Covid ‘viral tsunami’ floods California hospitals

In April, with California’s coronavirus rates among the lowest in the country, many nurses in the state flew to different parts of America to help with the pandemic. This Christmas, it’s the Golden State hospitals that are desperate.

“You never really know if you’re going to get enough staff,” said Valerie Ewald, who has been a nurse in the intensive care unit at Santa Monica Medical Center at UCLA for almost 20 years.

“It’s a lot of calling, flattering and begging,” she said. “It hit us and in every hospital in California. But the LA area is really being hit. “

California has the highest number of new positive daily cases in the U.S. – an average of more than 40,000 cases per day during the past week, with about 250 average daily deaths over that time. On December 23, it became the first U.S. state to exceed 2 million known positive cases – with the second million cases coming in just the previous six weeks, versus 10 months for the first million.

The crisis is particularly acute in Southern California, where, at the time of this writing, there were no ICU beds available. In LA County, the most populous in the country, the death rate over the past seven days averaged more than three an hour.

“It’s a viral tsunami,” said Robert Kim-Farley, professor of epidemiology at the School of Public Health at UCLA Fielding and a former senior official in the LA Department of Public Health. “It is much bigger than what we experienced before”.

Line chart of continuous average new deaths over seven days, Los Angeles County, showing that Covid fatalities are increasing in LA

The difference, he suggested, was the combined effects of complacency, economic despair and the flood of family-oriented holidays at the end of the year: Halloween, Thanksgiving, Hannukah and Christmas.

Although the number of new daily cases in the state is more than 20 times greater than when the blocking orders were first applied in April, Californians’ fear of the virus is considerably less than it was at that time, according to the Center for the University of Southern California. Social and Economic Research, which conducts a biweekly survey to assess attitudes towards the pandemic.

“People [in California] they were less sensitive to rising case rates, less sensitive to risk than at the beginning of the pandemic, ”said Kyla Thomas, a sociologist at the center, although she noted that researchers observed the same pattern in most parts of the country.

Data from December 22 suggested that the average perceived chance of contracting the coronavirus among Californians was 23 percent, while it had been 30 percent in April. The perceived average chance of dying from Covid-19 dropped to 16 percent, from 29 percent earlier this year.

In LA County, the survey also suggested that nearly a third of respondents visited a friend, neighbor or relative in the past week – or were visited by others.

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“If the survey is representative of LA County residents,” said the health department in a statement requesting adherence, “more than 3,000,000 residents are not following security guidelines that tell us not to meet with people out of our immediate home ”.

As California sought to increase treatment capacity, nursing unions resisted state efforts to loosen minimum requirements for the number of nurses per patient, a measure that doctors said would significantly worsen the quality of care and put nurses in even greater risk. The California Nurses’ Association had held strikes against the move, and several hospitals reversed their planned changes.

More than 60,000 health workers in the state have contracted Covid-19, according to the California Department of Public Health, with at least 240 deaths.

“Nurses are together, always, and we are never afraid,” said Mendy Baxter, a Texas emergency room nurse who has been working in California since February, first in San Antonio and most recently in Salinas. The hospital where she works – Natividad Medical Center – erected tents outside the main building to care for the sick.

“It’s all we can do just to keep our heads above water,” said Baxter. “The hospitals are full, the beds are full, there is nowhere to move patients after you receive them and start taking care of them.”

According to Aya Healthcare, one of the main national “travel nurses” contractors, on December 21 there were 4,390 nursing vacancies open in California, by far the largest number in the country. Nationally, the number of vacancies for “crisis” positions increased by more than 90 percent last month. Compared to this time last year, the number of vacant nursing positions is almost 200 percent higher.

With state availability of ICU beds at Christmas at just over 1 percent, Gavin Newsom, governor of California, looked further, in countries like Taiwan and Australia, to find intensive care nurses, drawing on the relationships created by its other crisis of 2020 – forest fires.

Other measures by the governor included emergency training – in just two days – to bring nurses from other disciplines to the ICU. This raised even more concern among nursing groups, who argue that the lack of staff was a “fabricated crisis”. Hospitals were accused of dismissing nurses and cutting contractor salaries during the “quieter” months of the pandemic.

Looking at the new year, Mr. Newsom said during a press conference that the vaccination efforts left him “excited by the light at the end of the tunnel, but aware that we are still in the tunnel”. Just over 70,000 people in California – mostly health care workers – received a coronavirus vaccine on December 21.

Much of the state will be commissioned to stay home in 2021. To deter travelers, some popular escape destinations have excluded tourists. In Tahoe, a region of northern California that is often filled with skiers at Christmas, local authorities have imposed additional restrictions on accommodation, requesting Airbnb’s short-term rental service to inform guests of their home stay request. Airbnb said it informed the hosts of the guidelines, with any actions or refunds at the host’s discretion.

Among those who had to cancel their trip to Tahoe was Josh Larney, who lives in Oakland and works at WeWork. There were “definitely frustrations around the cancellation,” he said, “but that was the story of 2020”.