Bodies pile up, patient care falters as COVID-19
slams L.A.
- Los Angeles Times
Los Angeles County’s healthcare system was buckling
Wednesday under the unprecedented surge of COVID-19
patients, with bodies piling up at morgues and medical
professionals resorting to increasingly desperate
measures as they brace for conditions to worsen in the
coming weeks.
With hospitals overwhelmed by patients and no outlet
valve available, doctors, nurses and paramedics are
being forced to make wrenching choices about who gets
care and at what level.
“No one would believe this is in the United States,”
said Scott Byington, a critical care nurse at St.
Francis Medical Center in Lynwood. “Everyone is doing
what they can do. It’s not that anybody is slacking.
It’s just that it’s too overwhelming for everyone.”
Hospital morgues are so full that the National Guard is
being called in to help county workers as corpses are
moved into storage at the L.A. County Department of the
Medical Examiner-Coroner. The overcrowded crypts at
hospitals are a result of private mortuaries running
out of space and staff to handle the unprecedented
number of COVID-19 deaths.
The deteriorating conditions came as Gov. Gavin Newsom
announced that a new, potentially more contagious
variant of the coronavirus identified in the United
Kingdom had been found in Southern California, though
officials said the findings were not unexpected and
should not cause undue alarm.
Los Angeles County on Wednesday tallied its 10,000th
COVID-19 death. On the same day, it recorded 262
deaths, breaking the single-day record for COVID-19
deaths for the second day in a row. L.A. County is now
averaging about 129 COVID-19 deaths a day over the past
week, a figure that has never been higher.
‘Unfortunate outcomes’
While officials have not provided details on patients
who suffered because resources were not available, it’s
clear the crisis is taking a terrible toll on care.
Dr. Christina Ghaly, the L.A. County health services
director, said Wednesday, “There have been some
unfortunate outcomes from patients in hospitals and
ambulances across the county who couldn’t be offloaded
into an emergency department in a timely manner.”
County officials have been concerned about patients
suffering from things such as strokes, heart attacks
and seizures waiting in ambulances outside hospitals,
said Cathy Chidester, director of the county Emergency
Medical Services Agency. “The early intervention, in
some of these cases if you don’t get it, may lead to
worse outcomes,” she said.
The crush of patients has led the county to allow
certain types of ambulance patients to be offloaded
into the waiting room instead of the emergency room,
according to memos issued by the EMS agency.
Additionally, 911 patients who have a do-not-
resuscitate directive will not be taken to acute-care
facilities such as a hospital, nor will certain trauma
patients whose hearts have stopped.
The agency is also allowing emergency medical service
providers to decline to take low-risk patients to
hospitals with mild respiratory illnesses.
Patients gasping for breath
At St. Francis, a backed-up intensive care unit has
made the emergency room a landing spot for people who
under normal circumstances would be admitted to the
ICU, including COVID-19 patients on ventilators. The
hallways of the ER are lined with sick patients. The
part of the hospital where gunshot and car accident
victims are typically triaged is also often packed with
people infected with the coronavirus.
On a recent shift, Byington, the critical care nurse at
St. Francis Medical Center, cared for 12 patients in
crisis. On the overhead speakers, he heard near-
constant calls of rapid response and Code Blues as
patients crashed.
“I’m upstairs in a COVID room, he’s coding, and then I
go downstairs to a COVID room, he’s coding, and then
there’s a problem and I go back and forth and back and
forth,” he said. “It’s all night long — it’s crazy.”
Noticias en español
Watching COVID-19 patients suffer is horrifying. Their
eyes widen with panic as they struggle to take in
enough oxygen and gasp for breath. It is a process much
like suffocation.
“You hope for some of these patients who are not going
to survive, that they actually become unconscious
before this, because it’s very scary,” Byington said.
“It’s no different than probably drowning.”
On a recent shift, there were more than 40 patients in
the telemetry units — some with heart attacks and
others with COVID-19 — but staff couldn’t find
technicians to watch their heart monitors, because
employees also have fallen sick with COVID.
Some nurses and doctors have been hospitalized with
severe cases of the disease, he said.
