04.09.20 COVID-19 Briefing Live Stream Transcript

The County of Santa Clara
April 9, 2020
Live Stream - Live with the County of Santa Clara
10am PT

David Campos: Good morning, my name is David Campos. I'm a Deputy County Executive and we are here, Live with the County of Santa Clara.

We are in the Administrative Building at the Valley Medical Center campus.

And we have this morning two incredible individuals, who are actually on the ground running our hospitals. It is my honor to introduce to you Paul Lorenz, who is the CEO of the Santa Clara Valley Medical Center.

Dr. Meenesh Bhimani, who is the Executive, Chief Executive of the O'Connor Hospital.

And they're gonna talk to us about our hospitals and how they are preparing for this crisis. But let me begin with Paul and thank you for being here. Can you talk to us about our hospital system? What do you do?

Paul Lorenz: So thank you, David and good morning everyone. So again my name is Paul Lorenz, I'm the Chief Executive Officer for the County's hospitals and clinics. And for most of you that probably do not know this, the County of Santa Clara operates a pretty large and integrated healthcare system. It is the second largest in the state of California. We have approximately eighty-five hundred employees.

We have three hospitals now and most of you have probably heard in the news that we acquired O'Connor Hospital and St. Louise Regional Hospital. So we really have become a geographic integrated healthcare system. And in that, I think it's also important for the public to understand that Valley Medical Center has been around for 150 years. O'Connor Hospital probably for about the same period of time over 150 years.
So these institutions, if you will will, healthcare institutions, are truly here to serve the entire community.

Our mission as being a public hospital system is to ensure that everyone has access to healthcare and as you can imagine, particularly during these times, this is rather important. Also to give you some perspective, and this is really important, when we talk about an integrated healthcare system, we're not just talking about the hospitals, we're also talking about outpatient services, primary care, specialty care, these services are available to the entire community and that's something that we take very great pride in.

We are, at Valley Medical Center, a level one trauma center for both pediatrics and adults. We actually have a regional burn center that serves the entire Bay Area. And of course, we have a nationally recognized rehabilitation center. So this truly is, once again, a comprehensive healthcare
System that I think we should all be proud of. Again, because it's servicing the entire community and it is really the public's health care system, your health care system.

I I do want to just remind the group also that it was probably less than thirteen months ago that we acquired St. Louis Regional Hospital and of course O'Connor hospitals. Those are truly assets of the community. They serve those communities in terms of providing basic health care services from emergency room services all the way through to acute care hospitals services as well as some other critical outpatient services such as wound care, etcetera.

The other thing that I would add, when we acquired those two hospitals, I think everyone understood the geographic importance of those two hospitals relative to serving the entire county.

What was also important, and I think the public may not know is, collectively, inclusive of St. Louise and
O'Connor hospital, we probably have, during the normal times, about 600 plus emergency room visits.

So these are hospitals that truly are there to serve the community, not only in terms of emergency healthcare services, but ongoing acute care services.

Today obviously I'm joined by Dr. Meenesh Bhimani. He's been with O'Connor hospital for quite some time as an ER physician. I'm very pleased and proud that we have someone at the helm of O'Connor hospital.

The integration that has occurred over this past 13 months has gone extremely well. As a public hospital system acquiring two community hospitals is quite the undertaking and what really made the difference were the people within those two hospitals: The staff, the nurses, the housekeepers. That really bought into the importance of working together to better serve our community.

So I'd like to actually ask Dr. Meenesh Bhimani to say a few words about how that integration has gone and then I think this will really set the stage of why these hospitals are important for our community during this infamous crisis.

Campos: I mean thank God fortuitous that this happened, Dr. Bhimani.

Meenesh Bhimani: Thank you. Thanks, Paul.

So as you know, we the integration and acquisition was as of March 1st in 2019 and in the initial phases of the the integration efforts, we it was a tremendous effort made to start to revitalize both O'Connor Hospital and St. Louis Regional Hospital and this was everything from staff stabilization to facilities upgrades to modernized equipment to physician outreach and tremendous amount of effort was made to really bring back O'Connor Hospital to the point where we could serve the entire Santa Clara County community.

The biggest one of the biggest changes that that went and occurred last year was the go-live of a new electronic medical health record called Epic or Health Link and this went live in August which was
you know roughly five months after the integration and this this one powerful tool allows us to communicate not only with the entire system but with the county and outlying hospitals as well.

So it's really all these efforts have truly now made us an integrated health delivery system in which we can outreach to the entire community.

What what that's also done is prepared us for a time like this: A disaster in a crisis that we've come upon now and it's allowed us to respond, not as a hospital, but as a healthcare integrated healthcare system. And we've been able to respond to the needs of the County and our community as a whole as opposed to a single hospital.

Campos: Okay you know you know I think that's sort of the question for many folks is, are the hospital's ready? And given what you have gone through in terms of this integration and the incredible system that you have created, can you talk about that? What what do you want people to know in terms of how prepared and ready our hospitals are for this crisis?

Lorenz: It's obviously a really good question and I'm sure a lot of people are wondering where we stand ready relative to our preparedness. I think it's first of all important for me to say to the public that when Dr. Cody in early March, mid-March announced the social distancing and made it very clear that this was our first step in protecting the public, saving lives. That really did make a difference.

She also made sure that we understood as a community that that decision to implement social distancing and shelter in place allowed the healthcare systems in the county to prepare, to get ready for what we anticipate to be a significant demand on a healthcare system, and frankly it wasn't just the
county health care system that understood that, it's every hospital in Santa Clara County, from Stanford, to the Kaiser hospitals, to the HCA hospitals, El Camino, all of us collectively as a county health care system. Understand that we need time to prepare for something as significant as this. And so that Public Health order from your Public Health Officer Dr. Cody has really made a huge difference.

