Hospital staff in California are increasingly limited amid an explosion of coronavirus cases that threatens to overwhelm the state’s emergency care system.
As of Sunday, more than 16,840 people were hospitalized with Covid-19 infections, more than double the previous peak reached in July. A state model that uses current data to forecast future trends shows that the number could hit 75,000 by mid-January.
Until vaccines became mainstream, hospitals braced for the possibility of rationing care. A document that recently circulated among doctors at the four hospitals run by Los Angeles County asks them to change their strategy: instead of trying everything to save one life, their goal during the crisis is to save as many patients as possible . That means those who are least likely to survive will not receive the same kind of care that is offered in normal times.
“Some compromise of the standard of care is inevitable; It is not that an entity, system or locality chooses to limit resources, it is that the resources are clearly not available to provide care on a regular basis, ”reads the document obtained by the Los Angeles Times.
The county’s director of health services, Dr. Christina Ghaly, said the guidelines were not in effect until Friday night, but that it was essential to develop them as the increase has come and “the worst is yet to come.”
California intensive care units serve more than 3,610 Covid-19 patients. All of Southern California and the 12 counties in the San Joaquin Valley to the north have exhausted their usual ICU capacity, and some hospitals have begun to use the “surge” space. Overall, the state’s ICU capacity was just 2.1% on Sunday.
In Los Angeles County, Nerissa Black, a nurse at Henry Mayo Newhall Hospital, estimated that she had received an average of less than 10 minutes of care per patient every hour. That includes not just bedside care but also putting on equipment, writing charts, reviewing lab results and consulting with doctors, he said.
“And the patients that are admitted are sicker now than ever, because so many people are waiting before receiving care. So when they come in, they’re really, really sick, ”Black said Sunday.
The large number of cases in the last six weeks has caused the death toll in California to rise more and more. Another 161 deaths were reported Sunday for a total of 22,593.
Across Los Angeles County at UCLA Health Santa Monica Medical Center, Nurse Wendy Macedo said all 25 beds in her unit were full of Covid-19 patients. He said a room on another floor that had been dedicated to orthopedic patients had been converted to care for people who tested positive for the virus. Nurses worked longer shifts, and more, he said. Nearly 5,550 people are hospitalized with Covid-19 across the county.
“The more patients we have, the greater the risk of making a mistake, especially if we rush,” Macedo said Sunday. “Obviously we are trying to avoid that, but we are only human.”
California was experiencing “some of the darkest days of our Covid-19 surge,” Governor Gavin Newsom said, but there was some light Sunday when a working group of scientists and experts endorsed a vaccine developed by Moderna. The move clears the way for the drug to be distributed throughout California and other western states that have reviewed it separately by the US Food and Drug Administration.
Shipments of the vaccine are expected to arrive in California earlier this week, but it could be months before it is available to the general public, authorities said.
“Until vaccines become more widely available throughout the state, it is critical that all Californians do their part to stop the rise by staying home and wearing a mask when leaving home for work and essential needs,” Newsom said. .
Corona Regional Medical Center in southeast Los Angeles has converted a former emergency room to help handle nearly double the usual number of ICU patients. You’re using space in two disaster tents to classify ER patients because the ER is full of patients who need to be hospitalized.
In hard-hit central California Fresno County, a new 50-bed alternative care facility opened in recent days near the regional community health center. Beds for Covid-19 negative patients will free up space in area hospitals, where only 13 of the 150 ICU beds were available Friday, said Dan Lynch, the county’s director of emergency medical services.
Lynch said he expected they would have to use the Fresno Convention Center, which can accommodate up to 250 patients, given current demand.
Fresno and three neighboring counties have also taken the unprecedented step of sending paramedics on emergency calls to screen people. They will not be taken to the emergency room if they can go to an urgent care center or wait a few days to speak with their doctors, Lynch said.
Some hospitals have canceled nonessential elective surgeries, such as hip replacements, which could require beds that will soon be needed for Covid-19 patients. Others are increasing staff hours or moving patients to free up space.
Los Angeles County health officials announced Saturday that they had modified their health orders to comply with recent US Supreme Court rulings calling for places of worship to be allowed outdoor services and indoors, with proper health safety precautions.
On Saturday night, Apple announced that it was temporarily closing its 53 stores in California due to the coronavirus outbreak. Under the stay-at-home order in effect for most of the state, retail stores are limited to 20% of capacity.
Supermarkets have been hit hard by the wave of viruses, further depleting an essential service that remains open during the last order to stay home. Of the six outbreaks at Food 4 Less locations in the Los Angeles area, three were recorded for the first time this month, linked to the current increase, according to a Times analysis. An outbreak is defined as three or more cases among staff in a 14-day period.
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