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SUNDAY, JULY 12, 2020 • SANTA ROSA, CALIFORNIA • PRESSDEMOCRAT.COM

Hospitals prepare for surge

SONOMA COUNTY » 2 more
die of COVID-19; officials
say they can expand capacity
By MARTIN ESPINOZA
THE PRESS DEMOCRAT
If Santa Rosa Memorial Hospi-
tal starts moving patients from the
emergency department to the vast
white tent outside the hospital, that
will indicate the dreaded coronavi-
rus surge has begun.
It’s what county public health of-
ficials and health care workers have
long feared since the pandemic ar-
rived in Sonoma County in March.
So far, Memorial Hospital — the
county’s highest-level trauma center
— has been able to manage its vol-
ume of COVID-19 patients, as have
other local hospitals.
“When you see us panic, you’ll
know,” said Scott Rocco, manager of
Memorial’s emergency department,
as he stood Friday outside the white
tent covering six medical bays where
doctors and nurses would care for
a rush of sick people. Later that
day, the county would report 89 new
cases of COVID-19, the highest sin-
gle-day total.
Late Saturday, the county report-
ed two more people have died of
COVID-19, bringing the total to 16
since the pandemic emerged in ear-
ly March. Details on the two new
deaths were not available Saturday.
Rocco explained a surge occurs
when the number of people showing
up at a hospital exceeds its ability to
treat them. It happened with recent
wildfires, but it hasn’t occurred in
the ongoing pandemic — at least not
yet.
If it does, Rocco and other lead-
ers at Sonoma County hospitals say
they’re ready, or as ready as they can
be.
In the spring, no surge of hospi- Dr. Sundari
tal patients materialized, although Mase
area medical centers had urgently Sonoma County
prepared. Now, the county is losing a public health
officer
TURN TO SURGE » PAGE A14

CORONAVIRUS

Risks of
“I thanked him for everything. He was breathing. I said, ‘You can go,
Dad. I love you.’ A tear rolled down out of his eye. He took his last breath.”

A family in anguish opening

JOSE MANUEL HERMOSILLO, whose father, Jose, died May 3 from complications of coronavirus

schools
after patriarch dies debated
Health experts worry
most about children
acting as virus spreaders
Jose Hermosillo, a generous friend, beloved father and grandfather, By PAM BELLUCK

was the third Sonoma County resident with COVID-19 to die

AND APOORVA MANDAVILLI
NEW YORK TIMES

As school districts across the

United States consider wheth-
er and how to restart in-person
classes, their challenge is com-
plicated by a pair of fundamen-
tal uncertainties: No nation has
tried to send children back to
school with the virus raging at
levels like America’s, and the sci-
entific research about transmis-
sion in classrooms is limited.
The World Health Organiza-
tion has now concluded that the
virus is airborne in crowded,
indoor spaces with poor ventila-
tion, a description that fits many
American schools. But there
is enormous pressure to bring
students back — from parents,
from pediatricians and child de-
velopment specialists, and from
President Donald Trump.
“I’m just going to say it: It
feels like we’re playing Rus-
sian roulette with our kids and
our staff,” said Robin Cogan, a
nurse at the Yorkship School
in Camden, New Jersey, who
serves on the state’s committee
on reopening schools.
Data from around the world
clearly shows that children are
far less likely to become seri-
ously ill from the coronavirus
KENT PORTER / THE PRESS DEMOCRAT
than adults. But there are big
unanswered questions, includ-
In his father’s workshop, Jose Manuel Hermosillo and his daughter, Aleeysa, 6, share a quiet moment Saturday in Roseland. Hermosillo’s father, ing how often children become
Jose, 66, was the third person to die of COVID-19 in Sonoma County. Both father and son would rebuild vintage bicycles together in the workshop. infected and what role they play
in transmitting the virus. Some
By JULIE JOHNSON research suggests younger chil-

