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EMS crews in 4 Calif. counties to deny transport to low-acuity patients due to COVID-19 surge

Fresno, Kings, Madera and Tulare County paramedics will assess patients and refer them to an urgent care clinic or primary care physician if their condition is not an emergency

Tim Sheehan
The Fresno Bee

FRESNO COUNTY, Calif. — Hospital emergency rooms in Fresno County and neighboring Valley counties have gotten so full with coronavirus patients and people with other serious illnesses and conditions that ambulance crews are being told, starting Friday night, to assess patients and deny them rides to hospitals if they are not true emergencies.

Dan Lynch, Fresno County’s emergency medical services coordinator, told reporters Friday that an unprecedented “assess and refer” policy will take effect Friday night for paramedic ambulance crews in Fresno, Kings, Madera and Tulare counties. “An ambulance will respond to a call (and) evaluate the patient,” Lynch said. “If you can be seen at an urgent care or wait a couple of days and visit your primary care physician, they will be referred to that and not transported to the emergency department.”

“This is precedent setting for our area,” he added. “We’ve never had to get to this point in Fresno County before,” he added.

Across Fresno, Kings, Madera and Tulare counties, hospitals were treating nearly 900 confirmed and suspected COVID-19 patients as of Thursday, including 153 people who were sick enough to require treatment in intensive-care units.

Lynch said that throughout the year, under ordinary circumstances, people call for ambulances who could otherwise go to a hospital by private vehicle or go to an urgent-care clinic. “Normally there’s no question. If they want to go to a hospital, you transport them to a hospital,” he said.

“But this is an abnormal situation, and now we need to get into the mode of protecting that hospital and health care system,” Lynch said. “So this is where we have to make some tough decisions, and this will be one of them where someone will be told that they won’t be transported to the hospital.”

Because hospital ICUs are practically filled to their capacity in the region, many are keeping seriously ill patients in their emergency rooms until an ICU bed becomes available.

“One of the things we’re concerned about is access to the emergency room by people who have alternatives other than going to the emergency department,” Lynch said. “We’re encouraging the public to go there if they have a real emergency, but utilize urgent care or telemedicine. ... Those should be utilized before going to the emergency department.”

Coronavirus case updates

Fresno County’s Department of Public Health reported Friday that 745 new confirmed COVID-19 infections had been discovered through testing since Thursday’s update, bringing the county to a total of almost 50,000 people who have tested positive for the virus since the first cases were identified in early March.

To date, 557 deaths in Fresno County have been attributed to the coronavirus and the respiratory disease it causes. No additional fatalities were reported Friday by the county

In other Valley counties:

  • Kings County: 216 new cases Friday, 14,289 to date, no additional deaths, 101 to date. The figures include more than 6,400 cases, and 14 deaths, among inmates at state prisons in Avenal and Corcoran.
  • Madera County: 133 new cases, 8574 to date; no additional deaths, 111 to date.
  • Mariposa County: Three new cases, 188 to date; no additional deaths, four to date.
  • Merced County: 215 new cases, 16,026 to date; four additional deaths, 216 to date.
  • Tulare County: 340 new cases, 28,130 to date; seven additional deaths, 353 to date.

Valleywide, more than 117,000 people have at some point been infected with coronavirus, whether they experienced symptoms or not, over the past 10 months. Of those, 1,342 have succumbed to the disease.


(c)2020 The Fresno Bee (Fresno, Calif.)