LOS ANGELES – For Dr. Anita Sircar, specialist in infectious diseases, there are no breaks and a few days off.
A relentless increase in cases of Covid-19 has burdened Southern California hospitals and intensive care units for most of December, after public health officials have warned for weeks that people should avoid meeting with people outside their homes. homes during the holidays.
Yet millions of Americans desperate to reconnect with loved ones and restore a sense of normalcy ignored Thanksgiving warnings. As a result, coronavirus cases increased and the ICU capacity decreased.
“It’s relentless,” said Sircar, speaking on the phone between patient visits and medical meetings at the Providence Little Company of Mary Medical Center in Torrance.
State public health officials recently extended modified home requests to regions hardest hit by the increase, including southern California and the San Joaquin Valley, where ICU capacity has been at 0 percent for several weeks.
Hospitals have built makeshift ICUs and sometimes take patients to gift shops or pediatric wards to care for the sick and dying. In Providence, a tent was erected in the parking lot to accommodate patients who were full when the time came. And the time will come, said several medical professionals working on the front line of the pandemic.
“We are on that wheel that keeps turning,” said Sircar. “It’s a revolving door that doesn’t stop.”
Across southern California, hospitals and their staff are forced to make tough decisions as the Covid-19 wave continues to hit the devastated region.
California recorded more than 2.2 million cases of coronavirus and 25,000 deaths. In Los Angeles County, where 10 million residents live, public health officials recorded about 756,100 confirmed cases and more than 10,000 deaths.
In Los Angeles County, one person dies every 10 minutes in Covid-19, public health officials say. More than 7,400 people were hospitalized with Covid-19 on Wednesday. The data were released just hours after Governor Gavin Newsom revealed that a potentially more contagious variant of the coronavirus had been found in Southern California.
Los Angeles County Public Health Director Barbara Ferrer said in a statement: “Our healthcare professionals are overwhelmed with patients with Covid-19 and this current path of increasing hospitalizations for Covid-19 is not sustainable.”
However, medical professionals must continue, even when the increase reaches an emotional and mental tribute to frontline workers.
For ICU nurse Lindsey Burrell, who works at the Providence hospital with Sircar, trying to reconcile family life with professional life sometimes means repressing her pain and anxiety after seeing patients die day after day.
Often, Burrell turns on the music in the car while driving home just to clear his mind and prepare for the transition from nurse to wife and mother. Before entering the house, she sits in complete silence and tries to get rid of what she saw that day.
Three years ago, Burrell underwent cardiac surgery and suffered a stroke shortly after the birth of his first child. Because of his comorbidities, Burrell maintains a strict regime of taking off his protective gear before entering his home, immediately throwing everything he wore in the washing machine, taking a hot shower and gargling with Listerine as an added precaution.
“We suffer silently,” she said. “I don’t even know how to put into words what I see and what I feel sometimes. It’s something you’re not prepared for on any level.”
Burrell knew when she became an ICU nurse that she would see death and families suffering unexpected losses. But she never expected to see the “inhuman” nature of Covid-19.
Many of his sickest patients are intubated, lying face down on their stomachs, with one arm stretched up and the other down to help clear the airway. Intravenous tubes and drops extend through their bodies, while dialysis machines help to filter the blood. When a patient’s heart stops, a team of doctors and nurses gets dressed in protective gear before entering the room. Sometimes Burrell needs to call his loved ones to ask if they would like to use Zoom or FaceTime to say goodbye.
“Patients are scared to death,” she said. “They beg for their lives. They know they are going to die. It separates us.”
Burrell has not been able to shake off the recent death of a beloved grocery worker known to many in the seaside community where she works. The man had been removed from the respirator and appeared to be awake, giving Burrell hope to survive. One day, just before Christmas, Burrell came into his room and took his hand. She begged him to keep fighting. He gave her a thumbs up.
“I could see the desperation in your eyes,” she said.
To deal with the pain, Burrell relies on co-workers who understand what it is like to fight for people’s lives, only to hear about their deaths days later.
“We can’t take much more,” she said.
At the beginning of the pandemic, Sircar made the difficult decision to move out of the house she shared with her mother, for fear that she would hire Covid-19 and not survive the devastation. Sircar has since lived in a rented unit near the hospital, a block from the Pacific Ocean. She hasn’t been to the beach ever since she moved.
“I don’t socialize outside of work,” she said. “It’s basically just an apartment, hospital, apartment, hospital. After a while, you forget that there is life outside.”
Sircar normally works 12-hour shifts and takes only four days off per month. Before the pandemic, she treated about 12 patients a day. It is now close to 27, and many die.
“It hasn’t stopped since Thanksgiving,” she said. “The virus is not out of control. People are out of control.”
Of those on his current patient list, Sircar estimates that more than half attended major Thanksgiving meetings. A 31-year-old woman told Sircar that 30 people were at a dinner she attended. Seventeen people later tested positive for Covid-19 and at least one is struggling to survive.
Sircar’s patient was discharged after several days and said that she regretted attending the Thanksgiving dinner.
Across the county, in the Boyle Heights neighborhood of Los Angeles, the Adventist Health White Memorial Hospital emergency department is already full, but still accepts patients. Dr. Juan C. Barrio, director of the hospital’s internal residency program, said that residents are so overwhelmed that medical assistants are forced to increase their patient lists.
“This is completely unprecedented,” he said. “We have enough fans, but patients in the ICU are getting sicker and in critical condition.”
Improvised ICUs are emerging across Adventist Health to accommodate the increase in patients, including the former cardiac care unit. Barrio described the indoor scene as a “mess of PPE and activity”, with some emergency room patients being treated in the corridors.
On Tuesday, Dr. Mark Ghaly, the state secretary for health and human services, said that some Los Angeles hospitals are turning to “crisis care” and preparing for a more dangerous increase in coronavirus, which is likely will get worse after Christmas and New Year. Ghaly said that while the Thanksgiving peak positivity rates appear to be stabilizing, this does not appear to be the case in Southern California.
“We have not yet heard that a hospital is at the point where they need to make a decision between two patients who need a ventilator and have only one ventilator,” he said, adding that some hospitals do not have space to discharge ambulances or oxygen for patients .
State officials have notified hospitals this week that they must prepare for the possibility of having to resort to “crisis care” guidelines, which would allow rationing of treatment when staff, drugs and supplies are scarce.
The Cedars-Sinai Health System, arguably the most famous hospital in Los Angeles, issued a “crisis alert” on Wednesday, pleading with its patients not to meet on New Year’s Eve.
“We know that these recommendations are challenging, but it is important to remember that the actions you take in the coming days can help protect you, your family and loved ones – and those who are fighting for their lives in our hospital beds now,” hospital said. “Compliance is crucial if we are to prevent what is already a public health emergency from becoming even worse.”