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After 'insane' few months, emergency medical system in Kern shows signs of recovery

Hall Ambulance Decontamination Press Conference (copy)

In this file photo, a Hall Ambulance detailer wipes down a gurney as part of a stringent decontamination process that utilizes two detailers and one manager.

Emergency medical services workers may finally get to breathe a sigh of relief after Kern County’s emergency medical services system finally hit levels not seen since the early part of the coronavirus winter surge.

In another sign that COVID-19 is declining, Kern County Public Health Services has returned the county’s EMS System Surge Plan to the lowest of four tiers due to improvement in 911 call volume, increased ambulance availability, lower offload times and percentage of staff impacted by COVID-19.

Enacted as COVID-19 cases were skyrocketing at the end of December, the plan was meant to protect the county’s medical system as patients threatened to overwhelm it. Using lessons learned from the summer surge, the plan allowed the county to remain self-sufficient throughout the worst of the winter surge.

In July and August, the county had needed state ambulance “strike teams” to keep up with the demand. But in December and January, even as cases nearly doubled the count during the summer surge, local EMS providers were able to keep up with the call volume themselves.

That doesn’t mean it was easy.

“It was insane,” said Jeff Fariss, EMS program manager for the Kern County Public Health Services Department. “The call volumes were through the roof and the number of COVID calls that were being run were having an effect on our system.”

With 11,050 emergency calls in December, followed by 10,648 in January, the county’s EMS service was strained like it never had been before. The pandemic introduced the added difficulty of requiring decontamination of ambulances any time a suspected or confirmed COVID-19 patient was taken to the hospital.

On Dec. 30, the county introduced its surge plan, which was meant to streamline procedures and keep as many ambulances running as possible.

“They realized California as a whole was overwhelmed, and there’s no more resources, such as ambulance strike teams, that they could send us,” said Hall Ambulance spokesman Mark Corum.

A key part of the plan was a change in how EMS personnel responded to “low acuity” calls, or patients who do not need immediate medical assistance. Instead of taking the caller to an emergency room in an ambulance, EMS staff would either advise the caller to seek treatment with their primary care provider or urgent care.

“By helping take off the burden so we could focus our efforts on those who truly needed an ambulance most, it helped exponentially,” Corum added.

The county also reduced the amount of time an ambulance would have to idle in front of an emergency room by designating a specific employee to handle offloads. Previously, some ambulances would wait for hours to deliver a patient to hospital staff. Under the new system, wait times lowered, allowing more ambulances to be in circulation at one time.

Inside the hospitals, doctors and nurses worked long shifts and struggled to find beds for everyone seeking care.

“There were beds in the hallways, and the ER was stacked up pretty bad at one point, but we ultimately were able to manage folks through our overflow bed plan,” said Dr. Glenn Goldis, chief medical officer at Kern Medical. “It was especially difficult for our nurses, who, while they were caring for patients and spending long hours doing so, were under additional strain as some of our health care workers got sick.”

Throughout February, EMS saw a significant drop in the number of patients seeking care.

Fariss said less than 8,000 calls came in, a 44 percent decrease. The number of ambulances needing to be decontaminated due to suspected COVID-19 also went down last month, from 884 decontaminations in January to 364 in February.

If the pattern continues, the county may be headed toward levels not seen since October. New vaccines being distributed give health officials hope the downward slope will be permanent. Still, COVID-19 variants could add difficulty to the upcoming months.

History could also repeat itself and another wave of coronavirus could roll over Kern County.

“We were hoping that maybe all of this was behind us after the peak in the summer and look what happened again,” Corum said. “Now, hopefully with people getting vaccinated, people are taking this seriously and doing the social distancing, and the masks. And hopefully everything that we’ve been asked to do over the past year is making a difference.”

You can reach Sam Morgen at 661-395-7415. You may also follow him on Twitter @smorgenTBC.

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