By Tom Mueller
With the number of coronavirus cases in California continuing to surge precipitously following the relaxation of coronavirus-related restrictions in mid-June, Stanford Hospital — along with others in the Bay Area — revealed they have accepted transfer patients from overwhelmed hospitals in Southern California. In doing so, both state-agency officials and hospital administrators hope to alleviate some of the burden for hospitals in Southern California currently operating near or at maximum capacity.
Despite being situated in Santa Clara County, which was regarded as one of the most severely afflicted California counties early on, Stanford Health Care does have the capacity to admit and treat more COVID-19-positive patients; facilities at 500 Pasteur Drive and 300 Pasteur Drive in Palo Alto have a combined 600 hospital beds on campus, enabling the Stanford Health Care system to buffer a potential deluge of patients requiring hospitalization.
The system’s designation as the sole Level 1 trauma center between San Jose and San Francisco gives it a central role in the greater northern California region’s framework; such classification indicates a degree of functionality that includes having general surgeons in-house 24-hours a day and expedited access to surgeons specializing in the holistic spectrum of medical domains, spearheading research to augment trauma care and organizing and leading efforts to publicly educate surrounding communities about prevention.
“Stanford Health Care has 26 COVID-19 positive inpatients,” Rudy Arthofer wrote in an email to The Daily. Arthofer, an associate chief nursing officer and overseer of Stanford Health Care’s Transfer Center, added that “five inpatients COVID-19 transfers from other hospitals, including but not limited to Imperial County,” noting that the data was accurate as of Sunday, July 12. In addition to these admitted patients, 88,784 unique polymerase chain reaction (PCR) coronavirus tests have been administered by Stanford Health Care as of July 16, with 3,415 individuals testing positive — a positive rate of 3.85%.
Protecting the Stanford Health Care system from becoming overwhelmed thus involves the coalescence of multiple factors, according to Arthofer, ranging from the availability of crucial resources (e.g., personal protective equipment (PPE) and hospital beds) to public adherence to guidelines issued by county and state officials. While current rhetoric about preventing COVID-19 spread merely parrots the mantras of health agencies at the pandemic’s incipience, the advice remains relevant and effective: washing your hands with warm water and soap for, at minimum, twenty seconds, physically distancing from others at a distance of at least six feet, wearing a mask while in pubic, covering your face when you sneeze or cough and seeking medical help when warranted.
Determining which patients may be transferred to Stanford Hospital is also a complex process, according to Dr. Stepehen Ruoss, medical director of Stanford Health Care’s Transfer Center. After receiving calls from external facilities, either Stanford Hospital alone or state agencies queried to Stanford Hospital’s treatment capacity will work with direct provider physicians at both the origin and receiving institutions to determine the appropriateness of the patient’s transference. Additionally, administrative steps, such as identifying whether the patient’s insurance plan covers their admittance to Stanford Hospital or requires them to be treated elsewhere, may be influential in determining which patients can be transferred into the hospital.
“There may be somebody who is desperately sick, but they may be so sick and so far away that the process of transporting that patient to our medical center may involve prohibitive risk for the patient,” Ruoss said. “There may be still a need for transfer, but the transfer may need to consider different institutions or different circumstances once there’s stability achieved with some aspect of the patient’s clinical course.”
With these transfers and the consequential increase of coronavirus-positive patients near the Stanford University campus, questions arise regarding the possible dangers of exposure and spread amongst students. Currently, tentative plans are in place that will allow approximately half of Stanford’s undergraduate student body to begin living on campus as early as the fall. A university announcement on June 29 outlined a quarter-by-quarter plan in which two grades would be permitted to live on campus at once, with first-year students and sophomores returning for fall quarter.
While first-year undergraduates may benefit from the experiential introduction to student life at Stanford, there is also an accompanying risk: an asymptomatic population catalyzing viral spread. Mortality rates may be lower for younger people, but age has shown no reductive qualities in terms of one’s likelihood for transmission.
Thus, the close proximity of Stanford Medical Center to campus may primarily serve as a calming presence, a reassurance that, should hospitalization be required, access to one of the nation’s preeminent hospitals exists. Understanding the synchronous nature of their presence on campus with older populations (e.g., administrators and/or professors) and following CDC guidelines is paramountly important for students in precluding more susceptible populations from infection.
“A wizened professor in the front of a classroom, in which might sit 25 students, may be smart, have great experience and vast knowledge to impart on that student group but be at much greater risk of having active disease that makes them sick enough to need one of our hospitals,” Ruoss said. “There’s this disproportionate or non-uniform risk that exists in reactivating a university, just like reactivating a business workplace where not everybody is at the same risk of consequential events should the virus roll through.”
The Stanford Health Care system is not in Florida’s Miami-Dade county. It is not in Texas’ Harris county. It is not in Illinois’ Cook County. While the hospital has seen substantial disease activity, it has not been at the staggering, dangerous scope with which the aforementioned counties–including Los Angeles county–are currently dealing.
Nonetheless, positivity has prevailed.
“With [some] exceptions I’ve encountered, and certainly in this institution and neighboring institutions where I know people, the care providers — from nurses to respiratory therapists to physicians — are overwhelmingly positive,” Ruoss said. “[They] are [treating patients] with a positive sense of meaningful care provision, even though the patient population can at times be very sick.”
“They are doing it with pride in what they do rather than overwhelming fear or problems,” he added.
Contact Tom Mueller at mueller26tigers ‘at’ gmail.com.