Hospital staff stretched thin as the California virus grew

LOS ANGELES (AP) – Medical staff is getting thinner as California hospitals struggle to find beds for patients amid an explosion of coronavirus cases that threatens to overwhelm the state’s emergency care system.

As of Sunday, more than 16,840 people had been hospitalized with confirmed COVID-19 infections – more than double the previous peak reached in July – and a state model that uses current data to predict future trends shows that the number could reach 75,000. until mid-January.

More than 3,610 patients with COVID-19 were in intensive care units. All of Southern California and the San Joaquin Valley in the northern 12 counties have exhausted their regular intensive care capacity, and some hospitals have begun to use the “growth” space. Overall, the state’s ICU capacity was only 2.1% on Sunday.

In Los Angeles County, Nerissa Black, a nurse at Henry Mayo Newhall Hospital, estimated that she has an average of less than 10 minutes of care per patient per hour. This includes not only bed care, but also dressing the equipment, drafting the chart, reviewing lab results and conferring with doctors, she said.

“And the patients who come are sicker now than they have ever been, because a lot of people are waiting before they get care. So when they come, they’re very, very sick, “Black said Sunday.

The sheer number of cases in the last six weeks is causing the death toll in California to rise. Another 161 casualties were reported Sunday for a total of 22,593.

Nurse Wendy Macedo said all 25 beds on her unit are full of COVID-19 patients in LA County at UCLA Health Santa Monica Medical Center. She said that a ward on another floor, which had been dedicated to orthopedic patients, had been turned into the care of people who had tested positive for the virus. The nurses work longer shifts and more of them, she said. There are almost 5,550 people hospitalized with COVID-19 in the county.

“The more patients we have, the greater the risk of making a mistake, especially if we are in a hurry,” Macedo said on Sunday. “Obviously we’re trying to avoid this, but we’re just human.”

California is facing “some of the darkest days of COVID-19 growth,” said Gov. Gavin Newsom, but it was an easy Sunday as a working group of scientists and experts approved a vaccine developed by Moderna. The move paves the way for the drug to be distributed in California and other Western states that have reviewed it separately from the US Food and Drug Administration.

Shipments of the vaccine are expected to arrive in California earlier this week, but it could be months before it is available to the general public, officials said.

“Until vaccines become more widely available across the country, it is essential that all Californians do their part to stop growth, staying home and wearing a mask when they leave home for work and basic needs,” Newsom said. .

Until the expansion of vaccinations, hospitals were preparing for the possibility of streamlining care. A document recently released among doctors at the four hospitals run by Los Angeles County calls for them to change strategy: Instead of trying everything to save a life, their goal during the crisis is to save as many patients as possible. This means that those with a lower chance of survival will not receive the same type of care offered in normal times.

“One compromise of the standard of care is 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 said.

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 “.

Many hospitals have already implemented emergency procedures to expand staff and space.

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.

In Fresno County, California, a new 50-bed alternative care facility has been opened in recent days 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.

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.

Health officials in Los Angeles County announced Saturday that they have changed their health orders to comply with recent U.S. Supreme Court rulings seeking permission for places of worship to have outdoor and indoor services with safety measures. corresponding to.

On Saturday night, Apple Inc. announced that it was temporarily closing all 53 stores in California due to the coronavirus outbreak. According to the home residence order in force for almost the entire state, retail stores are limited to a capacity of 20%.

Supermarkets have been hit hard by the rise of the virus, further straining an essential service that remains open during the last home stay order. Of the six outbreaks at the Food 4 Less locations in the Los Angeles area, three were first recorded this month, linked to current growth, according to a Times analysis. An outbreak is defined as three or more cases among staff over a period of 14 days.

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