With emergency rooms and intensive care units operating at maximum capacity in Fresno area hospitals, county health officials on Wednesday advised the public to avoid using ambulances or emergency rooms unless they are in dire need of medical aid.

The goal is to keep hospitals from experiencing patient overloads, said Dale Dotson, the county’s emergency medical services operations coordinator.

“We are frequently seeing ambulances waiting two to four hours to turn over a patient and the EMS agency is taking the step of directing ambulance providers to no longer transport individuals with nonemergency medical complaints that meet a predetermined criteria,” Dotson said.

Where the Public Can Go to Seek Medical Help

Fresno County’s Public Health Department and the Central California Emergency Medical Services Agency announced the emergency policy early yesterday morning after implementing it earlier this month.

For nonemergency medical care, health officials say the public should go to private physician offices, urgent care centers, clinics, or as a last alternative, contact a telehealth service through an insurance carrier.

Fresno County Public Health Director David Luchini said the policy was being reintroduced to reduce patient overload  on local emergency departments and increase availability of ambulances across the community.

“An ambulance will continue to be sent to all requests for service,” said Luchini. “If it is determined by ambulance personnel that the patient is stable and does not require emergency transport, EMS personnel will assess the patient and provide an appropriate alternative recommendation.”

State Staff Assisting Fresno Hospitals 

Fresno County EMS Director Dan Lynch says there is no quick fix to the problem, and he hopes that the hospitals will still be able to depend on the extra help that was sent by the state.

In early September, county hospitals that were overloaded with patients amid staffing shortages during the Delta variant surge of the coronavirus got a big boost from traveling nurses.

“We’re working on sustaining staffing from the state because that’s the key to this situation that we’re in right now,” said Lynch. “We want to make sure that we have the staffing available to those hospitals from wherever we can get them to help maintain some steady care within the emergency departments, but also throughout the hospitals.”

This aid was crucial for county hospitals earlier this summer after they had to transfer some patients out of the region to receive care.

Transferring Patients, Expanding Hospital Space Could Help

Lynch says officials have looked at other regions that have not been as impacted as Fresno County where patients might be transferred if need be.

However, this solution only works if families are willing to allow patients to be moved and some families aren’t always open to that.

Another alternative could be to expand hospital space by setting up an alternate care site, but Lynch says such efforts last year weren’t always successful.

“As you know, last year we built out this beautiful alternate care site,” said Lynch. “But the problem with the alternate care site, it couldn’t take care of the level of care that the patients required and so building additional space at the hospitals was actually the best case scenario because the services were available and we could increase the level of care in those expanded areas.”

Ultimately, extra spaces would need extra staffing, which hospitals already lack enough of.

Patients Needing Care Vary In Medical Problems

The influx of patients taking up hospital beds are not just COVID patients, but include others with a wide range of medical problems.

Since the start of the pandemic, hospitals deferred elective surgeries, and they are now dealing with the fallout of having patients who needed care return because they require additional attention.

Many of these surgeries are necessary now, Lynch said, and the long wait has only exacerbated patients’ issues.

“‘It’s a domino effect when we’re in this type of a situation and so this really just really bogs down the system,” he said.

Along with surgery delays, there’s also been a rise in mental and behavioral health problems that could be adding strain to a healthcare system in crisis, Dr. Rais Vohra, the county’s interim health officer.

“Mental health crises and psychiatric admissions and psychiatric holds, those really increased in recent months and probably for the whole year,” said Vohra. “And it’s really hard because we don’t have a lot of mental health inpatient resources to refer people to.”

Fresno COVID Cases

As of the week ending Nov. 5, COVID-19 cases declined to 264, compared with 336 cases on Halloween weekend. However hospital beds remain full with 325 patients currently hospitalized.