While new COVID-19 hospitalizations have recently leveled off in Los Angeles County, many medical facilities remain overwhelmed. The intensive care unit at one South Bay hospital, Memorial Hospital of Gardena, has 320% occupancy, officials said Wednesday.
The 172-bed medical center has been at various levels of ‘internal disaster’ since March, and the latest coronavirus surge is manifesting in worrying but increasingly well-known ways – including shortages of oxygen supplies slowing the release of many COVID-19s. patients and to keep beds busy.
According to hospital spokesperson Amie Boersma, the demand for oxygen within the hospital has also skyrocketed.
“The delivery of oxygen in large quantities went from once a month to every three days and became narrower,” Boersma said in an e-mail. “We have to monitor every day.”
But it is the shortage of staff that presents the biggest challenge. In a region besieged by COVID-19, “it remains very difficult to find enough ICU nurses,” Boersma said, adding that the hospital is looking for travel nurses from across the country and has also requested nursing resources from the National Guard.
While the hospital waits for extra help, it has implemented a team structure that enables staff from closed wards, such as outpatient surgeries on the same day, to facilitate workload and enable ICU nurses to focus on key tasks.
The hospital also uses advanced registered nurse practitioners and medical assistants to supplement the 10-bed ICU and emergency departments and offer a different set of hands and eyes, ‘said Boersma, along with the final-year nursing students to serve as nursing assistants.
Nearly two dozen patients in need of intensive care are also being treated on the telemetry floor and in recovery rooms, she said.
And although ambulances with critically advanced life-support patients are being diverted because most require ICU admissions, Boersma said the request for diversion could do just as much.
“When most hospitals are diverting ALS, no one is diverting,” she said.
LA County hospitals reported an average of 750 to 800 new COVID-19 hospitalizations per day – an astonishing number that have remained largely steady since Christmas Eve. The count has led to the ICUs effectively over capacitying, and hospitals’ mortuaries being so full that the National Guard has been called in to help move corpses to the country’s coroner’s office until funeral homes and mortuaries can work through the backlog.
The fear still exists that new hospitalizations may rise again, due to transfer during the winter holidays. If that were to happen, LA County hospitals would have to provide rations, which would have to activate teams of triage officials who would have to decide which patients get nurses, respiratory therapists and access to ventilators, and which patients get palliative care while they die.
Dr. Christina Ghaly, the director of health services in LA County, said the number of hospitalizations has flattened slightly over the past few days – just under 8,000.
“Although it did not increase at a rapid pace, they equalized a pace that is really unsustainable,” she said during a briefing on Wednesday. “This high plateau does not leave enough beds to care for patients.”
This is especially the case, Ghaly said, because the country has yet to determine the full consequences of potential exposure after holidays. She warned that any increase in the transfer “would be absolutely devastating for our hospitals.”
“To meaningfully relieve healthcare providers, we need a rapid decline in hospitalizations for a minimum period of one to two months,” she said.
The province still reports an unusually large number of new infections – averaging more than 15,000 a day – and officials say a portion of those tested positive will always need hospital care two to three weeks later.
As of Tuesday, the most recent day for which full state data is available, there were 7,906 coronavirus-positive patients hospitalized in LA County, with 1,699 intensive care units.
Although both of these figures have remained relatively similar, or even declined slightly, Ghaly stressed that they ‘remain unprecedented in the course of this pandemic in LA County, and everyone should remain concerned about what might happen’ if they continue.
Any optimism should also be based on the fact that the transfer to the holiday remains unclear, she added.
“If our numbers are still that high, and even some are rising, it promises to be very bad for hospitals,” said Barbara Ferrer, director of public health in LA County.
Unless conditions improve, Ferrer said it is possible the province will pursue further restrictions – especially in light of the looming threat of the new variant of the coronavirus first detected in the UK and which is even more contagious be considered.
“We are currently considering all options,” she said. “We are very, very concerned about the sustained number of cases and feel that there is not a big window here to get the boom under control.”
According to her, the interests are literally life and death – and all Angelenos must double their efforts to protect themselves.
“Pretend your life or the life of a loved one depends on it,” she said. “Because it just may.”