Coronavirus patients overwhelm many emergency rooms and intensive care units in Los Angeles County, and hospitals are seeing ripple effects affecting surgeries and care in the medical network.
With 700 nurses from primary care clinics being diverted to hospitals and other critical needs, provincial officials have to temporarily close five public primary care clinics across the province and reduce most other hours, providing children with vaccinations and managing people with chronic medicine.
“We kept a skeleton crew to keep working in our outpatients,” said Dr. Christina Ghaly, director of health services in LA. “But overall, our capacity for outpatient services is much less than in normal times.”
This means that patients with chronic illnesses are at greater risk of going to the emergency room if they become more seriously ill due to the lack of outpatient care.
“But in the absence of sufficient staff to care for our inpatients, we do not have a better option,” Ghaly said.
Paramedics now regularly decide to transport non-critical patients to overcrowded hospitals, hoping to make room for the needy. This forced people who would otherwise go to the emergency room to seek other care.
Hospitals are scrambling to find staff. Sometimes medical technicians are asked to work in hospitals. Older hospitals are being rebuilt to accommodate more patients than they ever expected.
Patients who choke on their inflamed lungs need oxygen to the extent that some hospitals have the adequate air pressure needed to maintain a high flow rate for oxygen delivery. “It’s a problem to get too little oxygen and oxygen tanks,” said Cathy Chidester, director of the LA County Emergency Medical Services Agency.
A chronic shortage of oxygen tanks is a problem for hospitals trying to discharge COVID-19 patients as quickly as possible as they often have to be sent home with oxygen tanks.
“There are just as many oxygen equipment and suppliers doing this supply of oxygen therapy,” Chidester said. It was also difficult to transfer patients from smaller hospitals that need more specialized care to larger hospitals that can better care for patients suffering from things like trauma, heart attacks and strokes, she said.
Sometimes there are no beds available in hospitals that are better equipped to handle such patients.
“We’re experiencing extreme conditions in LA County,” said Barbara Ferrer, director of public health in LA County. “Our hospitals remain overwhelmed. As more and more people are rushed to hospitals, the tragic fact is that hundreds more people will die from COVID-19 every week. Unfortunately, these trends will continue until January. ‘
On Friday, California reached two more milestones, surpassing 2.3 million cumulative cases of coronavirus and more than 26,000 cumulative COVID-19 deaths.
But there was still some hopeful news on New Year’s Day. For the first time in 50 days, the net number of people admitted to the COVID-19 hospital in CO County has declined – albeit by only one.
On New Year’s Eve, there were 7627 COVID-19 patients hospitalized in LA province, lower than 7628 the previous day, according to data released Friday. New Year’s Eve broke a consecutive 32-day daily series of record-breaking COVID-19 hospitalizations in LA County.
During the past seven days, LA County added a net additional 122 new COVID-19 patients to its hospitals, a slower pace than that between December 16 and December 22, when an average of 234 new COVID-19 patients were admitted to the hospital. is. daily.
The slower increase in daily patients is a sign that the stay-at-home order has had an impact in Southern California for nearly four weeks.
“There is no doubt in my mind that if we did not have the home order, the situation would be much more dire than it is now,” said Dr. Robert Kim-Farley, medical epidemiologist and expert in infectious diseases at UCLA, said. Fielding School of Public Health.
“I think, however, that the magnitude of the numbers shows that many people prefer to ignore it in the face of the stay-at-home order, and without it being strictly enforced, this mixing of households and parties continues to take place,” Kim said. -Farley said.
Kim-Farley said the number of trips spotted during Christmas and New Year will soon be reversed, Kim-Farley said, adding that he expects the number to start rising.
Kim-Farley said LA County is in the midst of a ‘viral tsunami’, but ‘we should not be frozen in despair because we can do nothing.’
ICUs are still being hit hard so far. There was a net additional 38 critically ill patients entering the LA County ICUs daily last week, only slightly better than December 12-18 when a net average of 44 critically ill patients was added daily.
Hollywood studios have begun responding to a plea from LA County health officials to consider suspending film productions due to the catastrophic increase in disease.
ABC Signature and 20th Television will delay the resumption of production of 16 programs in LA by at least a week later from the earlier plans, according to a source close to production who did not want to be named.
These productions include ‘911’, ‘911: Lone Star’, ‘American Crime Story: Impeachment’, ‘American Horror Story’, ‘American Housewife’, ‘Big Shot’, ‘black-ish’, ‘Grey’s Anatomy’, “Last Man Standing,” “Love, Victor,” “Mayans,” “Mixed-ish,” “The Orville,” “Rebel,” “Station 19” and “This is Us,” the source said. A Disney spokesman declined to comment. Productions will resume on January 18 at the earliest.
Universal Television is extending its holiday break in six shows by at least a week.
