YAKIMA, Wash. — Hospitalizations for COVID-19 continue to increase at Virginia Mason Memorial Hospital in Yakima, including younger Latinos who are getting sick in greater numbers.
Tuesday saw the hospital's all-time high with 36 COVID-19-positive patients and nine awaiting test results, said Dr. Tanny Davenport, ambulatory division chief, with 11 of those patients on ventilators. Along with the number of COVID-19-positive patients, the total of those on ventilators is increasing, he said.
"In the last seven days, things are moving in the wrong direction," Davenport said Wednesday.
Davenport joined Memorial CEO and President Carole Peet and Hospitalist Dr. Bismark Fernandez in a Zoom update on cases of COVID-19, the disease caused by the novel coronavirus.
The pandemic has pushed the hospital to capacity and prompted the transfer of some COVID-19 patients even as space for critical care has been expanded, Peet said.
"Before COVID we had 11 critical care beds. We've expanded to 27 critical care beds (and) we are going to keep it at 27 permanently," she said. "We're seeing very sick people."
Recently there's been a "huge increase in Latino" patients, particularly those 65 and under, Davenport said.
"We think this is ... reflective of activity we're seeing in agricultural areas, farms and warehouses. It's just really affecting this population," he said. "In Yakima, about half of our population is Latino. Fifty-five percent of our positives are Latinos (ages) 25 to 49."
Fernandez, who works closely with COVID-19 patients, said some have shared that "a lot of the working conditions haven't been adequate. They have been improving lately."
He is seeing more COVID-19 patients who are younger, in their 30s or 40s, with controlled diabetes or obesity who have deteriorated to the point they require intubation. They have a better survival rate, though, Fernandez said; older patients with conditions such as diabetes, liver and lung disease tend to have a slightly higher death rater.
Younger patients, "once they start to get better, they tend to get better quite rapidly. That's something that we've learned," Fernandez said.
As the number of patients remains at levels rarely seen, staff continue to take precautions to ensure they don't become infected. The number of hospital employees who have tested positive for COVID-19 has more than doubled in the last month, Davenport said, with about 1.3% of Virginia Mason Memorial's roughly 3,000 to 3,500 employees infected.
But when experts check those employees' contacts, "it's not from being on the front line" of care, he said. A lot of times, the people they are getting it from aren't socially distancing or masking, or they're being infected by family members who are asymptomatic.
Mother's Day and Memorial Day in particular had an impact.
"When we look at our employees, one thing we notice, even though we've done a great job protecting our employees, is after a major holiday, about seven to 10 days after, we see a huge spike activity in employees calling in sick or having symptoms," Davenport said.
It all correlates to people having social gatherings where some aren't masking or social distancing. Approximately 20% of people infected are asymptomatic, he said.
"We can't stress enough to the lay public — when it comes to holidays, COVID doesn't take a break. ... We know these holidays are important, Father's Day and the Fourth," Davenport said, but "we really want to urge people to follow their masking and social distancing. "
He, Peet and Fernandez spoke on the day a Yakima Health District directive urging people to wear face coverings in public took effect. Dr. Teresa Everson, county health officer, has repeatedly referred to an observational study in which only 35% people of visiting businesses over the Memorial Day weekend wore masks.
Everson hopes the directive will encourage at least 80% of people to start wearing masks when in public.
"Universal masking has been shown in some studies to prevent the spread of virus from somebody who's infected. Many of our patients can be asymptomatic carriers," Fernandez said. "That's why it's crucial to follow universal masking procedures."
Yakima County remains in Phase 1 of Gov. Jay Inslee's four-phase plan to reopen Washington and will until certain metrics change. The infection rate and number of new cases, among other statistics, both need to decrease substantially.
"We make up at least 60% of the new cases statewide each day," Davenport said. "Another interesting fact — King County has done 10 times as many tests as we have, but we have half the number of positives. Our (COVID-19) positive rate is through the roof. We're above 20%.
"Remember that Yakima County is a tenth of the size of King County but has nearly half the number of COVID patients," he added. "There are lots of numbers where we're No. 1 in a way we don't want to be."
Everson said Wednesday case counts haven’t reached a point where the county caneven consider applying for a modified Phase 1, which would open additional activities.
"I'm not sure when Yakima is ever going to move from Phase 1 at the increased rates we're seeing right now," Peet said.