California hospitals are struggling to find beds to accommodate patients, amid fears that the explosive rate of coronavirus infection will deplete resources and medical staff.
As of Saturday, nearly 17,400 people had been hospitalized with confirmed or suspected COVID-19 infections – more than double the previous peak in July – and a state model that uses current data to predict future trends shows that the number would could reach 75,000 incomprehensible -January.
More than 3,600 confirmed or suspected COVID-19 patients were in intensive care units.
Some areas of California are “exactly at the starting point,” said Dr. Anthony Fauci, the country’s leading infectious disease expert, at an event hosted by the California State University system.
The Corona Regional Medical Center, southeast of Los Angeles, has transformed an old emergency room to help manage almost double the usual number of intensive care patients. Use the space in two disaster tents to sort out ER patients, as the emergency room is full of patients who need to be hospitalized.
Ambulances can stay for two hours, unless they bring patients with critical, life or death emergencies.
“There’s no room at the inn, so to speak,” said Mark Uffer, the hospital’s general manager. “Literally, all corners of the hospital are used.”
It’s a scene that is played all over California. According to state data on Friday, all of Southern California and the San Joaquin Valley in northern 12 counties have depleted the regular capacity of the intensive care unit, and some hospitals have begun to use the “growth” space.
In Fresno County, California, a new 50-bed alternative care facility opened Friday near the community’s Regional Medical Center. Beds for COVID-19-negative patients will free up space in area hospitals, where only 13 of the 150 ICU beds were available on Friday, said Dan Lynch, the county’s director of emergency medical services.
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Lynch said he expects to have to use the Fresno Convention Center, which can accommodate up to 250 patients, given the current demand.
Fresno and three neighboring counties have also taken the unprecedented step of sending paramedics to emergency calls to assess people. They will not be taken to the emergency room if they could go to an emergency care unit or wait a few days to talk to their doctors, Lynch said.
Some hospitals have canceled non-essential elective surgeries, such as hip replacement, which may require beds that may soon be needed for COVID-19 patients. Others increase staff hours or move patients to free up space.
“I am not going to wear this. We are crushed, ”said Dr. Brad Spellberg, chief physician at Los Angeles County-USC Medical Center, which has more than 600 beds and is one of the largest hospitals in the county.
Spellberg said that every day at his hospital for the last week has begun, with no intensive care beds available and a struggle to find a place in areas that are not usually cared for by critical patients, such as post-surgical recovery areas. .
“And they’re not just COVID patients,” he said. “There are car accidents and heart attacks and victims of violence. They need a place to go to receive critical care.”
Increasing demand can be even more difficult for human resources.
“We still have physical beds available, but we need staff to take care of patients. It doesn’t do much good to stay in bed without someone taking care of you, “Dr. Amy Herold, chief medical officer at Regina Napa Valley Medical Center, told the San Francisco Chronicle. “People work over and over overtime and are exhausted and getting worse.”
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John Chapman, president and CEO of Upland San Antonio Regional Hospital, said telemetry nurses who monitor patients’ vital signs should monitor no more than four people, but could end up taking five or six because of number of cases.
“It definitely increases the risk of something going wrong,” he said.
Many emergency rooms have already used outdoor tents to make more space, said Dr. Marc Futernick, a Los Angeles emergency physician who is on the board of the California chapter of the American College of Emergency Physicians. . A hospital that has expanded its open-air tent is expanding into a nearby gym, he said.
However, coronavirus cases have not reached their peak in this third and most devastating wave, which means that more drastic measures are on the horizon.
Many hospitals are preparing for the possibility of rational care. A document recently circulated among doctors at the four hospitals run by Los Angeles County asking them to change their strategy: instead of trying everything to save a life, their goal during the crisis is to save as many patients as possible.
“Some compromises of the standard of care are inevitable; it is not about an entity, system or locality choosing to limit resources, but it is clear that resources are not available to provide care on a regular basis, ”the Los Angeles Times document reads.
The director of health services in the county, Dr. Christina Ghaly, said that the guidelines were not in place since Friday night, but that they are essential for development, given that the growth has arrived and “the worst is yet to come. come “.
As of Saturday, the nation’s most populous state had more than 43,000 new confirmed cases and 272 deaths, both among the highest totals in a single day during the pandemic. In the last week, California has reported more than a quarter of a million cases and 1,500 deaths.
California has begun receiving new COVID-19 vaccines. But the doses available are too few and too late to have any immediate impact on the increased rate of infection.
The latest explosion of cases has been linked to people ignoring the rules of social distance during Thanksgiving. Health officials and workers have expressed frustration that many people are not following state-imposed safety rules designed to slow the rate.
“Whatever comes, I don’t think any of us will manage it,” Uffer said. “You have a dam that is going to break and you don’t have to put water in the dam anymore.”
If people do not limit travel and future vacation meetings, the state could see “growth after growth,” Fauci said.
“I’m afraid it will be worse than what I saw in New York,” Futernick said. “When hospitals in New York became overwhelmed, health care providers spilled out across the country.”
“None of this is happening right now and there is no way it’s going to happen because every seat is occupied,” Futernick said. – No cavalry is coming.
On Saturday night, Apple Inc. announced that it was temporarily closing all 53 stores in California due to the coronavirus outbreak. The move came after the new state mandates limited stores to 20%.
“Due to the current Covid-19 conditions in some of the communities we serve, we are temporarily closing stores in these areas,” Apple said in a statement obtained by Bloomberg News. “We take this step with great caution while closely monitoring the situation and look forward to returning our teams and customers as soon as possible.”
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Taxin reported from Orange County. Associated Press writers Adam Beam and Don Thompson contributed from Sacramento, and Janie Har contributed from San Francisco.