Dying in the ER hallway
Hospital staff are also dealing with non-COVID patients
in crisis who have put off urgent medical care for fear
of contracting the coronavirus at the hospital. A
patient might have had shortness of breath and chest
pain for a few days, but doesn’t come into the hospital
for treatment for a heart attack until it’s nearly too
late, Byington said.
“We had a lady who walked in and had a stroke in the
lobby,” he said.
On a recent shift, seven patients died in the hospital
within six hours, Byington said. The hospital morgue is
often at capacity. There have been patients passing
away who were in their 20s and 30s, he said. Recently,
a sick patient was cared for in the ER hallway because
there was no more space in the hospital.
The patient could not be saved, and died there,
Byington said.
“When it came time for them to pass, they passed in the
hallway.”
Running out of oxygen and critical machines
Byington, who has worked at the hospital for nearly 30
years, said medical staff are trying as hard as they
can. The situation is equally bleak at other nearby
hospitals, he said.
“They give 110% and come back the next day to start all
over,” Byington added. “It’s like a MASH unit,
everywhere in the hospital. This is a situation where
people come in and it’s like rolling the dice.”
At different times, the hospital has run out of high-
flow oxygen as well as BiPap machines, a mask that
helps push oxygen into the lungs, often a last resort
before placing ill patients on a ventilator.
Science
As COVID-19 vaccines come online, fewer Americans want
to take them
Americans’s interest in a COVID-19 vaccine is waning,
with only 56% of adults saying they would get it if it
were available. That’s down from 74% in April.
The choices are often grim. A patient might require a
BiPap machine, and there may be only one left, just
surrendered by a patient who died, Byington said. Once
the machine is given to the patient in need, it could
be just minutes before another might need one — but
there aren’t any left.
“You have to pick and choose,” he said. “That’s where
we really are — we’re really at that point.”
That sentiment was shared by medical professionals
across the region, who fear that as bad as the
conditions are now, they would get worse.
‘It is so frightening’
“I have never been in the position in my career where I
couldn’t offer lifesaving care to someone who needed
it,” said Dr. Marc Futernick, a Los Angeles emergency
room physician who also serves as regional medical
director of VEP Healthcare. “That is literally what we
are talking about. If there is no space, no ventilator
and no oxygen. ... We are going to have to sit on our
hands. Just saying it out loud, it is so frightening.
None of us want to face that.”
At Greater El Monte Community Hospital, staffers were
trying to squeeze as much space as possible out of the
small facility but conditions were becoming
increasingly difficult.
“The chatter you hear … is very grim,” said Dr. Victor
Lange, the hospital’s clinical epidemiologist and
director of quality and risk management. “It’s pretty
common to see someone crying in the hallway.”
While both California and L.A. County have seen some
easing in the net daily increase of ICU patients with
COVID-19 — probably related to the stay-at-home order
that began rolling out across the state on Dec. 6 —
L.A. County is seeing less relief than other parts of
the state.
At its peak in mid-December, L.A. County was averaging
a net daily increase of 44 ICU patients for COVID-19;
by Tuesday, L.A. County was averaging a net additional
35 ICU patients every day over the past week.
L.A. County reporting 20% positive test rate
The rate at which coronavirus test results are coming
back positive continues to climb. The daily positivity
rate is now at 20% — five times worse than the
comparable figure from Nov. 1, when the rate was less
than 4%.
“And we’re not even accounting for the incoming
Christmas surge,” said L.A. County Supervisor Hilda
Solis. “From what we saw with so many people who
attended gatherings and travels, we remain very
concerned about another surge on top of the current
surge.”
Solis implored the public to cancel New Year’s parties
to reduce the intensity of the forecasted January
surge.
Guard troops are stationed at 13 medical facilities in
the state, including Adventist Health White Memorial in
Los Angeles, Methodist Hospital of Southern California
in Arcadia and Pacifica Hospital of the Valley in Sun
Valley.
“It’s such a grim reality,” Solis said.
But she added: “Please don’t give up. Widespread access
to the vaccine, as we know, is coming in a matter of
months. And don’t be a casualty to this pandemic.”
Times staff writers Harriet Ryan, Laura Newberry,
Andrew J. Campa, Jaclyn Cosgrove, Lila Seidman and
Melissa Gomez contributed to this report.
