Coronavirus hospitalizations in Los Angeles County climbed to 5,763, another chilling record, on Friday, Dec. 18 punctuating the pandemic’s deadliest week.
The medical-center logjam helped fuel Southern California’s intensive-care unit availability index, which remained at 0% for the record day on the state’s pandemic dashboard.
Just since Monday, the county has reported more than 71,000 new cases. Friday’s 16,504 new cases brought the county’s total to 596,721 since the pandemic began.
L.A. County Public Health reported 96 people died from the virus, bringing the total number dead to 8,757. The pandemic’s 10-month-long siege has taken the lives of 312,722 people across the U.S.
Public Health officials also reported four more cases of multisystem inflammatory syndrome — a pediatric inflammatory condition associated with the virus — bringing the total cases of MIS-C in L.A. County to 49 children, including one child’s death.
The report did not include updated numbers for Long Beach and Pasadena, which operate their own health departments.
Long Beach reported one additional death for total of 311 and 547 new cases for a total of 24,622. A total of 117 patients are hospitalized there, an increase of 15, city health officials said. Pasadena had not posted an update as of 5 p.m. Friday. On Thursday, the city reported three additional deaths for a total of 142 and 201 new cases for a total of 5,271.
“To the many families mourning a loved one who passed away from COVID-19, our deepest condolences,” said Barbara Ferrer, director of Public Health, who once again had the grim task of reporting the number of dead, a task for which brought tears earlier in the week. “And to all the people sick and hospitalized with COVID-19, we wish you a full recovery.”
Even as the growing number of the Pfizer vaccine made its way to more healthcare workers Friday, the tone remained grim among officials.
“If we don’t stop the spread, our hospitals will be overwhelmed,” said Dr. Brad Spellman, chief medical officer at the Los Angeles County-USC Medical Center.
Non-COVID patients could soon be paying a steep price, he warned.
“If you have a heart attack. If you get into a car accident. If you fall off a ladder or have a stroke. We may not have a bed for you,” he said.
As it is, Dr. Angelique Campen, an emergency medicine physician at Providence Saint Joseph Medical Center in Burbank and Ronald Reagan UCLA Medical Center in Westwood, is already seeing the strain in the ER.
Before COVID-19, about 5% of her patients in the ER were admitted to the ICU. Now, it’s up to about 25%.
“(Patients) need to stay in the ER for many many hours waiting for someone to be discharged from upstairs,” Campen said. “That’s how I now we are at capacity.”
For the Southern California region, ICU capacity stood again at a bottomed-out 0% on Friday. The state’s metric may not reflect some hospitals that do have more capacity, local healthcare crews acknowledged that resources are strained.
Lines outside emergency rooms, scrambling ER staff, paramedics lining hallways waiting to get a bed for their patients — called “wall time” — are familiar sights.
“It’s not so much that you run out of beds, but they call it capacity because you need people to staff those beds — nurses, techs, doctors — that is the issue that hospitals are dealing with,” Campen said.
Despite resistance from nursing unions, the state issued guidance last week saying hospitals could seek waivers to increase staff-to-patient ratios.
In its “All Facilities Letter” last week, the state gave hospitals several triggers for loosening regulations staffing, licensing and physical space requirements, which if approved would be valid until March 1.
Loosened rules would allow hospitals to increase nurse-to-patient staffing requirements, which National Nurses United said would only lead to more infections among healthcare workers when they are already strapped.
“Heavier patient assignments sharply cut the time nurses can provide individualized patient care, properly monitor a patient’s condition, and increase the likelihood of mistakes, as studies have documented for years,” said Zenei Cortez, RN and a president of California Nurses Association and National Nurses United said in a statement. “In a pandemic, that’s an open invitation to increase the risk of spreading the virus to other patients and other staff.”
Amid staffing concerns, hospitals are scrambling for extra surge space.
“We are leveraging the flexibility of our team-based staffing to adjust staffing and align the right health care professionals with the unique needs of each patient,” said Dr. Gregory Kelman, Regional Medical Director of Operations at Kaiser Permanente in a Friday statement.
To accommodate the increased demand on Kaiser’s emergency department, Kaplan added, hospitals are lengthening existing staff hours, hiring temporary staff and redeploying qualified staff from other departments to help emergency workers. The hospital group is also using tents as extra auxiliary space for emergency care at its facilities.
Looming ahead is the Christmas holiday, on which doctors and public health officials worry families and friends will gather new — much like over Thanksgiving, which experts say is largely fueling the current surge.
With a transmission ratio of 1.20, and assuming no changes in physical distancing behavior, the number of increased cases will create more shortages of ICU beds over the next four weeks, experts said. Officials also fear a shortage of ventilators.
The county’s estimates suggest that about 1 in 80 L.A. County residents are infectious to others and that about 1 in 4 have had COVID-19.
Vaccinations multiply
The pandemic’s enduring ray of hope, however, continued to grow brighter Friday: Vaccinations, which spread to county-run facilities.
Hope for the holidays. LA County kicked off a massive effort to vaccinate 10,000 frontline health workers before the end of the year–including 6,000 before Christmas. Learn more: https://t.co/rQEl2ZQCI4 pic.twitter.com/Np0gWTuIsI
— Los Angeles County (@CountyofLA) December 18, 2020
Inoculations went to staff at L.A. County+USC near downtown, Olive View-UCLA in Sylmar and Harbor-UCLA in Torrance. By 10 a.m., officials said 1,500 people had been vaccinated against the virus, with more doses to be shipped soon. The first coronavirus vaccines were also administered in Long Beach on Friday.
The goal is to vaccinate 10,000 staffers before the end of the year.
Brandon Gatling, a nurse at MemorialCare Long Beach Medical Center, rolled up his left sleeve as he sat in front of the hospital where he works Friday morning, Dec. 18, to become one of the first people in the city to receive the vaccine.
“I’m just honestly — I’m so honored and humbled to be here and be chosen to receive the vaccine,” he said.
Hospital cleaning, nutritional and security staff have also been designated to receive the initial doses of the Pfizer-manufactured vaccine.
Beyond medical teams, the goal is to vaccinate 80% or so of the U.S. population by mid-2021 — an effort to spread enough immunity to effectively deaden the pandemic.
That moment alone represents “hope and promise of what lies ahead,” said said Dr. Christina Ghaly, the director of the county’s Department of Health Services, which administrates the county’s system of hospitals.
But even while joining Ghaly to buoy the vaccinations, Spellman warned that they won’t be an immediate answer to long-sought prayers.
“While we now see the light at the tunnel, we have not reached the light yet,” he said. “The pandemic will continue for many, many months after we begin vaccinating people. This is not the time to start ignoring public health advice and recommendations.”
United Teachers Los Angeles called on the Board of Supervisors to implement a strict lockdown for the month of January, accompanied by critical “safety net” benefits to help people disproportionately burdened by the virus — the poor and working class.
As it is, said UTLA President Cecily Myart-Cruz, “while some people are able to stay home to work, the working class and poor people of Los Angeles have to choose between risking their lives or putting food on the table for their families. A shutdown must be accompanied by a financial survival package for workers as well.”
Ferrer didn’t hint at further lockdowns, but she once again urged compliance with county health directives.
“Let’s keep everyone we can healthy and alive until it is their turn to receive the vaccine,” she said. “Instead of debating and undermining, it is time to follow the guidance and directives, because this will save lives.”
If not, Spellman said, the stakes are high.
“L.A. County is moving toward becoming the epicenter of the pandemic,” he said.
Reporters Tyler Shaun Evans and Hayley Munguia contributed to this story.
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