A
THE PRESS DEMOCRAT dren are less likely to infect

fter lunch one day back in 1985, Jose Her- TURN TO SCHOOLS » PAGE A2
mosillo walked into the Tex-Mex Video on
Sebastopol Road in Santa Rosa carrying INSIDE
boxes of takeout food, a gift for a stranger.
GLEANING SAVES THE DAY:
Gonzalo Esquivel had recently opened the small Local farms harvest then
store renting Mexican and Mexican-American donate surplus of produce
movies in the city’s Roseland neighborhood. Her- to help impacted food
banks, pantries. / A3
mosillo said he just had lunch with his brother
and thought Esquivel might be hungry, working SANTA ROSA
High 96, Low 52
alone in his shop.
THE WEATHER, C4
“He came with food, comida,” Esquivel said. “At Jose
that time I didn’t know his name. He didn’t know Hermosillo was
Books D9 LeBaron T1
born March 12,
me and he’s thinking about me and worrying 1954, in Business E1 Lotto A2
about me. We became friends on that day.“ Mexicali. He Classified E4 Nevius C1
Togetherness for Hermosillo began with bowls was 14 years Community B8 Obituaries B4
old when he Crossword C3 Sonoma Life D1
full of spicy menudo, birria or simple caldo de res and his brother, Forum B9 Smith A3
with his family and his two best friends, Esquiv- Mario, traveled
el and Pablo Mendoza of Santa Rosa, who now north to work
in the Healds-
mourn his loss. burg vineyards.
FAMILY PHOTO
TURN TO HERMOSILLO » PAGE A12 ©2020 The Press Democrat
A14 THE PRESS DEMOCRAT • SUNDAY, JULY 12, 2020
Omar Ferrari, medical director of Santa Rosa Memorial Hospital’s emergency department, pauses in the COVID surge tent in Santa Rosa. If Santa Rosa Memorial Hospital starts moving
patients from the emergency department to inside the white tent outside the hospital, that will indicate a coronavirus surge has begun, Ferrari said.
SURGE
CONTINUED FROM A1
grip it had on the virus, re-
sulting in soaring numbers
of new infections, nine
deaths since late June and
more residents suffering
from the infectious disease
needing hospital care.
To be sure, the spike in vi-
rus-related hospitalizations
statewide over the past two
weeks is alarming and a
reminder the pathogen has
not taken a summer break.
California’s 416 hospitals
have had a 49% increase
in patient admissions with
COVID-19, and a 38% boost
in patients needing inten-
sive care.
Challenges mount
This time around, Sono-
ma County hospital lead-
ers say nurses and doctors
know much more about
treating the highly con-
tagious disease and have
many more therapeutics
like Remdesivir available.
Dr. Chad Krilich, chief
medical officer for St. Jo-
seph Health Sonoma Coun-
ty, operator of Santa Rosa
Memorial and Petaluma
Valley hospitals, said a
hospital’s readiness for
an inundation of virus-af-
flicted people depends on
a number of factors, in-
cluding whether there are
enough health care work-
ers and protective gear for
them to take care of the
influx of patients.
“Given our current vol-
umes today and given the
projections that I’m seeing
today, are we ready for a
surge? Yes,” Krilich said
Friday. “Tomorrow will be
a different day and we'll
need to reevaluate every-
thing all over again.”
The COVID-19 hospital-
ization rate was the one
local statistic that had re-
mained relatively stable,
even as infections steadily
increased. That changed a
few weeks ago.
In late May, the largest
number of coronavirus
patients hospitalized in the
county was eight. Through
most of June, the average
number of virus patients
in a local hospital was five,
and there were never more
than seven.
Since June 26, though,
the number of COVID-19
cases in local hospitals has
jumped to 28 patients on
Friday, according to the
county’s hospital capacity
dashboard.
As of Saturday, the av-
erage number of people
hospitalized over a three-
day period had increased
30%, far exceeding the 10%
benchmark established by
the state, signaling trouble
with suppressing the virus
outbreak. Therefore, Sono-
ma County on Friday land-
ed on the state’s coronavi-
rus watchlist, joining 29
other counties and trigger-
ing eventual restrictions
expected Monday to halt
The COVID surge tent is outside of Santa Rosa Memorial Hospital. The tent hasn’t been used since the pandemic started.
HOSPITALS’ BED CAPACITY FOR SURGE IN CORONAVIRUS PATIENTS
Here’s a look at the number of existing hospital beds and the potential number of beds that could
be added or converted for use as COVID-19 beds during a surge in coronavirus cases.
Licensed Surge
Hospital beds beds
Santa Rosa
329* 76
Memorial Hospital
Kaiser Santa Rosa
173 11
Medical Center
Sutter Santa Rosa
84 N/A
Regional Hospital
Petaluma Valley Hospital 80 16
Sonoma Valley Hospital 24 35
Healdsburg
38* 11
District Hospital
Sonoma Specialty Hospital 37 35