So let me give you some sense of what we have been doing locally, relative to our three hospitals and the entire enterprise system. Our first priority was to make sure that our patients and our staff were attended to, that they understood what we were heading into and that we were taking the appropriate measures to protect them.

So first of all, for our patients we did cancel elective surgical cases. We focused our system on
those individual patients that required emergent or urgent services from our three hospitals. We changed our routine outpatient primary care visits and specialty visits to phone consultation and our telemedicine, which I think all of us can fully appreciate now given the need for technology around for for all of us to social distance. That has made a huge difference for our system.

The other thing that has occurred is that the emergency room, if you recall, there were a lot of public notices about making sure you as individuals, if you were having symptoms, influenza-like symptoms,
that you first called your healthcare provider and received directions of where to go to get the care that you needed and not come to our emergency rooms. That has made a huge difference
and I really want to thank the public for understanding the importance of that.

I can tell you today the three hospitals, we are down to maybe 33% of a typical volume in our emergency rooms. So at the height I had mentioned, we typically would see you around 600 individuals or visits 650 plus visits in our emergency rooms. We're down to about 150 to 200 visits to our emergency room.

Those individuals that are presenting to our emergency room are acutely ill. 23 to 27 percent of those patients present with influenza-like illnesses and of those individuals, only about  10 to 15 percent test positive for COVID.

So we really have, onthe front end of a health care system, been able to get us to a point in which
we can be prepared for any surge that may come upon us in this county.

The other thing that I think a lot of people are interested in knowing is what is our bed capacity as a health care system. So prior to this this issue that we're dealing with, this emergency we're dealing with, we would typically staff all three hospitals to the tune of around 580 beds.

Today, we are about 50% of that. And so we have 50% of our beds available that are typically staffed. Of that, only about give and take in terms of which day we're speaking of, we're only averaging around ten to twelve percent of those patients being COVID positive. So we are serving the community even during this crisis in terms of their normal healthcare needs which is really important when 85 percent of our patient population in the hospitals are acutely ill that are non COVID, we have to remember that we have much greater needs in this community while we're really laser focused on a preparedness around COVID. ICU bed capacity we're only at 20 excuse me 70, 80 percent of our bed capacity so we still have around 20 to 30% of our ICU bed capacity available.

The other thing that the public should appreciate is that we have the ability, given the acquisition of O'Connor and Saint Louise Hospital, to increase our surge capacity by another three hundred and forty beds, 200 of which would be ICU capable and ready, inclusive of ventilators.

So I really want to express to the public that this time that the Public Health Officer has given your
public healthcare system has been invaluable. And with that, we've been able to focus on making sure the staff are ready and prepared, including making sure that we obtain the appropriate PPE equipment and supplies necessary for any demand or surge on our system, but I'd also like to have Dr. Bhimani talk about what he's experienced and what he can provide in terms of the front lines

Campos: And one question that I know that I get asked a lot about, and you know this is something you both care  about is the safety of our staff.

So can you talk about that, Dr. Bhimani?

Bhimani: Sure. So we, you know, we've gone through extraordinary efforts across the enterprise, every hospital system. To ensure the safety of both patients and our staff. Those efforts include things such as you know, screening every person entering the hospital. Staff, you know, patient, physician you know maintaining our supplies of PPE so that every staff member has the appropriate PPE at the appropriate time we've you know limited our visitors you know we have a restrictive visitor policy and all of these efforts are really aimed at maintaining the safety of our staff as well as our patients, and allowing us to provide the care that we can.

We've also developed kind of specialized COVID units so these are hospital based units along you know
different levels of care: ICU and non ICU. And we've developed teams that are truly experts in caring for this patient population. We also have a COVID response team, so any any needs that come up in the hospital around COVID patients we have a specialized team that can respond to those needs instantaneously 24/7.

So all of this has really allowed us to create an environment where where you know our staff safety is paramount and we're allowed you know we're able to provide the best care that we can to our patients and their families.

Campos: We're grateful to both of you and to the incredible team and all these three hospitals.

One last word to the residents of the county. I just want to make sure that you have that opportunity to say to the people that are out there wondering what's going on.

Lorenz: So I have to first of all really express my deep appreciation to the staff on the front lines that are caring for not only our COVID positive patients but also in the hospital caring for all of our patients. They are truly the heroes and if, I was telling my staff the other day, if I can bottle up what's going on in our hospitals as we care for these patients, I know that the public would be very very proud of how we're caring for our community and our patients.

So really a deep appreciation to our staff and then I want to acknowledge our board supervisors, our County Board of Supervisors, the County Executive Office, and the Emergency Operation Center has
done a phenomenal job in supporting this health care system.

And then to the public, this is a public hospital I have to say that without your support we
would not be where we are today. So thank you for your continued support.

Campos: Dr. Bhimani, you're last, you have the last word.

Bhimani:  No thank you you know I want to reiterate what what Paul said I mean I think our staff has truly risen to the this occasion and it's been absolutely phenomenal in every way.

The other thing is the amount of community outpouring and outreach that we have gotten the number the amount of you know well wishes and you know donations it's been tremendous and it just it's a testament to how much I think the that the hospital system means to this this community and and you know well I think that that outreach that we've received has been really uplifting to our entire
staff.

So thank you.

Campos: Thank you for joining us and we'll be back tomorrow with our daily briefing.