Latest COVID surge forces Fresno-area emergency medical providers to take dire step

Ambulance crews across Fresno County and neighboring Kings, Madera and Tulare counties are once again implementing a policy in which rides to hospital emergency rooms will be denied to patients unless they have a life- or limb-threatening emergency.

The “assess-and-refer” policy was announced Wednesday by Dan Lynch, emergency medical services director for Fresno County and the Central California Emergency Medical Services Agency. It comes as hospitals across the region are seeing a rising number of COVID-19 patients, as well as people with other ailments, seeking treatment in their emergency rooms.

Such a policy, which requires ambulance paramedics and emergency medical technicians to assess a patient’s needs before taking them to a hospital emergency department, has been an on-again, off-again measure several times over the past two years during the coronavirus pandemic to relieve the burden of non-emergency patients on hospitals.

“Ambulances will respond and assess patients,” Lynch said. “If it is determined that the patient is stable, and does not require emergency transport, the ambulance personnel will provide an appropriate alternate recommendation and not transport the patient by ambulance.”

Such alternatives may be for the patient to contact their primary care doctor, urgent-care clinics or use telehealth services offered by many health insurance carriers.

Many hospitals are operating at or over their capacity, and officials said emergency rooms are “close to disaster levels” because of patient volumes, including for the highly contagious omicron BA 5 variant of the coronavirus.

“Our hospitals remain busy. … All of the area hospitals are really just at capacity,” Dr. Rais Vohra, Fresno County’s interim health officer, said in a media briefing last week. “We’re really straining, not only because of COVID but because of everything else. It’s just a really hard time right now.”

For patients who have an actual emergency, including trouble breathing, persistent chest pain or pressure, a new sensation of confusion, a bluish tinge to the lips or face, or an inability to wake up or stay awake, health officials advise to call 911 or go to the nearest hospital. But because of call volumes, they warn that non-emergency calls may expect delays in ambulance response.

The most recent previous implementation of the assess-and-refer policy in the local counties was in place for six weeks, during a significant surge in new coronavirus cases, before it was lifted in February.

The region has been experiencing another surge of new cases each week over the past couple of months, reaching their highest levels since earlier this year.