Hospitals in Los Angeles County lost a battle on Tuesday to stay ahead of the coronavirus outbreak, as the number of COVID-19 patients admitted to the hospital was more than 8,000 and the nationwide coronavirus mortality rate has dropped recently week increased by almost 1,300.
LA County has reached another alarming milestone and has surpassed 11,000 deaths since the start of the pandemic. Officials have warned that conditions will only worsen in the coming weeks as people who become infected during the holidays become ill and need medical care.
“It is becoming increasingly difficult for health professionals to look at the hospital with gunshot wounds, heart attacks, strokes and injuries due to car accidents,” said Hilda Solis, supervisor in Los Angeles. “Hospitals declare internal disasters and must open church gyms to serve as hospital units.”
Over the past week, LA County has averaged 183 deaths per day COVID-19 – the equivalent of one every eight minutes – and 13,500 new coronavirus infections, which are expected to increase after the holidays with the reopening of test sites. The cumulative number of coronavirus cases in the country is now 841,000.
Hospital staff remain stressed across the country, and officials have warned that the quality of care is at stake. More than three-quarters of the patients in ICUs have COVID-19.
Christina Ghaly, director of health services in LA County, told the provincial board of supervisors Tuesday that all hospitals have a large number of staff members who are unable to work because they are in isolation or under quarantine.
Another major problem is discharging patients quickly. Across the four provincial hospitals, about 10% of hospital patients no longer need hospital care, but ‘we have a number of problems and delays in moving it out’ to lower levels of care institutions, such as nursing homes, Ghaly said.
Some nursing homes refuse patients from hospitals; Sometimes patients do not want to be moved to a lower level of care, and the law prohibits the movement of a patient unless the person agrees to it. Skilled nursing homes and other areas that can offer lower levels of care have their own staff shortages, which limits the number of patients they can take in.
Dialysis centers are also starting to struggle with staff shortages, and there are not enough outpatient dialysis resources available right now. This causes problems because hospitals cannot discharge patients from hospitals if there are not enough outpatient dialysis chairs available to accommodate them. Dialysis facilities also send patients to the emergency room to receive coronavirus tests rather than perform the tests on-site at the dialysis center, Ghaly said.
It was also difficult to find portable oxygen containers needed to send patients home from hospitals that still needed oxygen treatment. There is a shortage of containers needed to transport oxygen through the hospitals and store it in tents used to care for patients.
Like facilities in California, the provincial hospital system is struggling to find temporary medical staff to fill the shortage of staff. The provincial hospital system has increased its wage offer to recruit medical staff and submitted requests for assistance to the state.
So far, the land system has received 36 contract nurses from the state and expects two medical teams of 20 people from the U.S. Department of Defense, which will be deployed at the Harbor-UCLA Medical Center near Torrance and LA County-USC Medical. Center on the east side this week.
Five private hospitals in LA County will also receive federal health teams to support medical staff, Ghaly said.
The largest source of additional staff in the hospital comes from the outpatient clinics in the country.
The province has closed five of its public outpatient clinics and reduced the hours and services for the rest, diverting more than 800 nurses and other staff to work in emergency departments and quarantine and isolation areas for people with COVID-19 or who have been exposed to the virus.
The provincial hospital system has already ordered more fans, BiPAP machines and more high-flow oxygen devices – all devices designed to breathe patients – and officials do not believe there will be a problem for the devices in the coming weeks, Ghaly said.
Two of the provincial hospitals had problems delivering oxygen in the hospital to their patients, Ghaly said. Olive View-UCLA Medical Center in Sylmar has resolved its issue of oxygen freezing in its pipes; Harbor-UCLA Medical Center still has a problem with the flow of oxygen through its pipes. It does not create urgent issues for patient care at Harbor-UCLA, “but it does offer some limitations in what physical spaces within Harbor we can use to keep patients,” Ghaly said.
Amid the already overwhelming boom, California faces another potential threat: the presence of a new coronavirus variant, which grew rapidly in England, which according to some scientists is more likely than the conventional version to infect people exposed to it.
Although it is unclear how common the variant is throughout the country, San Diego health officials reported Tuesday 24 additional confirmed cases and four probable cases. This increases the total number of known or suspected infections by the variant virus to 32.
The two dozen newly infected patients “apparently have no travel history and come from 19 different households, but the investigation and contact tracing continues,” according to a statement from San Diego County officials. Those infected are geographically widespread and range between 10 and 70 in age.
The variant was also identified in two people from the same household in Big Bear in San Bernardino County.
Experts believe that there is no evidence that the variant, known as B.1.1.7, is likely to cause death, serious illness or vaccines less effectively once infected with someone. But any increased risk of infection is unwelcome news, especially in areas that are already declining due to the high levels of coronavirus transmission.
Although LA county officials have yet to document the presence of the variant, “it’s a scary thought ‘to have a virus that can infect more people faster than we see today,” the provincial director of public affairs said. health, Barbara Ferrer, said Tuesday.
Although many of the infected experienced only mild or no symptoms at all, California health officials warned that a significant portion, about 12%, would be sick enough to be hospitalized within a few weeks of being exposed. Twelve percent of the people admitted to the hospital end up in the intensive care unit.
A significant and sustained wave of new infections will therefore always strike hospitals with extra patients.
Government officials have asked hospitals to draw up a plan in which they must present ‘crisis standards for care’, in which the most serious form of disaster has arrived at the hospital and, in the worst case, forced certain supplies, therapies. and staff to be rationed.
In such a situation, it is necessary to prioritize the time of highly trained staff – such as respiratory therapists, ICU nurses and critical care physicians – to keep so many people alive. This means that those who are less likely to survive may not receive the same care they would otherwise have had.
According to a state note issued in June, in a situation where there are severe shortages of medical resources and a patient has a poor immediate survival prognosis, healthcare providers may need to decide to provide palliative care aimed at relieving patients when they die, rather than improving their prognosis.
When deciding who should be eligible for ICU admission or have access to a ventilator, patients who are likely to survive with such care will be given preference.
A hospital-appointed triage officer is expected to make decisions to benefit patient populations, “although these decisions may not necessarily be in the best interests of some individual patients,” according to the memorandum.
The LA County Department of Public Health said Tuesday night that no hospital has formally declared to the state that they operate under ‘crisis standards of care’.
Andrea Roberson, author of Times, contributed to this report.