“When you run out of capacity, doctors and bioethicists in these hospitals will need to decide which patients are recoverable – potentially recoverable – and which are not,” explained CNN medical analyst Dr. Jonathan Reiner.
This increase in cases would put Martin Luther King Jr. Community Hospital in Los Angeles in a position to need rationing care, said CEO Dr. Elaine Batchlor on Monday.
“If we continue to see an increase in the number of Covid patients, we may be forced to do something that, as healthcare professionals, we all really hate to have to think about,” Batchlor told Brooke Baldwin of CNN.
At Huntington Memorial Hospital in Pasadena, California, nurses who usually care for one or two patients are now caring for three or four, infectious disease specialist Kimberly Shriner told CNN on Sunday.
“We have a limited number of ventilators, we have a limited number of ICU beds,” explained Shriner, adding that a team including a bioethicist, a community member, a doctor, a nurse and an administrative leader will decide how to share these resources if the case.
“If you don’t have respirators, you don’t have nurses to care for patients, you don’t have ICU beds, we will have to have these terrible discussions with families, so people need to stay home, and when they go out, they need to wear a mask “said Reiner.
Battlefield Screening Techniques
Martin Luther King Jr. Hospital will not refuse patients, Batchlor said, but the team may have to employ techniques that were used in the war.
“We use what on the battlefield is called screening techniques, which is to assess each person’s needs and prognosis and use scarce resources with patients who are most likely to benefit from them,” she said.
The resources are already being used in unconventional ways to accommodate the increase.
“Our team has been incredibly skilled and flexible to accommodate an increasing number of patients, so, as you heard, we have five tents outside the hospital,” said Batchlor. “We have patients in our conference room, in our chapel.”
Many apples are taken to the gift shop, she said.
Although Batchlor did not specify how many new patients have Covid-19, the increase in their numbers is stressing all care.
LA County Health Services Director Christina Ghaly said some hospitals are treating patients who are still in ambulances.
“These patients are being seen and treated in the ambulance as if it were part of the emergency room compartment,” said Ghaly.
US needs to increase vaccines, says expert
So far, about 2.1 million doses of vaccines have been administered in the United States and more than 11.4 million doses have been distributed as of Monday, according to the United States Centers for Disease Control and Prevention.
Another 4.7 million will be distributed by the end of the week, said Assistant Secretary of Health for the United States Department of Health and Human Services, Admiral Brett Giroir. This would bring the total to more than 15.5 million doses “in the hands of the states”.
With doses reaching state leaders, New Jersey hopes to vaccinate some 31,000 long-term care residents by the end of the week, Governor Phil Murphy told a news conference.
“With each passing day, our vaccination program is growing a little bigger and stronger,” Murphy told reporters. “With the New Year, we expect the inauguration of our six mega vaccination sites and the further expansion of our vaccination efforts, and the continued movement through each priority group.”
Despite these developments, Dr. Ashish Jha, dean of the Brown University School of Public Health, said on Monday that the United States is lagging behind countries like Israel and Canada in the pace of vaccination efforts.
“We really have to increase this,” he said. “Things are in crisis.”
Manufacturers like Pfizer have millions of doses waiting to be allocated, he said, attributing this problem in part to the federal government not following through with its administration after the doses are delivered to the states.
“There is a lot of work to get the state vaccine into people’s arms, and we needed a clearer set of plans than the one we have,” he told CNN’s Jim Acosta.
California restrictions are likely to be extended
Already hard hit by the impacts of the coronavirus, Los Angeles County reported nearly 100,000 new cases last week, said LA County Public Health Director Barbara Ferrer.
“The sad reality is that all the indicators show us that our situation can only get worse in the beginning of 2021,” said Ferrer.
Southern California and the San Joaquin Valley are under a regional home stay order, which will expire on Monday. But based on current trends and ICU capacity in these regions dropping to 0%, California Governor Gavin Newsom has announced that the order is likely to be extended.
The state added 33,170 new cases of the coronavirus and 64 additional deaths on Monday. Newsom warned that the slightly lower number of deaths was due to a reporting delay over the weekend.
California Health and Human Services Agency secretary Dr. Mark Ghaly will use Monday’s final data to announce projections based on a four-week period on Tuesday, Newsom said.
California has reported more than 2.1 million cases of coronavirus and more than 24,000 deaths since the pandemic began.
CNN’s Lauren Mascarenhas, Virginia Langmaid, Paul Vercammen, Artemis Moshtaghian, Taylor Romine, John Bonifield, Naomi Thomas, Deidre McPhillips, Jenn Selva, Sarah Moon, Steve Almasy and Holly Yan contributed to this report.