* Includes skilled nursing beds
** Includes 3 ventilators; 3 backup anesthesia machines; 3 bilevel positive airway pressure (BiPAP)
machines
*** Hospital capable of converting all its medical/surgical beds into ICU, depending on available
staffing and equipment, in a surge
N/A: Hospital declined to provide information
Source: California Health & Human Services Agency and Sonoma County hospitals
indoor dining and drinking ma Valley sister hospitals,
at restaurants, wine tast- negative pressure rooms
ing rooms and breweries, for virus patients could
among other pullbacks. be increased from 11 to 25
and 26 to 32, respectively.
Expansion of beds, care Memorial could add six
As local hospitals admit more ICU beds to its 26 and
more coronavirus patients, Petaluma Valley similarly
they are revamping plans could add another five ICU
to potentially add more beds to its nine.
beds as they need them, Kaiser Permanente of-
including staffing addition- ficials say they can add
al ICU beds as patients fill 11 regular hospital beds
them. and 29 more ICU beds in
In the event of an actu- the event of a surge, while
al surge, the county’s six Sonoma Valley Hospital in
acute-care hospitals and its Sonoma and Sonoma Spe-
one long-term acute care cialty Hospital in Sebas-
hospital could add at least topol both said they could
an additional 184 regular add 35 more hospital beds.
hospital beds, along with Up north at smaller sub-
at least 58 beds for ICU pa- urban Healdsburg District
tients to its 707 staffed beds, Hospital, 11 regular hospi-
67 of which are ICU beds, tal beds could be added and
according to a Press Dem- any one of the 13 medical/
ocrat survey of the seven surgical beds could be con-
medical centers. Sutter verted into ICU beds.
Santa Rosa Regional Hos- So confident in their
pital was the only one that preparation to manage a
declined a request for infor- surge, hospital officials
mation about the number don’t plan to stop surger-
of extra beds it planned. ies or elective procedures
At Memorial and Petalu- should a wave of virus pa-
Intensive care Ventilators
(surge added) (surge added)
26 (6) 23
20 (29) 19
12 12 (8)
9 (5) 4 care system could accom-
6 9**
4 (13)*** 13
5 (5) 14
tients flood local medical
centers.
“We currently have plen-
ty of capacity and do not
have plans to postpone
or cut back on any proce-
dures at this time,” said Dr.
Sabrina Kidd, Sonoma Val-
ley Hospital’s chief medi-
cal officer.
Kidd said the hospital,
which is largely an outpa-
tient center for procedures
and surgeries, would con-
tinue outpatient services
even if inpatient beds fill
up. But she’s closely mon-
itoring staffing and sup-
plies of personal protective
equipment.
“If any of these become
limited, we may be forced
to make other plans or
restrict some services de-
pending on the shortages
and needs at that time,”
she said.
Michelle Gaskill-Hames,
senior vice president of
hospital and health plan
operations at Kaiser Per-
manente Northern Cal-
ifornia, said Kaiser has
PHOTOS BY KENT PORTER / THE PRESS DEMOCRAT
remained in a “state of
readiness“ since initial
surge planning in spring.
“As a result, Kaiser Per-
manente facilities and staff
can manage the current
growth in hospitalized
cases, expertly treating pa-
tients with the virus, while
safely caring for patients
with other conditions as
well,” Gaskill-Hames said
in a statement.
She said if necessary,
Kaiser’s integrated health
modate patients moving
from one Kaiser medical
center to another, as they
did during the 2017 North
Bay fires.
Carmela Coyle, presi-
dent of the California Hos-
pital Association, said hos-
pitals know how to address
the rising tide of patients,
with many more tools that
are “actually shortening
the stay of those patients,’’
making the challenge dif-
ferent than at the onset of
the pandemic.
“The surge is about
finding a balance between
caring for COVID-positive
patients, and continuing
to care for everyone in the
state of California,” Coyle
said.
Unpacking numbers
On Friday, Memorial
Hospital in Santa Rosa
was treating 12 patients
who had tested positive for
COVID-19. Krilich said that
while there has been an
increase in virus-stricken
patients, the majority of
them are being treated on
the medical/surgical floor
and not in intensive care.
What’s more, he said,
while there are more coro-
navirus patients receiving
care, a significant number
were admitted to the hos-
pital for another illness be-
fore getting diagnosed with
the infectious disease.
“By virtue of our prac-
tice to test all patients who
have been admitted to the
hospital, we also find out
that they’re COVID posi-
tive,” Krilich said. “They
may be someone who's an
asymptomatic shedder and
who isn't actively having
the disease.”
Krilich also said not ev-
