The astronomical increase in coronavirus in Los Angeles has infected thousands of health care workers in recent weeks and exacerbated the pressure on hospitals struggling to care for critically ill patients.
More than 2,200 people working in hospitals in LA County tested positive for the virus in December alone, making up about a third of all hospital infections reported during the pandemic. While in the previous months, nursing homes and outpatient clinics suffered most illnesses, the besieged hospitals and their besieged workers were most affected by the winter surge.
Dr. Anish Mahajan, medical director of the Harbor-UCLA Medical Center in Torrance, said that providing adequate staff for his hospital – where the ICU is expanded to 150% of its normal capacity – is a constant challenge, with staff outside because they are patients with COVID-19 or quarantine due to exposure. Hospitals across California have reported similar trends.
“Whoever uses PPE perfectly and deals with high-risk patients is not sick at work. … When they get home, your child can give them COVID. We see that a lot, ”said Mahajan. “We ended up with a shortage of staff at everything, from nurses to doctors and even the custody team that helps us deliver the rooms. And all this makes it even more difficult to face a violent attack from more and more patients. “
The recent coronavirus explosion has trapped LA hospitals in a vicious cycle. The more people are sick, the more likely it is that other people will become infected, both on and off the job. This, in turn, intensifies staff shortages in hospitals – just when the public most needs medical care.
Outbreaks have also increased dramatically in recent months among grocery store workers and retailers and elsewhere. But the rise in infections comes at a crucial time for LA hospitals, as they fold under a deluge of patients and refuse ambulances, line corridors with stretchers and bodies huddled in overflowing morgues.
Authorities reported on Tuesday that a record 7,898 people with COVID-19 were admitted to hospitals in LA County, a total record that is expected to grow in the coming weeks.
“We will continue to work with organizations across the county to ensure that healthcare professionals everywhere are protected,” said director of the LA County Department of Public Health, Barbara Ferrer, this week.
Since the start of the pandemic, 28,448 health workers and first responders have tested positive for coronavirus in LA County, and 132 have died of the virus, Ferrer said. Hospitals, nursing homes and outpatient clinics are responsible for most cases.
Infections among healthcare professionals increased as general cases increased. In a single week in mid-December, when LA County reported more coronavirus infections than ever before, 2,363 health workers and first responders fell ill with COVID-19, compared with 360 two months earlier.
Hospitals are where these problems get worse. Nurses and doctors are overwhelmed while COVID-19 patients invade hospitals, and the staff themselves have the disease, said UCLA emergency room nurse Márcia Santini.
“We have COVID which is on the rise and we have a very sick population – in addition, we have a personnel crisis,” she said. “All of this combined is putting real stress on these facilities.”
Santini fell ill with COVID-19 last month, although he is not sure how he contracted the virus. She took care of patients with COVID-19 before falling ill, but her husband had symptoms before her, suggesting that he caught the virus at work and then passed it on to her.
Her illness became so severe that she was unable to breathe and was admitted to the hospital for several days. Almost three weeks later, she is easily tired. “I’ve never been through anything like this,” she said.
At Kaiser Permanente San Jose Medical Center, at least 43 employees recently contracted the coronavirus, including one who died, part of an outbreak possibly related to an employee who wore an inflatable hospital vacation costume to lift their spirits.
In Fresno County, where only 11 ICU beds remained available on Tuesday, a recent wave of health workers who fell ill or needed to stay home due to exposure to the virus has hampered hospitals’ ability to treat patients, the official said. interim Dr. Rais Vohra.
“We have hundreds of people outside who would otherwise be working in our hospitals,” said Vohra. “There are so many cases going on, whether it’s a health professional who is sick or a relative who is sick, that really affects our ability to provide care because that person then has to take time off.”
Unlike spring, when the lack of personal protective equipment and fans was the most urgent problem, concerns during this latest increase focused mainly on personnel. The US Department of Defense is lending combat doctors and nurses to help hospitals across California.
LA County officials have relocated some 800 clinical nurses to work in their public hospitals, while other local hospitals have recruited doctors and nurses from other departments to assist in the ICU, although with varying success.
“To be honest, you are comfortable in your field of knowledge and when you are placed elsewhere, you are a fish out of water,” said Dr. Frank Candela, who is on the West Hills Hospital executive medical committee. “People are spread out. They are persevering. They are adapting, but it puts a lot of pressure on the person who does it, as well as on patient care ”.
Many health professionals cited the emotional damage of seeing not only seriously ill strangers, but also their own colleagues hospitalized with the virus, or even killed by it. Candela said Ernesto Ruelas, a hospital environmental services worker, died this week from COVID-19. “We missed him very much,” said Candela.
For the most part, employees who fall ill with COVID-19 are believed to have contracted it outside the hospital, he said. But it was not always so.
In an unfortunate summer incident, COVID-19 infections were transmitted among employees who spent time together in the break room, often without masks and distance, he said. This outbreak eventually spread to patients, too, he said.
Candela said the hospital started taking breaks so that people would not have lunch at the same time and now prohibits bringing food to share with others. But he said he hoped his hospital experience would show the public that even small lapses can have devastating consequences.
“We kind of learned the lesson the hard way: that we can’t let our guard down,” he said.
This gloomy moment in the pandemic is eased by ongoing vaccinations, health professionals say.
The first people vaccinated in California will receive their second dose this week, which offers 95% immunity to coronavirus. With that protection, hospitals will eventually have fewer staff, said Mahajan.
“Now is the worst time, because the vaccine has not been released long enough,” he said. “But that will become less and less problematic as January days and weeks pass.”
Mahajan warned his team that the extreme increase will continue for at least another five weeks. LA county officials said this week that they expect the number of people hospitalized with COVID-19 to grow by at least 1,000 in the next two weeks, although only about 20 ICU beds are available.
“One of the things I tried to say to our team when we entered the Christmas holiday is that we are on break,” said Mahajan. “I asked them to control themselves during the holidays – to devote some time to them and their families – because we have so much more to do.”