LOS ANGELES (Reuters) – Strict home requests were renewed indefinitely on Tuesday for much of California, a major focus of the COVID-19 pandemic in the United States, as the state’s top health official said that many hospitals were on the brink of crisis.
Severe restrictions imposed earlier this month on social and economic life have been extended in densely populated southern California – home to more than half of the state’s 40 million people – based on data showing that intensive care units are likely to remain busy or close to capacity for weeks to come.
Home stay orders, among the strictest in the United States, are also being renewed in the agricultural heartland of the San Joaquin Valley, whose hospital ICUs have also remained weeks with little or no sleeping space.
California Health and Human Services Secretary Dr. Mark Ghaly said Los Angeles County, the most populous, has been hit particularly hard by weeks of infections and hospitalizations.
At least 90 percent of county hospitals, he said, were overwhelmed with the flow of COVID-19 patients who were forced to divert emergency patients to other facilities for much of the day over the weekend.
No hospital has yet formally notified public health officials that they have gone so far as to operate on the basis of “crisis care”, involving wholesale rationing of medical treatment and supplies for the sickest patients, said Ghaly.
However, he added, “some hospitals in Southern California have implemented some practices that would be part of crisis treatment,” such as assessing “the effectiveness of certain treatments for certain patients who are unlikely to survive or be well.”
Ghaly said he was not aware of cases so drastic as to require doctors to choose, for example, between two patients who needed to be placed on a ventilator when only one was available. But he said that hospital managers are doing everything they can to prepare for deteriorating conditions in order to avoid such dire scenarios.
“We could see the worst in early January,” he told reporters in an online interview. “And most of the hospital leaders I spoke to in Southern California are preparing for just that.”
The gloomy projections are based on expectations that many individuals will continue, as they did, to ignore public health warnings and orders to avoid crowds and unnecessary travel for the remainder of winter holidays, fueling new spikes in coronavirus transmissions.
Authorities want to prevent the state’s health care system from shrinking as much as possible until the recently approved COVID-19 vaccines can be made widely available to the public in the spring.
Residents under stay-at-home orders are required, for the time being, to remain largely indoors and avoid travel, except when necessary for permitted activities such as grocery shopping, medical appointments, individual outdoor exercises and dog walks .
Restrictions have also been imposed on a range of commercial activities, with restaurants limited to delivery and pick-up service and bars closed completely.
Orders can be suspended once projections show that a region’s available ICU capacity will reach at least 15%.
The San Francisco Bay area and the greater Sacramento are under the same restrictions, with ICU capacities around 10% and 19%, respectively. They each come for their first three-week review at the beginning of next month.
Steve Gorman reporting in Los Angeles; edition by Grant McCool