"Their emergency departments are now holding patients in their emergency departments that are actually admitted to the hospital," says Fresno County EMS Director Dan Lynch.
Ambulances are forced to be at a standstill, in some cases for up to four hours, as they wait for patients to be admitted to overwhelmed ERs.
"Ambulances are unable to turn patients over into the emergency department, get back in service and that leaves communities undeserved," Lynch said.
To make matters more complicated, American Ambulance says about a dozen of its workers are sidelined due to COVID-19 cases or exposure.
Now, an 'assess and refer' policy is in place for Fresno County EMS, the same measure that had to be taken during last December's COVID surge.
"We would show up on scene, we would assess that patient and if that patient was not having a life-threatening emergency, we would have dialogue about what are other options that do not involve an emergency room visit," says Edgar Escobedo.
It's an attempt to protect the health care system for those who need it most.
Anyone with the following symptoms should call 911: trouble breathing, persistent pain or pressure in the chest, new confusion, blush lips or face or inability to wake or stay awake.
Health officials are also reminding people that using an ambulance service won't get you treated in the ER quicker.
"That ambulance will take you directly to the waiting room and put you in line," Lynch said.
In the South Valley, the emergency department at Kaweah Health in Visalia saw a big backup Monday.
Without a single hospital bed left, staff was forced to hold over 60 patients in the emergency department with another 100 waiting to be seen.
"Yesterday was a perfect storm," says Kaweah Health CEO Gary Herbst said. "I can't remember ever having a single day where we had that many patients."