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California's new one-day record for COVID-19 cases:
74,000 - Los Angeles Times
Los Angeles County hit another disturbing milestone
Tuesday, exceeding 11,000 COVID-19 deaths. Officials
warned of dark weeks ahead amid a post-Christmas surge
that is expected to put pressure on already overwhelmed
hospitals.
The county has reported more than 1,000 deaths since
Dec. 30, according to health officials, including 224
on Tuesday.
Over the week to Monday, Los Angeles County averaged
184 COVID-19 deaths a day — the equivalent of one every
eight minutes — and 13,500 new coronavirus infections a
day, a count expected to grow with the reopening of
testing sites after the holidays. The county’s
cumulative case count now tops 841,000.
L.A. County Supervisor Hilda Solis said Monday that
while it took 10 months for the county to accumulate
400,000 coronavirus cases, it took only about a month
to record an additional 400,000.
“That is a human disaster, and one that was avoidable,”
Solis said. “But I need to underscore that it could be
worse. The situation is already beyond our imagination.
But it could become beyond comprehension if the health
restrictions in place are not fully obeyed.”
L.A. County is a national epicenter of COVID, but the
problem extends across many other parts of California.
After a relative New Year’s lull, the state on Monday
reported its highest number of new coronavirus cases in
a single day, more than 74,000, according to a Times
tally of local health jurisdictions. That is 11% more
than the previous record of 66,726, which came Dec. 28.
California has averaged 37,000 new cases a day over the
last week, down from a high of 45,000 in mid-December.
Still, the situation is far worse than it was at the
beginning of December, when 14,000 cases a day were
recorded.
On Monday, California posted its sixth-highest daily
tally of COVID-19 deaths: 379. The average over the
last week was 353 a day, the highest yet. The state’s
cumulative fatalities top 27,300.
Even when figures are adjusted to account for the
state’s population, California’s COVID-19 outbreak
ranks among the worst in the country.
Over the past week, the state has averaged 96 new daily
cases per 100,000 residents — tying it with Rhode
Island for the second-highest rate in the nation,
behind Arizona’s 112, according to data from the
Centers for Disease Control and Prevention.
The nationwide daily average for new cases over the
same period was 64 per 100,000 residents.
Amid the already overwhelming surge, California faces
another potential threat: the presence of a new
coronavirus variant, first identified in the United
Kingdom, that some scientists believe is more
contagious.
Though it’s unclear how prevalent the variant is
statewide, San Diego County health officials Tuesday
reported 24 additional confirmed cases and four likely
cases. That raises the county’s total of known or
suspected infections by the variant virus to 32.
The two dozen newly infected patients “are believed to
have no travel history and to have come from 19
different households, but the investigation and contact
tracing are ongoing,” according to a statement by San
Diego County officials. Those infected are widely
dispersed geographically and range in age from 10 to
their 70s.
The variant has also been identified in two people of
the same household in Big Bear in San Bernardino
County.
Experts say there’s no evidence that the variant —
known as B.1.1.7 — is deadlier, causes more severe
illness or has an impact on vaccine efficacy. But any
heightened risk of infection is unwelcome news,
particularly in areas already reeling from sky-high
levels of coronavirus transmission.
Though L.A. County officials have yet to document the
variant’s presence, “having a virus that is able to
infect more people more quickly than what we’re seeing
today” is a “frightening thought,” county Public Health
Director Barbara Ferrer said Tuesday.
While many of those infected may experience only mild
symptoms or none at all, California health officials
have warned that a sizable slice, about 12%, will fall
ill enough to require hospitalization within a few
weeks after they are exposed.
A significant and sustained wave of new infections,
then, will invariably slam hospitals with additional
patients.
“This week is critical in terms of a bigger
understanding of where we are and if we’re going to hit
that surge on top of a surge, on top of yet another
surge,” Gov. Gavin Newsom said.
Noticias en español
Though the figures dipped around New Year’s Eve and New
Year’s Day, the number of coronavirus-positive patients
hospitalized statewide rose to 21,597 Monday, a new
record. Of those patients, 4,634 were in intensive care
units.
The story is much the same on the local level, as
California’s most-populated counties continue to see
record or near-record levels of hospitalizations.
