Fire Dept. EMS Help Deployed to Besieged Calif. Hospitals

The Press Democrat, Santa Rosa, Calif.

California firefighters sent across the state to battle wildfires are now being deployed through the same mutual aid system to work at hospitals struggling to keep enough staff on duty during the coronavirus pandemic.

Petaluma Valley Hospital was among the first four hospitals in the state — the only facility in Northern California — that received firefighters trained as emergency medical technicians or paramedics this month to help bolster staffing levels as COVID-19 cases skyrocket across the country.

On Wednesday, California officials announced they would deploy more firefighters to work at eight additional hospitals in Southern California, where an enormous surge of COVID-19 patients needing intensive care has led to a crisis at hospitals without the staff, space or equipment to handle all those in need.

Sonoma County is so far not experiencing an overwhelming number of very sick people, though 110 people — an all-time high — were hospitalized with COVID-19 this week. Petaluma Valley Hospital officials requested the assistance because of the difficulty providing the kind of intensive care COVID-19 patients need while ensuring staff with any sign of illness stay home, said Wendi Thomas, the hospital's director of nursing.

"It's been challenging to keep staffing at a level we'd like it to be for a variety of reasons," Thomas said. "The nurses are tired. They've been doing this since March and it's been exhausting."

This week, California officials have announced additional plans to bring more trained workers to help hospitals and to add makeshift medical clinics and alternative hospitals to help with a surge of patients.

The state Tuesday asked the federal government to send 500 medical personnel to work at hospitals, skilled nursing homes and medical surge hospitals. California has already deployed nearly 1,500 workers with various levels of medical training from organizations, including the California National Guard, to help at hospitals, public health departments, nursing homes and other medical facilities.

Sonoma County Supervisor David Rabbitt said the ability of local hospitals to increase staffing and meet the need of a worsening surge is one of his top concerns. Rabbitt said he's struggled to get an accurate picture from local health care companies about how many more patients they can serve with the resources they have — and when they will need the government to step in.

"The bigger question is how many patients do you have before you're overwhelmed?" Rabbitt said.

Sonoma County Fire District Chief Mark Heine said the New Year's Eve call he received from the state Office of Emergency Services for local firefighters to join the effort was the first time the state has used its program for sharing resources across the state for something other than a major wildfire. All firefighters are trained as emergency medical technicians and some receive additional training as paramedics.

"This is a new threat to the community in the form of a dire need for patient care. Hospitals are overwhelmed," Heine said. "Staffing shortages that already existed are coinciding with a pandemic."

The firefighters will be paid by their local agencies, which will be reimbursed by the state.

Heine said he will review each request carefully to ensure there are enough resources locally to handle needs within the county. He rejected a request through the state to send 11 local paramedics to Kern County, but he said that if it becomes clear resources are utterly depleted, he will send resources to meet needs in other parts of the state.

Heine said he believed the program is "laying the groundwork" for the county to be ready if the surge continues to worsen before enough people are vaccinated.

Thomas said Petaluma Valley has been requesting help with staffing from the state since August, and she was surprised to receive a call Dec. 31 alerting her nine personnel would arrive the next day.

Nine paramedics and EMTs from Sonoma and Solano county fire agencies showed up at 8 a.m. Jan. 1 for the first 12-hour shift of a 14-day stint at Petaluma Valley, which is run by Santa Rosa Memorial Hospital operator St. Joseph's Health.

The reinforcements included personnel from the Sonoma County, North Sonoma County, Cloverdale, Dry Creek Rancheria, Graton and Sonoma Valley fire departments as well as two paramedics from Rio Vista and Fairfield fire departments in Solano County. They are providing support to nursing staff, and are able to do tasks like take vital signs and assess patients, Thomas said. They provide extra hands for patients seriously ill with COVID-19, who require significant care, she said.

The number of patients being cared for at Petaluma Valley's 30-bed campus hasn't increased, but those with COVID-19 are typically sicker and stay longer, requiring more staff involvement, she said. The hospital has struggled to hire more nurses to keep staffing levels up while others are sick or home in quarantine after being exposed, Thomas said.

"We had sicker patients, nurses off duty, and because of that combination, we'd been asking for months," Thomas said.

The hospital employs 150 part-time and full-time nurses, though not all are currently working. They have open positions they are unable to fill due to several factors, including an overall demand for nurses and stalled negotiations with the local union.

St. Joseph Health has found it more difficult to bring in travel nurses because of the demand nationwide. Bryan Cleaver, emergency medical services administrator for Coastal Valleys Emergency Medical Services Agency serving Sonoma and Mendocino counties, said he is part of the county team working closely with hospitals to ensure the area has the resources it needs.

Cleaver said there were no additional requests pending from local hospitals.

Emergency medical technicians and paramedics from local fire departments, ambulance companies and local health care districts have stepped in since the start of the pandemic to work at an alternative care site at Sonoma State University and testing sites, and will be helping with vaccination efforts.

Anticipating an influx of patients, the county's hospitals have increased the number of staffed ICU beds, county Health Officer Dr. Sundari Mase said. The 110 people hospitalized with COVID-19 as of Thursday, the latest data available, is the highest number since the first local case of the virus was detected in early March.

"Our ICU capacity was initially quite low and our hospitals recognized they needed to add staffed ICU beds," Mase said.