SVMHS Chief Medical Officer On COVID-19 Spike, Pandemic Politics And What Worries Him

Jul 22, 2020

As COVID-19 boomerangs in California, local hospitals are treating a record number of patients. KAZU News checked in with Dr. Allen Radner, Chief Medical Officer of Salinas Valley Memorial Healthcare System.

Dr. Allen Radner is Chief Medical Officer of SVMHS and an infectious disease specialist.
Credit Salinas Valley Memorial Healthcare System

Erika Mahoney (EM): How did we get here?

Dr. Allen Radner (AR): We went from a period in our community, as much of the country did, where we were staying at home, sheltering in place, following a lot of, kind of, rigid guidelines. And unfortunately, we rapidly opened things up and the virus has taken advantage of that and has spread throughout our community. 

EM: So could you describe what it’s been like inside the hospital recently? 

AR: We have two areas in the hospital that are designated as COVID wards and they're both very full. So we have multiple patients on ventilators, multiple patients who are ill. We also have a lot of patients that come in and are discharged within a day or two, they're getting better.

EM: How are you treating patients? 

AR: People who are critically ill from a respiratory standpoint, they require mechanical ventilation. And that's the ventilators that we talk about. There's other things we do. These people can get blood clots, so we give them blood thinners. If they're a candidate, there are some therapeutic modalities that we try to utilize. So there's a drug called Remdesivir that, unfortunately, there's very limited supplies nationally, very limited supplies in the county, and we do administer Remdesivir to patients. Another therapeutic modality we've been using is something called convalescent plasma, which is essentially antibodies harvested from people who've recovered from COVID-19. And we've administered that to a number of patients in our community as well. 

 

An ICU patient is put on a ventilator, which involves intubation.
Credit Richard Green

EM: What happens if you run out of treatment supplies?

AR: We are living with limited supplies and we do what we've done. I mean, when the disease started in our community, we gave supportive care… supporting them from an oxygen standpoint, a blood pressure standpoint if need be, and kidney standpoint, if need be. So we don't have a lot of other choices other than to support their body and hope that their normal immune system will help them recover. So that's what we did before we had some of these therapies. And we fall back on that if need be.  

EM: Younger people now make up most of the new infections. Are you seeing people in their twenties and thirties showing up in the hospital?

AR: We've definitely had younger people hospitalized at the hospital, but the majority of our admissions have been people who are older. Younger people may not become ill to the point of hospitalization, but they certainly can transmit the virus. And we've had innumerable cases of families where everyone in the family has become ill and the grandparents or parents are the ones that are hospitalized. 

EM: And are you seeing any children testing positive?

AR: We're seeing a lot of young children testing positive again, usually as part of families. Fortunately, most of the children have done extremely well and have mild illnesses and frequently asymptomatic illnesses.  

Nurses who work in the COVID units at Salinas Valley Memorial Hospital meet for a huddle.
Credit Richard Green

EM: And what's your biggest worry right now? What are you thinking about when you go to sleep? 

AR: We are worried about… and the caveat to really overwhelming our healthcare system is that we have two large state prisons in the South County. And unfortunately, as they've shown nationally and in a number of prisons in California, this can spread very rapidly in prison systems. We're also... remain worried that patients who have non-COVID related illnesses won't be seeking care and it's really worrisome and troublesome and upsetting to think that there are people having very serious medical problems and even dying because they weren't seeking the medical care they needed.

EM: The Monterey County jail is experiencing an outbreak right now. What are your concerns around that?

AR: The number of people housed in the Monterey County jail is significantly less than the total number at Salinas Valley State Prison and CTF Soledad. So we feel we can accommodate those as we need to. But it's just a matter of scale, frankly, that the jail is kind of a smaller example of something that could really overwhelm our healthcare systems at a bigger scale if there are serious outbreaks at the bigger facilities.  

EM: Nationally and locally, we continue to see this pandemic disproportionately affect communities of color. From your perspective, why?

AR: Well, I think there are a lot of socioeconomic reasons. I mean they all kind of feedback to issues related to access to health care and preexisting medical problems they hadn't been able to address. They often come late to the medical system and they don't have resources to get health care even now. Fortunately, our community is providing those sources at all of the institutions. But I think... we all think that the drivers here are these underlying socioeconomic problems and access problems to healthcare. 

EM: We’re in an election year and this is a very emotional time amid the pandemic - people are scared. Are politics affecting you, the hospital and the communities you serve?  

AR: I believe that starting at a federal level, there needs to be a consistent message recognizing that information is changing daily for all of us. But being honest and transparent in trying to bring people together is in everyone's best interest. And when there are messages out there that this is a hoax and that what we know about science isn't accurate, I think is very disruptive and makes it hard to give factual information or realistic information or timely information to people in our community. 

EM: So what's your message to the community?

AR: I think we as a community need to understand that this is going to be here for a long time. I mean, we're all hopeful there'll be a vaccine by the end of the year, but we're going to have to deal with this for many months. So I think we need to do everything we possibly can to mitigate the spread of this disease in our community. And I don't believe that it's a simple kind of binary equation, where it's... everybody in our community needs to be sheltered in place, stay at home, never go outside. And clearly at the other end of that continuum is to completely disregard this and walk around without any concerns of physical or social distancing or masking or hand washing. And we really have to try to find somewhere in between.

We'd like to note that Salinas Valley Memorial Healthcare System is one of the many organizations that supports KAZU.