A surge of serious COVID-19 cases fueled by the delta variant has swamped hospitals in California’s Central Valley. The region’s health care system is so overwhelmed that Fresno County’s interim health officer implored county residents at a press conference to do more to control transmission.

“Please wear a mask,” Rais Vohra, MD, pleaded as he waved a black disposable mask. “If you want to know how you can make sure your loved one has a bed in a hospital tonight if they have a heart attack, then wear a mask. . .  Please know that we are begging you on behalf of the health care system.”

By early September, more than 400 people were receiving inpatient treatment for COVID-19 in the county’s hospitals, Tim Sheehan reported in the Fresno Bee. That included more than 90 patients in intensive care units.

The San Joaquin Valley, the Sacramento area, and rural Northern California are the regions most affected by the current surge, according to a Los Angeles Times analysis published on September 8. Fewer people are vaccinated in these regions than in densely populated coastal areas of the state, according to Times reporters Rong-Gong Lin II and Luke Money.

A System Overwhelmed

“Our system is still paralyzed and is at a standstill, as we’re trying to move a huge number of patients through this health care system that is completely overwhelmed,” said Dan Lynch, who oversees emergency medical services for Fresno, Kings, Madera, and Tulare Counties.

The number of COVID-19-infected patients in Central Valley hospitals doubled between early August and early September, Sheehan reported.

In Fresno County, there are 41 hospitalized patients for every 100,000 residents, Lin and Money reported, which is more than double California’s overall COVID-19 hospitalization rate. Fresno’s rate is triple that of Los Angeles County’s, where there are 14 hospitalizations per 100,000 residents.

By September 3, only 8.6% of fully staffed ICU beds were available in the region. The low number of available beds, which was below 10% for more than three days, triggered the state’s surge protocol in the valley.

Surge Protocols in Place

During last winter’s COVID-19 upsurge, state health officials implemented a protocol to alleviate the strain on hospitals. Last month, the state ordered that the additional measures will be imposed whenever a region’s hospitals have less than 10% of total ICU beds available for three straight days, Money noted in the Times.

The protocol stipulates that hospitals in the region must admit transfer patients if they have bed space available. Those hospitals “must accept transfer patients when clinically appropriate and directed by the regional disaster medical health specialist.” If space isn’t available in the region, hospitals elsewhere in the state must accept transfers “when clinically appropriate” and if ordered by the director of the state Emergency Medical Services Authority or the agency’s designee, Money wrote.

Some critically ill patients have been taken more than 100 miles away because local intensive care units were full. Patients have been sent as far as Watsonville, in Santa Cruz County, Lin and Money reported.

“Our system is still paralyzed as we try to move a huge number of patients through this health care system that is completely overwhelmed,” Lynch told ABC30 in Fresno.

Low Vaccination Rates in the Valley

The Central Valley’s vaccination rate is significantly lower than that of California as a whole, Lin and Money reported. Only about 63% of residents age 12 and older had at least one dose of a COVID vaccine. In Los Angeles County, 75% of residents have had at least one dose. More than 87% of vaccine-eligible residents in San Francisco and Santa Clara Counties have received at least one shot.

Latinx Californians, who make up 39% of the population, account for 56% of COVID-19 infections and 46% of deaths. They have faced significant challenges during the pandemic, as journalist Sharon Bernstein reported recently for Reuters: “Many Latinos in the Central Valley are poor, working in industries such as agriculture that have been deemed essential during the pandemic. Many employers have not reliably provided protective equipment to workers or implemented social distancing or rules requiring masks to be worn, measures essential to containing the virus.”

Latinx people are also more affected “because they are more likely to live in multigenerational households [and] tend to have higher rates of chronic conditions,” Ana Ibarra reported last year in CalMatters during the summer 2020 surge.

Staffers from Clinica Sierra Vista, a community health organization serving Fresno and Kern Counties, made thousands of calls to encourage vaccinations. That outreach resulted in “perhaps 100 vaccinations,” Stacy Ferreira, the clinic’s chief executive, said at a recent press briefing.

Exhausted and Bracing for a Post–Labor Day Surge

Kenny Banh, MD, the medical director of the UCSF Fresno COVID-19 Equity Project, said at a press briefing that he sees a daily average of about 150 vaccinations and around 500 coronavirus tests. The number of tests was 10 times higher than it was two months earlier. “I wish the lines were flipped,” Banh said, and that hundreds of people were getting vaccinated rather than tested for an infection.

“People are tired. It’s not just the numbers, it’s the morale,” Fresno County’s Vohra said. “People are exhausted, and that’s something the community needs to know.”

Public health officials in the area are bracing for another bump in infections following the social gatherings of Labor Day weekend.

To send questions or comments, tweet at me with #EssentialCoverage or email me.

Heather Tirado Gilligan

Heather Tirado Gilligan is a journalist who has written for publications including Slate, The Nation, CNN, and the Washington Post. Previously, she was executive editor of the California Health Report, a news nonprofit covering disparities in health and access to health care. Heather received a master’s degree in journalism from UC Berkeley and a PhD in English from Rutgers University, where she studied race in American culture.

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