eryone in the hospital who
has tested positive for the
coronavirus is actively
battling the disease or has
symptoms such as fever,
elevated heart rate or diffi-
culty breathing.
For example, Dr. Omar
Ferrari, medical director
of Memorial’s emergen-
cy department, said there
have been cases in which
patients come into the hos-
pital as a result of an opi-
ate overdose and then test
positive for COVID-19.
“There are those hospi-
tal admissions that would
have been admitted, re-
gardless of their COVID,”
Ferrari said. “But they
wind up in the COVID pool,
simply because we're test-
ing for it.”
Nevertheless, Krilich
said he didn’t want to min-
imize the severity of illness
suffered by some patients
battling the contagion. And
he said asymptomatic peo-
ple can lead to more virus
spread and endanger those
who are more vulnerable or
susceptible to severe symp-
toms.
Rising concerns
Of all the coronavirus
tracking metrics the pub-
lic has come to know or
at least get familiar with
— including case rates
per 100,000 residents and
positive testing rates — in-
creasing hospitalizations
has been among the most
worrisome for county pub-
lic health officials.
“Hospitalizations are
important because they
tell you who's getting re-
ally sick, and they tell you
something about vulnera-
ble populations, and how
much vulnerable popula-
tions have been impacted
by COVID,” said Dr. Sund-
ari Mase, the county’s
health officer who has or-
chestrated the community
pandemic response.
Mase said the recent
spikes in hospitalizations
and related deaths of
COVID-19 patients — the
local death toll stands at 16
with 11 of them since June
28 — is tied to recent out-
breaks in skilled nursing
and residential care facil-
ities. In recent weeks, the
county has seen at least
seven COVID-19-related
deaths of senior care home
residents, including five
who lived in a skilled nurs-
ing home.
“There is no mistake that
we've had a significant in-
crease in hospitalizations
due to our skilled nursing
facility outbreak,” she said.
Positioned for the worst
Local hospital officials,
doctors, nurses and medi-
cal staff have learned a lot
since March when they
were planning for the un-
known, a hypothetical
TURN TO SURGE » PAGE A15
THE PRESS DEMOCRAT • SUNDAY, JULY 12, 2020 A15
SURGE
CONTINUED FROM A14
surge based on computer
models that predicted 600
to 1,500 virus patients at
once needing hospital care.
Deborah Burger, a
longtime local Kaiser
nurse and a president of
National Nurses United,
said a major difference
between today’s surge
planning and that of a few
months ago is the ability
to quickly test patients for
COVID-19.
That allows hospital staff
to better plan patient care,
which is crucial since hos-
pitals now expect to manage
both COVID-19 patients and
regular patients, Burger
said. Anticipating a surge
early in the pandemic, hos-
pitals canceled all elective
procedures, which greatly
reduced patient volumes.
Although confident area
hospitals should be able to
handle a steadily increas-
ing flow of virus patients,
Burger warned that nurs-
es and other health care
workers continue to endure
inadequate supplies of per-
sonal protective equipment,
especially N-95 masks.
Hospitals are stockpiling
the masks and in some cas-
es asking nurses to wear
the same mask for a week,
Burger said, noting the
inherent risks. Hospitals
can’t afford to let nurs-
es and other health care
workers become ill with
the virus, she said.
Equally important, the
veteran Kaiser nurse said,
at the beginning of the pan-
demic, Sonoma County resi-
dents took the public health
emergency seriously. That
could easily change, she
said, if people "decide that
they’re fed up with social
distancing and limiting en-
counters with groups.“
This public resistance to
mask wearing, and staying
a proper distance apart
from anyone but family,
has greatly contributed
to the virus roaring back
with a vengeance in other
parts of California and in
Florida, Texas and a few
other states.
BREAKING DOWN SPREAD OF CORONAVIRUS
Sonoma County public health officials continue to urge
residents to call their doctor if they are ill, think they have
Trump finally dons
face mask at outing
flu-like symptoms and want to learn whether they should be
tested for coronavirus.
914 16 1,703
Active cases
as of Saturday
Deaths
as of Saturday
(3%)
Positive results By TOLUSE OLORUNNIPA
59.4K 773 57.7K
WASHINGTON POST
Tests finished Recovered
as of Saturday as of Saturday (97%) WASHINGTON — Pres-
ident Donald Trump wore
Negative results a mask in public for the
first time Saturday, more
than three months after
VIRUS CASES IN COUNTY BY AGE public health officials
3% 12% 13% from his own administra-
tion recommended that
Under 5 5-17 18-24 all Americans cover their
