LA's Covid 'Tsunami': Inside the New Center of America's Raging Pandemichttps://www.theguardian.com/us-news/2020/dec/26/los-angeles-coronavirus-surge-hospitals... “Do we need to start filming people dying?” said Marcia Santini, a nurse at the University of California, Los Angeles (UCLA), medical center, who is recovering from a brutal Covid-19 infection that forced her to be hospitalized at her own workplace.
“People need to understand, there is no place to take care of you. You can’t have this mindset that this isn’t going to happen to you. It doesn’t work like that any more. The virus is rampant.”Heading into the darkest holiday season some have ever endured, there were grim reminders across the LA region that the virus is spreading uncontrolled. The city’s mayor briefed the public while in quarantine after his daughter became infected. Hospitals were setting up triage tents. Residents waited in line for hours for Covid tests at Dodger stadium. The region recently ordered more body bags.
Outbreaks were afflicting grocery stores, restaurants, stores, shopping malls, Amazon warehouses, manufacturing plants, government buildings, police and fire departments, jails and prisons and film sets.Officials in LA county estimated that one in 95 residents were currently infectious, and that two residents were dying of Covid every hour. More than 6,000 Covid patients are in the hospital, and intensive care units (ICU) are filled to capacity.
LA is now reporting an average of more than 14,700 cases each day, a 78% increase from two weeks ago, according to LA Times data. Seven hundred people are hospitalized daily; in October there were fewer than 150 daily hospitalizations. By January, officials say it could be 1,400 admissions each day. More than 9,000 people have died.
The situation inside some hospitals this week became untenable, and workers were bracing for it to get worse.
... MLKCH, a 131-bed hospital in a predominantly Black and Latino area in South LA, is caring for 200 patients, requiring doctors to use tents and waiting rooms for patient care, and forcing some staff to do frontline work outside of their normal positions, Reyno said on Wednesday. The hospital went from one Covid unit to three and is now seeking more ventilators: “We are just seeing an unrelenting and crushing volume of very sick patients,” he said. ...
The overflow is so severe that the lobby has been converted to a place to care for patients while an outside tent has been erected to act as a waiting room. Gurneys are now stored in the hospital's gift shop."Everything is backed up all the way to the street," said Dr. Oscar Casillas, the medical director of the hospital's emergency department told the Times.
The hospital serves the low-income South Los Angeles area, which has a 72 percent higher mortality rate than the rest of L.A., according to MLKCH. Though the hospital only has 133 beds, as of Tuesday, it had 206 patients, according to the
Los Angeles Daily News."The testing site on our campus, has a COVID positivity rate of 25 percent, versus 12 to 13 percent countywide. We're a small community hospital, 131 beds, and we have already exceeded our surge capacity.
We started this morning with 206 patients in our 131-bed hospital, and 70 patients in the emergency department—that is a 29-bed emergency department."-------------------------------------------
Overwhelmed L.A. Hospitals Brace for Post-Christmas Coronavirus Wavehttps://ktla.com/news/local-news/overwhelmed-l-a-hospitals-brace-for-post-christmas-coronavirus-wave/https://ktla.com/news/california/california-hospitals-delay-surgeries-face-difficult-decisions-amid-coronavirus-surge/In Covid-19 ravaged California on Christmas Day, remaining ICU capacity for the first time fell to zero across the entire state.
Some counties, like Los Angeles and Orange County have been at 0% for over a week, but the state at large has recently floated between 1 and 3%.
... There are still beds available in the state because, as health officials have explained, the official omits NICU availability — for kids — and other beds not appropriate for the majority of the state’s adults.
Still, scenes of patients lined up on stretchers outside of emergency rooms are beginning to emerge. They are frighteningly similar to images seen earlier in the pandemic in New York and in hard-hit countries like Italy or Wuhan, China.
-----------------------------------------------
... Some hospitals in L.A. County are running dangerously low on their supplies of oxygen, a person familiar with the matter told
The Times.
Oxygen is critical to treating severely ill COVID-19 patients who have begun to suffocate because the virus has inflamed their lungs. So now, hospitals need 10 times more oxygen than they did before.
There have been periods of time when hospitals have run dangerously low on their stores of oxygen before obtaining additional supplies, said the source, who spoke on the condition of anonymity.
Hospitals are also running short of other key supplies, such as the special sterile plastic tubes used to bring the oxygen into the lungs.----------------------------------------------
... California hospitals are facing increasingly difficult decisions about which services to postpone amid a crushing load of coronavirus patients. All regular intensive-care beds are full in Southern California and the Central Valley, and hospitals elsewhere are nearing capacity.
“While our state works to get the COVID-19 surge under control in the weeks ahead, we cannot allow patients’ healthcare needs to go unmet – medical care delay or avoidance could increase morbidity and mortality risk associated with treatable and preventable health conditions,” Michelle George, president of the California Ambulatory Surgery Association, wrote to the governor this month.
Hospital executives were reluctant to speak in detail about which surgeries are getting delayed and how severe conditions were, saying several factors are considered.
Kaiser Permanente has halted “elective, non-urgent surgeries and procedures” until Jan. 4 at 21 hospitals in Northern California and until Jan. 10 at its 15 hospitals in Southern California.
Dr. Rais Vohra, interim health officer for Fresno County, which is among the places seeing the greatest crush of cases, said hospitals are being asked to take a hard look at which surgeries can wait.
“Just because something is elective, like for example a tumor operation or spinal operation, that can’t go forever or else the patient is going to have a really bad outcome,” he said.
Dr. Anneli von Reinhart, an emergency physician at Community Regional Medical Center in Fresno, said plenty of important surgeries are considered “elective.”
“Elective doesn’t mean frivolous,” she said. “If you break your ankle into three pieces, we need to put you back together if you’re ever going to walk on it again, but we don’t necessarily need to do it today.”At Pioneers Memorial Hospital in Imperial County,
more than 65% of surgeries that are normally done “are not being done” since early December, said Larry Lewis, chief executive officer. He declined to elaborate on the type of surgeries, saying decisions vary case-by-case.
https://mobile.twitter.com/KPSCALnews/status/1341814218538926080On Friday, director James Gunn tweeted about the heartbreaking trouble a friend’s family had finding treatment at a hospital because of Covid-related overcrowding.
“My friend’s father had cancer surgery a week ago,” wrote Gunn.
“Two days later he had complications. He went back to the hospital but he couldn’t get a bed because of all the Covid patients…”... The next two to four weeks, ..., “will surely be difficult and more challenging.”