.co/DTFUoYtGbK

— erica pan (@ericapanMD_CDPH) December 26, 2021

Dr. Dean Blumberg, chief of infectious pediatric disease at UC Davis Medical Center, is already noticing an uptick.

“We're starting to see an increase in hospitalizations in the pediatric age group as well as in adults,” he said on CapRadio’s Insight.

New York saw a fourfold increase in pediatric COVID-19 cases during December. Data from the U.S. Centers for Disease Control and Prevention shows pediatric case numbers have risen dramatically since just before the holidays.

Children 5 years and older are eligible to be vaccinated, and teens age 16 and up can get a booster shot. COVID-19 vaccines still haven’t been approved for children under 5.

That makes life challenging for Phaelen Parker, a dad raising a 6-year-old and a 3-year-old in Sacramento’s Oak Park neighborhood. His older child is immunized, but his youngest is not.

“It’s added a whole layer of stress and caution to our behavior,” he said.

Over the holidays, Parker says his family did “surveillance testing” by going to county sites to take PCR tests. They were careful to only gather with fully immunized family
members over the holidays. And they’ve pulled back on indoor dining and other activities, mostly because of their unvaccinated toddler.

“At this point it wouldn’t be fair of us to expose him to a higher level of risk,” Parker said. “It’s a moment of family solidarity.”

While neither of Parker’s children have serious health conditions, and omicron cases among children are generally mild, he’s still worried about the potential long-term effects of the virus on his youngest.

“He probably wouldn’t have much more than a cough or a fever,” Parker said. “But also his body and his mind are developing, and I’d rather not have him have that exposure.”

Like adults, children who are vaccinated are more protected against severe disease than children who are not, said Dr. Anne Liu at Stanford University. But she says both vaccinated and unvaccinated children are at risk when someone in their household isn’t immunized.

“My concern is that there will be increases in pediatric severe cases in parts of the state where vaccination rates are lower,” Liu said.

She said kids who are being admitted in hospitals are largely coming from families where the adults are not vaccinated. “It could be because families that are vaccinating the adults are also having somewhat different lifestyles and taking different precautions from families where adults are not vaccinated,” she said.

In addition to getting children immunized as soon as they are eligible, Liu recommends making sure everyone in the family has a well-fitted, high-quality mask such as a KN95, N95 or KF94 and ensuring that childrens’ activities are enforcing masking.

A Scramble For Staff

Adult COVID-19 patients are occupying more than a quarter of California’s ICU beds, according to Jan. 6 state data. In the Greater Sacramento and the San Joaquin Valley only 16% of ICU beds are staffed and available.

Hospitals are worried that as the omicron surge continues, they won’t have enough health workers to care for these patients.

More than 35% of California hospitals are experiencing a critical staffing shortage, according to federal data.

Kiyomi Burchill with the California Hospital Association says the problem is getting worse as workers get exposed to or test positive for COVID-19.

“Staffing’s the first, second and third issue on the minds of hospitals as the number of patients with COVID-19 increases,” she said.

When someone calls out sick, hospitals typically turn to staffing agencies and travel nurses to augment their workforce. But Burchill says with the national surge, even that isn’t a guarantee.

“It’s getting harder and harder for hospitals to secure enough of those travel staff.”

Liu, at Stanford University, says the staffing shortage can also affect pediatric facilities and units.

“I worry about the ability of these health systems to be able to take care of sick kids as well as other sick adults who have conditions besides COVID,” she said.

Burchill says she doesn’t expect hospitals to cancel or postpone procedures, as they had earlier in the pandemic. But she does want to get the message out that people should not seek testing in the emergency room.

“We need to preserve the emergency departments for people with acute medical needs,” she said. “And COVID-19, but only if they’re experiencing a severe disease.”

Copyright, 2022 Capitol Public Radio