face when social distanc-
ing was not possible.
37% 13% 9% Trump’s decision to
25-44 45-54 55-64 don a mask during a trip
to Walter Reed National
Military Medical Center
5% 5% 0% followed several months
of controversy over his re-
PATRICK SEMANSKY / ASSOCIATED PRESS
President Donald Trump wears a mask Saturday as he
65-74 75 older Unknown luctance to abide by public walks down the hallway during his visit to Walter Reed
health guidelines even as National Military Medical Center in Bethesda, Maryland.
novel coronavirus cases
VIRUS CASES IN COUNTY IN PAST WEEK surged nationwide. Before mon situation because dinances and guidelines
53 89 42 32 wearing the navy-colored
mask Saturday, Trump
he is regularly tested for
the coronavirus. Trump
in Michigan, Oklahoma,
Florida, Arizona and else-
New cases Friday Thursday Wednesday had disparaged his Dem- resisted, and the concept where as he traveled the
Saturday
21 36 25 ocratic rival, Joe Biden,
for wearing a mask and
of mask-wearing became
part of the country’s parti-
country maskless.
Trump has attacked
Tuesday Monday Sunday publicly downplayed the san political battles as the Biden on Twitter for wear-
importance of face cover- coronavirus spread rapid- ing a mask and told Fox
HOSPITALIZATION ings. ly in America and other News on Thursday that
While the president said countries gained control Biden’s mask was the “the
Currently hospitalized: 28 confirmed cases, 9 suspected cases;
in recent interviews that of the pandemic. largest mask I think I have
as of Friday
he had no problem with “Unfortunately this ever seen. It covers up a
Total hospitalized during pandemic: 76 masks, Saturday’s public simple lifesaving prac- big proportion of his face.”
appearance was the first tice has become part of Biden’s campaign criti-
Sources: Sonoma County health department; state of California; tangible example of him a political debate that cized Trump on Saturday
Centers for Disease Control and Prevention; Press Democrat reporting following through on that says: If you’re for Trump, for waiting so long to wear
ONLINE: See more coronavirus-related data and charts at with action. you don’t wear a mask. a mask publicly.
pressdemocrat.com/coronavirus-numbers “I’ve never been against If you’re against Trump, As health officials in the
masks, but I do believe you do,” Sen. Lamar Alex- Trump administration
Krilich, the St. Joseph public health recommen- they have a time and a ander, R-Tennessee, said have tried to persuade
Health chief medical of- dations, such as wearing place,” Trump said Sat- last month during a Sen- Americans to wear masks
ficer, agreed. He said the facial coverings, social dis- urday at the White House ate hearing. “That is why to slow the spread of the
benefits of responsible be- tancing, practicing good before leaving for Walter I have suggested the pres- coronavirus, Trump has
havior by Sonoma County hygiene and avoiding large Reed. ident should occasionally repeatedly focused on the
residents in the spring, and groups, Krilich said any While visiting wounded wear a mask even though aesthetics of face cover-
that continues, enabled the gains against the virus veterans and health-care there are not many occa- ings and social distancing
community to gain an edge would vanish and it would workers at the facility, sions when it is necessary — adding to the politiciza-
reducing the worst of the have the upper hand. Trump wore a dark mask for him to do so. The pres- tion of the issue.
virus threat. Although the “If people choose not that covered most of his ident has millions of ad- Walter Reed’s website
county now is struggling to wear a mask, we won’t face. It featured the presi- mirers. They would follow includes guidance that
mightily to keep the vi- have the benefit that we’ve dential seal. his lead.” says visitors “are expected
rus in check, an infamous had thus far,” he said. For months, health offi- Trump instead chose to wear a cloth face cov-
surge that could over- cials and several Republi- to set a different example, ering over their nose and
run local hospitals with You can reach Staff Writer can lawmakers have urged holding several mass gath- mouth upon entering and
patients so far has been Martin Espinoza at 707- Trump to model good safe- erings in recent weeks while moving about the
avoided. 521-5213 or martin.espino- ty practices by wearing in which most partici- facility … when not able
If people let their guard za@pressdemocrat.com. a mask in public, even pants did not wear masks. to maintain 6 feet of social
down, though, and ignore On Twitter @pressreno. though he is in an uncom- Trump defied local or- distancing.”
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