The holiday season has now manifested itself in the worst outbreak of new COVID-19 cases in California since the pandemic began and is forcing state hospitals and ambulance teams to make life and death decisions about who to treat.
New confirmed cases of coronavirus broke records in the first week of the year, with more than 74,000 people testing positive on Monday alone. The state continued reports of surprising counts, ending the week with 695 deaths on Saturday, setting a new record for the death toll on a state day. Since the beginning of last year, more than 2.5 million have tested positive for COVID-19 in the state, and nearly 28,000 people have died from the disease, according to Johns Hopkins University.
“There have been many days when during your shift, after your shift, you are just scratching your head while enjoying how fast you are spinning, trying to control everything that is going on around you,” Dr. Sam Torbati, an emergency physician and medical director at the Ruth and Harry Roman Emergency Department at Cedars-Sinai Medical Center, told Yahoo News. “Patients are incredibly sick and there are many of them.”
Los Angeles County saw most of the post-holiday increase, with an average of about 13,500 new cases registered per day and 184 daily deaths from COVID-19 in the past week. This is the equivalent of someone dying from COVID-19 every eight minutes.
LA Mayor Eric Garcetti said on Thursday that 259 people died of COVID-19 on Wednesday, more than all the homicides recorded in the city in 2019. More than 11,000 people, 40% of the state total, died of COVID-19 in Los Angeles County. Officials expect this alarming rate to increase, as many test sites were closed during the New Year holidays.
“We are likely to experience the worst conditions in January when we face the entire pandemic, and that is hard to imagine,” said LA County Public Health Director Barbara Ferrer during an interview on Monday, adding that the The increase in numbers will have a ripple effect attributable to the holiday season and returning travelers.
On Thursday, the Governor of California’s Emergency Services Office responded to the growing emergency with the distribution of 88 refrigerated trailers to be used as makeshift morgues.
Hospitals in the state, particularly in Southern California, have been described by Dr. Nicole Groningen of Cedars Sinai Medical Center as being at their “breaking point”, and health professionals warn that the health care system may be on the verge of collapse. .
California Governor Gavin Newsom said at a state coronavirus news conference on Monday that 96 percent of LA county hospitals diverted ambulances to other facilities sometime over the weekend due to overcrowding in emergency rooms.
“This latest increase has been incredible with the numbers coming up. They are young, they are older. They are across the spectrum, ”says Torbati.
“I have never seen a healthcare system taken to the level we are at.” said Scott Brickner, a nurse at Cedars Sinai Medical Center’s medical intensive care unit, his voice choked with emotion. “Coming to work is … very stressful, to say the least, when you have to motivate yourself mentally to be ready for anything.”
More than two weeks have passed since the state reported that its intensive care units have reached maximum capacity. Hospitals are now beginning to feel the impact of the holiday’s outbreak, as the numbers have only started coming in from Christmas and New Year. In Los Angeles County alone, more than 7,400 patients with COVID-19 are hospitalized on Tuesday, with 21% needing treatment in intensive care units.
In response to the dire situation, the LA County Emergency Medical Services Agency issued a directive on Monday to stop transferring patients to hospitals if they could not be resuscitated, instructing paramedics to “use their existing authority to declare the death of a patient in the field, if there is no pulse, instead of transporting the individual to a hospital ”, in order to conserve limited resources.
Cathy Chidester, director of the LA County Emergency Medical Services Agency, told Yahoo News in a statement on Wednesday that “transporting these patients to the emergency department is useless and has a greater impact on hospitals”.
In a separate memo on Monday, the county directed emergency personnel to ration concentrated oxygen, which is in short supply, prioritizing its use for patients with an oxygen saturation level below 90 percent.
“Paramedics make this determination after a thorough assessment, which includes a measurement of blood oxygen saturation and consideration of certain known or suspected underlying medical conditions,” said Chidester.
“We were already starting to think about the allocation of care,” said Torbati. “It is appropriate for the county to also look at management and resource adequacy issues. The goal in a pandemic and a crisis is always to try to help as many people as possible, but now it is even more important for us to ensure that we won’t do it if it doesn’t work out. We still believe in heroism, but now we just need to make sure that the heroic efforts we can make for one individual do not end up hurting another 10 ”.
Last week, the home order was extended indefinitely to LA County and the rest of Southern California. The county also instituted a 10-day quarantine period for anyone who traveled outside the region. The authorities continue to repeat the same public guidelines they have been delivering for months: wear a mask, distance yourself socially, avoid meetings and wash your hands.
“If they break the rules, there will be consequences,” warns Torbati, adding that there is hope on the horizon. “Hold on for another six months, allow time for vaccines to be provided and readily available to the large population and we will overcome this. We just need everyone to be on the same page ”.