The daily total of new cases in San Diego County fell below 1,000 for the first time since November 29 on Tuesday, as the number of vaccination sites continued to rise despite continuing uncertainty as to whether there will be enough doses to meet the demand of the region.
That total came just before the city of San Diego announced its first direct shipment of 1,200-dose vaccines, which will be used to inoculate the homeless beginning Wednesday morning. Earlier in the day, the region’s fourth vaccination superstation opened in La Mesa, even as UC San Diego announced its intention to open a fifth such center at Rimac Arena on its campus on Monday.
And the state’s top health official confirmed that the state is working on granting access to the special vaccine for those with severe medical conditions and disabilities, even as hospitals face a new mandate to return to nurse ratios per patient before the pandemic as early as Monday.
The new vaccination overlay that opened at the Grossmont Mall was by far the most visible of the latest COVID-related developments, with hundreds of vehicles entering the mall’s spacious parking lot without the occasionally crippling traffic jam. has shut down the region’s top spot of its kind near Petco Park.
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For now, though, the plan is to deliver up to 2,000 doses at Grossmont, just a third of the 6,000 doses that Petco’s site delivered per day over the past weekend.
As is the case with the super stations in Chula Vista and San Marcos, the new east county location is not a drive-through. Appointments park their vehicles and walk to the front of a shopping mall that used to house a Charlotte Russe clothing store. They log in and answer a series of health questions before they get their shots and head to the food court for 15-30 minutes of side effect monitoring from Sharp HealthCare employees and volunteers.
Annette Kaohu, 55, who works for the San Diego Padres and is waiting for the go-ahead to get vaccinated, was there with her 77-year-old mother-in-law, Gwen Jacquemart, who made the appointment yesterday, secured an hour and had no major problems.
“It wasn’t a challenge, but a lot of people saw the address at 5500 Grossmont Center Drive, and we saw people wandering around because they didn’t realize they were inside the mall,” Kaohu said. “I knew because I heard it was in the old Charlotte Russe!
“This has been very organized. They have flown by. He just arrived, 10 minutes and he was already out ”.
Scott Evans, CEO of Sharp Grossmont Medical Center, said he doesn’t expect the site to end up handing out leftover doses to people waiting in line, as has been the case at other supersites recently.
“We have piloted an electronic waiting list at our Coronado center and so as appointments are scheduled throughout the day, and (if) they are canceled or duplicated or for any reason, then we can electronically contact people and get them on a date that day, ”Evans said. “We have pharmacists who check each of the doses that pass so that we do not have anything left at the end of the night.”
UC San Diego also announced Tuesday that it plans to open its own vaccination booth at the campus Rimac Arena on Monday to vaccinate patients, campus employees and then the wider community. The plan, according to authorities, is to vaccinate up to 5,000 people a day, as is the case at the vaccination post near Petco Park.
San Diego State University received permission for a minor effort Tuesday; will begin administering 300 doses later this week.
Scripps Health has also indicated its intention to open a similar operation at the Del Mar fairgrounds.
While there are plenty of venues and volunteers lined up to massively expand the region’s ability to rapidly put doses into arms, it remains to be seen whether the goal of increasing to 25,000 or more vaccines per day in February is possible given the continued unpredictability of vaccine supply.
The county health department did not say Tuesday whether a new shipment had arrived expected by the end of the day. An official said Monday that the available supply was expected to last only until the middle of the week.
Currently, the vaccine is available only to healthcare personnel, nursing home workers and residents, and those over 65 years of age. While the supply is not yet strong enough to wipe out these fairly broad groups, pressure continues to mount to expand access to those who would suffer most if infected.
During a news conference Tuesday, Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said there are plans underway to expand access to the vaccine for those with difficult diagnoses and disabilities, even if are under 65 years of age.
Ghaly said her office is looking for a way to “gather and determine the best way to ensure that those with severe disabilities and serious underlying conditions have access to the vaccine in an equitable and carefully planned manner.”
He did not specify when that effort is expected to arrive.
The timeline for returning to the state’s nursing ratios, which force no more than two intensive care patients to be assigned to each nurse, is equally nebulous.
In a letter sent Monday to all hospitals in the state by the California Department of Public Health rejects the possibility of granting more temporary exemptions that have made the ratios more flexible, allowing, for example, three intensive care patients per nurse.
All hospitals currently operating under the waivers are directed to return to normal rates after February 8 “unless the CDPH determines on an individual waiver basis that there is an unprecedented circumstance.”
The announcement was applauded by the California Nurses Association, which recently staged statewide protests stating that patient safety had been put at risk by assigning too many patients to frontline nurses without enough support.
But it became clear Tuesday that local health systems are not going to return to old staffing levels next week. In a statement, Kaiser Permanente, which operates two hospitals in San Diego, noted that its 15 Southern California facilities have exemptions that are valid through March 1.
“Because the effects of the surge still persist, we have asked CDPH to continue the staff exemption,” Kaiser said.
Palomar Health said it was also requesting an extension because the number of patients admitted to the COVID-19 program continues to put pressure on staffing needs. A representative from Palomar Medical Center Escondido said Tuesday that it has recently had about 60 COVID-19 intensive care patients a day, filling many beds outside of the hospital’s 38-bed main intensive care unit.
Both Palomar and Kaiser said they have used the concept of “team nursing” to enable nurses to care for a greater number of patients. The model brings in nurses and other medical staff from other parts of the health systems to perform some lower intensity tasks, theoretically freeing up staff with more specialized training, especially those trained in intensive care, to focus on the more specialized aspects. technicians of their work.
Sharp HealthCare has long used that team concept in its hospitals, especially those in South and East County, which have been hit the hardest by the surge in COVID-19 patients.
Sharp said in a statement Tuesday that it will request additional staffing assistance from the state’s Health Operations Area Coordinator before deciding whether or not to ask to keep its exemption.
UC San Diego Health has not requested an exemption, saying in a statement that it has been able to meet the ratios. Rady Children’s Hospital in San Diego was granted an exemption but has not yet needed to use it, an official said.
Gary Robbins contributed to this report.
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