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July 22 2021 Community Engagement Virtual Meting

Thursday, July 23, 2021


    1. Positive Cases in Kaweah Delta: As of this morning, Thursday, July 22, 2021, we have 10 adult, COVID-positive patients in the acute Medical Center; 2 of them are in the ICU on ventilators.
    2. Positive Employees at Kaweah Delta: Over the entire pandemic, we have had 1,206 employees test positive for COVID-19; of these, 1,187 have recovered, 3 have passed away, and 16 are still out on leaves of absence (11 from 2020 and 5 newly-diagnosed in July 2021).
    3. Hospital Census: At 7:22 A.M. on Thursday, July 22, 2021, our adult acute inpatient census stood at 91%; 13 of our 41 ICU beds were unoccupied; 11 of our 54 ICCU beds were unoccupied but would result in double occupancy if we admitted any patients to these 11 beds; and, only 8 of our 249 medical surgical beds were unoccupied (6 of them in our pediatric overflow area).
  2. The burning question everyone wants to know, are we seeing the Delta variant here at the hospital? Since we cannot test for that particular variant we have no way of knowing who has it or not.
  1. How many patients that we are caring for who are C19+ and have had the vaccine, breakthrough cases. We have not historically asked patients admitted with COVID-19 if they have been vaccinated or have previously contracted the virus; however, we believe this would be valuable information going forward and are currently modifying our electronic health record to capture this information at time of admission. The CDC and other governmental agencies are reporting that 98-99% of all newly-hospitalized patients with COVID-19 are unvaccinated.
  2. Are microchips being hidden in COVID-19 vaccines? (According to a poll conducted earlier this month--with a sample size of 1500-- 20% of Americans believe it is true) I was asked this same questions many months ago shortly after we started rolling out the vaccine. I reported on some research I did to understand where this belief came from and learned that it stems from research being done to create biocompatible near-infrared quantum dots delivered to the skin by microneedle patches that could record vaccinations. The research and development was being funding by Bill Gates. Using a smartphone, you could scan over a person’s skin to see their “vaccination record”. Each year, 1.5 million vaccine-preventable deaths occur due to under-vaccination—primarily in areas of the developing world with poor health care infrastructure. Bill Gates and others believed that if we could essentially “tattoo” a person’s vaccination record onto the surface of their skin, we could better identify those people who have not been vaccinated, for many different diseases. When Bill Gates announced that “one day, we would all carry a digital passport for our health records”, he did not suggest a microchip but some kind of e-vaccine card that people could flash before going into a business. The next day, various websites went nuts about Bill Gates’ idea for human implantable microchips. I am definitely not part of the 20% of Americans who believe it is true.
  3. The American Academy of Pediatrics is recommending schools require face masks for children older than 2 and all adults-regardless of vaccination status. Dr. Fauci told “CBS This Morning” the academy wants to “go the extra mile” to make sure kids are protected at school because of the rise in cases blamed on the Delta variant. However, this differs with the CDC guidelines that have advised mask-wearing in schools just for unvaccinated children and adults. Dr. Fauci said the CDC is “carefully looking” at its COVID-19 school guidance. Do you think we are headed in this direction? The CDC came out on July 9th and stated that masks should be worn indoors by all individuals older than two years who are not fully vaccinated and that social distancing of at least three feet should be maintained. However, on July 12th, the California Department of Public Health issued updated guidance for California students that includes mask-wearing while indoors for all students, vaccinated or not, but eliminated social distancing requirements. On Tuesday, the Tulare County Board of Supervisors unanimously approved a resolution that delegates authority to local school boards regarding COVID-19 safety protocols. On Tuesday night, Visalia Unified School District Superintendent Tamara Ravalin emailed parents stating the district is required by law to follow the CDPH guidelines. So, it sounds like for VUSD, all students will be required to wear masks while indoors.
  4. Fresno County is strongly recommending masking indoors regardless of vaccination status. Fresno County has seen a 75% increase in the number of positive COVID-19 test results comparing the 1st to 2nd week of July. The rate of Californians testing positive to COVID-19 is now at 4.1%-- the highest since February. The Delta Variant has been identified in many of those cases. Do you foresee Tulare County and California starting to require masks indoors again? Somewhere between possibly and likely. Los Angeles County is already requiring full masking when indoors irrespective of your vaccination status. Fresno County is now leaning hard that way as they see their number of hospitalizations rise over the past couple of weeks (72 infected inpatients with 15 requiring ICU-level care). I haven’t heard anything from Tulare County but the number of new daily cases is certainly on the rise. The County reported 68 new COVID-positive cases yesterday; that’s 14 new cases per 100,000 population which would have thrown us back into the Purple Tier if we were still following the Blueprint for a Safer Economy. The Delta variant definitely has people nervous as the CDC reports that it now accounts for 83% of all new COVID cases. We are also seeing fully-vaccinated people contract the virus but few to none are being hospitalized or dying.
  1. CMS Survey On July 9th we were informed by the California Department of Public Health and the Centers for Medicare and Medicaid Services (CMS) that our Plan of Correction (POC) had been fully accepted and that we should prepare for a return survey to validate that everything stated in our POC had in fact been effectively implemented. That return survey concluded two days ago when we were informed that we were found to be in “substantial compliance” with our POC and all CMS Conditions of Participation. Definitely music to our ears. We now have our “deemed status” fully restored and don’t expect any further surveys or follow-up.
  1. ED Opening Unbeknownst to us until last month, there is a direct link between the CMS Survey and the CDPH approval to open Zone 5 of the ED. While we thought we had fully resolved the few minor issues that came up during the State’s on-site survey of our ED expansion, their site survey occurred right on the heels of the CMS survey. The CMS surveyors, which are essentially CDPH surveyors, felt that the propofol diversion event that occurred in the ED back in December 2020 was attributable, in part, due to understaffing of physicians who supervise residents. As such, they were not willing to grant approval to begin using Zone 5 until we fully concluded the CMS survey process and demonstrated to them that we are in fact adequately staffed to safely open Zone 5. We believe we have now demonstrated this to them and hope to receive their approval shortly.