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September 24, 2021 Community Engagement Virtual Meeting



Positive Cases in Tulare County:
From the onset of the COVID Pandemic, Tulare County has total reported COVID case number of 60,575 as of September 22, 2021. The active COVID cases stands at 3,552, which is down by 169 cases from the last report on September 15, 2021. The 7-day average of New Cases per 100,000 population is at 48.7, up by 7.3 cases from September 15. The 7-Day Positivity rate stands at 9.5% that which is down by 0.8% from last week.

Positive Cases currently in Kaweah Health:
As of today, 9/23/21, we have a total census of 108 patients in the acute medical center.

How many are in ICU and do we have empty beds in our ICU?
We have a present ICU COVID-19 census of 17 as of Thursday, 13 of these patients are on ventilators. We have 41 Critical Care Beds with a census of 37 patients as of Thursday, 9/23/2021.

Positive Employees at Kaweah Delta:
As of September 20, 2021, we have 68 employees who are out on leave due to COVID-19, no employees are hospitalized as of this date.

Hospital Census:
380 census, 435 total acute care licensed beds main hospital, this total number includes our maternal child beds, NICU beds as well as our ICU and Medical Surgical beds.

The hospitalized COVID+ numbers seem to be declining a little bit. How low will it need to go before you open up additional elective surgery slots?

The inpatient admissions and the total number of COVID patients in the ICU’s along with those in the Medical Surgical units are a factors that our Section Chief team takes into consideration when we decide to limit surgeries and or return to normal surgical volume. In addition, I am following the overall State positivity rate and our positivity rate in Tulare County.

The September 30th deadline is quickly approaching.

How many of your staff members have received the vaccination?
3,548 staff & 600 providers

How many have submitted the religious/medical exemptions?
We have received 720 declinations. We also have 350 employees on Leave of Absence and 350 employees are exempt from the mandate.

What happens to staff members who have done neither on 9/30?

The State of California has made COVID-19 vaccination a condition of employment for all Health Care Personnel. Any employee who works in a required that is neither vaccinated nor have turned in a declination form; this is considered a voluntary resignation.

We are working very closely with our employees to ensure that we are following the intent of the mandate from the State.

When you say declinations – is that the same as exemptions?

Right now, under the state mandate, there are some employees that do not have to test (employees who do not come into a clinical setting). Will that be the same rules if the federal mandate goes into place?

Declination means that a staff member or provider has declined to be vaccinated due to religious or medical reasons. We are still awaiting further clarity and details around the proposed federal mandate. From what it appears, the federal mandate would apply to all employees regardless of position.

Also under the federal mandate will medical and religious exemptions be allowed?
We are awaiting further clarity, but we assume so.

How does the government not see looming nursing shortages as a crisis that they are creating?
This question calls for speculation and way government acts the way they do. I trust that they believe their actions are supporting the healthcare needs during our COVID-19 Pandemic.

We have been talking a lot about the lack of access to testing. What changes have recently been made and has our capacity increased?

Yes. We’ve recognized the need to expand testing capacity for our community when this 3rd wave hit us earlier this summer. We immediately started to set things in motion to remobilize our Sea-Trains at our rural health clinics throughout the community. These became operational on Monday of this week essentially doubling our testing capacity for the community. Anyone can go onto the Kaweah Health website and schedule an appointment for any of our 8 testing locations in Visalia, Exeter, Lindsay, Dinuba or Tulare or you can also call our call center at 559-592-7300 if you are unable to schedule online.

People have been commenting on social media that they have been having a hard time getting their test results after calling many times. What is the timeframe people should be getting their results in?

If you requested an antigen test and were tested at any of our locations, patients are typically called with their results within a couple of hours that same day. Our clinics, however, continue to be inundated with patients seeking testing so timeframes may vary, but certainly results are given the same day. If you required a PCR molecular test, however, then those results can take up to 48 hours as they have to be couriered to our central lab in the hospital for processing.

Is there any truth to the rumors that the Johnson & Johnson vaccine is now recommending a second shot?

There is discussion about boosters for all the vaccinations including Johnson and Johnson. Evidence is showing that the booster for J&J increases the antibodies by 12-fold and 100% protection from severe infection. The experts in the field are stating that a booster will be needed down the road because of the waning efficacy of vaccines and natural immunity.

Last Friday, the FDA advisory committee met and made recommendations to provide the booster for patients age 65 and older and those at high risk for severe disease.

Are there any updates to when the 3rd vaccine dose will be available for healthcare workers and community?

This is a very timely questions and hot of the press released through the California Health Alert Network, California supports our federal partners’ determination to provide Pfizer BioNTech boosters, specifically for those over the age of 65, individuals 18 through 64 years of age at high risk of severe disease, and individuals 18 through 64 years of age whose frequent institutional or occupational exposure puts them at higher risk.

Why are you considering people who have only had one dose of the vaccine as unvaccinated?

Kaweah Health does not have any say as to what the State requires in their mandates nor what the FDA approves. The State made it explicitly clear that to be considered “full-vaccinated”, individuals would have to complete the recommended vaccine schedule. This isn’t something Kaweah Health decided or defined. On our COVID-19 snapshot, there is an option for declination.

Depending on the type of vaccine you receive, a person would be considered fully vaccinated with 1-dose if they received the Johnson and Johnson vaccine and for both the Pfizer and Moderna vaccine they are a 2-dose vaccine series.

Why is Kaweah Health not prescribing life-saving Ivermectin?”
At this point in time, Food and Drug Administration does not approve the use of Ivermectin for COVID-19. A recent statement from the FDA:

“As with other interventions that do not have a clear benefit, we recommend that Ivermectin not be used for treatment of COVID-19 outside a clinical trial. Several meta-analyses have highlighted that the effect of Ivermectin in patients with COVID-19 remains uncertain because of a lack of high-quality data. As an example, in a July 2021 meta-analysis that identified four trials comparing Ivermectin with placebo or standard care in outpatients with mild COVID-19, there was no clear reduction in all-cause mortality at 28 days (RR 0.33 in two trials, 95% CI 0.01-8.05), no reduction in need for invasive mechanical ventilation at 14 days (RR 2.97 in one trial; 95% CI 0.12-72.47), and no clear impact on symptom resolution at 14 days (RR 1.04 in one trial, 95% CI 0.89-1.21). The quality of the evidence for these outcomes was deemed low to very low because of imprecision and risk of bias. Although the meta-analysis also did not identify any increased risk of adverse effects with Ivermectin the CDC has subsequently reported a steep increase in calls to poison control centers about Ivermectin toxicity compared with pre-pandemic rates. Several of these calls involved Ivermectin obtained without prescription (eg, from internet or veterinary).”

How much money does the hospital receive exactly for every COVID-19 patient placed on a ventilator?”

There are many variables that dictate what we are paid for any hospital admission (i.e. insurance type, primary condition and secondary conditions, length of stay, etc.). With that being said, when we look at the average payment received by Medicare for a patient admitted for COVID-19 and who was placed on a ventilator we have been paid $46,923.51 and the average cost to care for these patients is $65,231.95, so on average, we lose $18,308.44 for every Medicare patient we admit to the hospital and place on a ventilator. When we look at all insurance types we, on average lose $7,384.41 for each COVID patient admitted and placed on a ventilator. Bottom line, it costs us more to care for COVID patients than what we are reimbursed.