Production on five shows – NBC’s “Mr. Mayor, ” Kenan ‘and’ Good Girls’, ‘Hacks’ from HBO Max and’ Never Have I Ever ‘from Netflix – will resume on January 11, instead of January 4, according to a person close to production, who did not want to be named. Production on NBC’s “Brooklyn Nine-Nine” will resume on January 18, the source said, who was not authorized to comment.
CBS Studios delayed the resumption of production by a week until January 11 on some of its shows.
Sony Pictures Television has postponed the resumption of production on ABC “The Goldbergs” and Netflix’s “Atypical” by a week until the week of January 11, to accommodate additional tests, according to a person close to production who did not want to be nominated does not become. “Danger!” and “Wheel of Fortune” will resume on Jan. 11 as originally planned, the person said.
Bunches of coronavirus infections have been identified among workers at three Warner Bros. productions in Burbank – on the set of ‘Lucifer’, ‘The Kominsky Method’ and ‘Young Sheldon’. In total, 35 people tested positive as part of the clusters of infections, according to data released by the LA Department of Public Health.
An additional 45 positive cases of coronavirus have been identified, according to provincial data at the CBS Studio Center in Studio City. Twenty-three cases of coronavirus were identified among workers at NBC Universal in Studio City and Universal City, as well as nine cases of coronavirus among staff at Netflix Productions’ office in Gardena.
As more deaths occur in LA County, there are some worrying trends. A greater percentage of people in LA County die from COVID-19 without having any underlying health conditions, Ferrer said. Earlier in the pandemic, more than 90% of those who died had underlying health conditions; now 86% of those who have died have underlying health conditions.
“There are more people than ever who are not only deceased but also without any underlying health conditions,” Ferrer said.
The threat to relatively young adults was hammered nationwide this week when Luke Letlow, who was elected to become Louisiana’s newest Republican member of the U.S. House, died Tuesday night of complications related to COVID-19, just days before taking office was sworn. Letlow was 41 and apparently had no underlying health conditions.
In Los Angeles County, the ripple effect is seen at many medical facilities.
According to the memoranda issued by the EMS agency, the province has allowed certain types of ambulance patients to be dropped off in the waiting room instead of in the emergency room.
In addition, 911 patients who have guidelines for not resuscitating will not be taken to acute care facilities such as a hospital, nor will certain trauma patients whose hearts have stopped.
The agency also allows emergency medical service providers not to take low-risk patients to hospitals with mild respiratory illnesses.
Many morgues in the hospital are now filled with corpses, and officials are trying to bring them into a temporary storage area at the office of the medical investigating officer. The morgue also has no more space and grieves families away. Single-day COVID-19 death records were broken every day for the last three days of the year, with 242 deaths reported Tuesday, 262 on Wednesday and 291 on New Year’s Eve.
It is worrying that the daily rate at which the coronavirus test results return positive has climbed to 22%, more than five times higher than from November 1, when it was less than 4%.
“This high positivity rate remains worrying and tells everyone that the coronavirus is very common and persistent in all corners of the country,” Ferrer said.
Provincial officials said Thursday that prolonged delays in dropping off patients in the critically overcrowded Los Angeles County hospitals no longer enable ambulances to respond to other emergency calls.
Sometimes as many as ten ambulances stand in line to wait to deliver patients, and ‘we waited for patients in ambulance bays [emergency departments] for seven hours, eight hours, ”said the EMS agency’s Chidester.
At Providence Holy Cross Medical Center in Mission Hills, patients are treated in places that do not normally house beds, such as the gastrointestinal laboratory, the outpatient clinic for surgeries on the same day and even at the end of the aisles, on the intestines. through privacy curtains.
“It’s pretty bad,” said Jodi Hein, the hospital’s head nurse. “We have two additional hearses that we have not had to use before.”
The hospital was short of 12 registered nurses on Wednesday due to the abundance of patients. The nurses who usually care for patients coming in and out of surgery and elective measures – which have already been canceled – have spread to other units, Hein said.
Due to a shortage of phlebotomists, nurses also helped draw blood throughout the hospital. The ICU itself has been short of nurses for several weeks, Hein said. But besides COVID patients, the ward is also typical of traumas. Within ten minutes, two trauma patients in need of blood transfusions arrived on Tuesday. Another was admitted for a stroke, another for a heart attack.
“We get into the emergency department very easily, especially now,” Hein said.
Hein released patients earlier than they would normally do to make room for new patients. A patient can stay in the hospital for an additional eight hours during normal hours for more tests and consultations, but doctors plan this for later dates if it is not urgent.
Because visitors are not allowed in the hospital, even during the holidays, doctors helped patients connect with their families via iPads – usually the work of chaplains, who were busier than ever before.
“Everyone is just exhausted,” Hein said. “But we make it, we do it, and I think the staff is just really trying to be as positive as possible.”
Times authors Andrew J. Campa and Wendy Lee contributed to this report.