Conditions in ICUs, which require specialized staff and
equipment to care for the sickest patients, are of
particular concern. The availability of intensive care
beds in Southern California and the San Joaquin Valley
has stood at 0% for weeks; the metric doesn’t mean no
beds are available, because the state uses a weighted
formula to ensure that some remain open for non-COVID
patients, but it does indicate that hospital capacity
is stretched to the limit.
Health officials in San Joaquin County reported Monday
that the need for intensive care had reached an all-
time high, with adult ICUs at 175% above their licensed
bed capacity.
“The impact of COVID-19 on the members of our community
and our healthcare system is glaring,” Dan Burch, the
county’s Emergency Medical Services administrator, said
in a statement.
The situation is less dire but still concerning in the
Bay Area and Greater Sacramento, where ICU availability
Tuesday was at 5.9% and 11.7%, respectively.
All four of the state-defined regions where ICU
availability is below 15% are under stay-at-home
orders, which include a host of restrictions on
businesses and activities aimed at stymying coronavirus
transmission. Those orders will remain in place until
ICU availability, forecast four weeks out, is 15% or
higher.
Noticias en español
In L.A. County, there were 8,023 hospitalized COVID-19
patients Monday — 125 more than the previous day. Of
them, 1,642 were in the ICU, also a record.
“It is getting harder and harder for healthcare workers
to care for those coming to the hospital with gunshot
wounds, heart attacks, strokes and injuries from car
accidents,” Solis said. “Hospitals are declaring
internal disasters and having to open church gyms to
serve as hospital units. Our healthcare workers are
physically and mentally exhausted and sick.”
The number of COVID-19 patients in ICU wards has
quadrupled since late November.
“Given the current state of the pandemic in Los Angeles
County, the worst is almost certainly still ahead of
us,” Dr. Christina Ghaly, the L.A. County director of
health services, warned. “As of today, hospitals
continue to be significantly strained. All hospitals
are being inundated with COVID patients.”
She said overcrowded hospitals have been forced to
leave patients in hallways or keep them waiting in
ambulances.
“The demand for oxygen is so great that some hospitals
are having trouble maintaining an adequate degree of
air pressure to keep a high-flow rate of oxygen pumping
into lungs of COVID-19 patients that have been
inflamed,” Ghaly said.
Both public and private hospitals are experiencing
“complicated and numerous” issues with their oxygen
supply infrastructure, she added Tuesday.
At Olive View-UCLA Medical Center in Sylmar, workers
had to fix the supply system because oxygen was
freezing in the pipes. Harbor-UCLA Medical Center is
still experiencing oxygen flow issues, which limit
where patients can be placed in the hospital.
Ghaly said vendors are struggling to provide hospitals
with enough oxygen canisters and staff to refill
portable containers — which are used primarily while
patients are being transported within the hospital or
when they’re in tents awaiting further care.
To address critical staffing needs at hospitals, L.A.
County has closed five outpatient clinics and reduced
hours and services at others.
As of Tuesday, almost 850 nurses and other healthcare
workers from the shuttered sites had been sent to serve
at either hard-hit public hospitals or one of eight
quarantine and isolation housing sites, Ghaly said. In
addition, two 20-person teams from the U.S. Department
of Defense and 40 contract nurses are being sent to
relieve beleaguered staff at county hospitals.
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As conditions continue to deteriorate, officials have
noted with alarm that many Californians disregarded
their pleas to stay home for the holidays — while some
anti-maskers have joined in protests against the health
orders that are in place.
“We are in the midst of an unprecedented and dangerous
surge,” Solis said. “Despite what protesters claim,
this is not a hoax.”
Ghaly reminded residents of the role they play in
battling the worst public healthcare crisis of the last
100 years.
“It’s not about you; it’s about the other people around
you,” she said. “And in this time of mass crisis, we
need to think of our neighbors. Please show others the
basic common courtesy and take the lifesaving action of
wearing a mask when you’re around others.”
California
New, extreme precautions urged for L.A. County
residents because COVID is ‘everywhere’
“You run the risk of an exposure whenever you leave
your home,” L.A. County Public Health Director Barbara
Ferrer says of growing COVID-19 threat.
Noticias en español
While officials say it’s understandable that Angelenos
are frustrated with the continued restrictions and
tired of living with the looming threat of the
pandemic, they point out that hope is on the horizon,
given the arrival of COVID-19 vaccines.
Since mid-December, L.A. County has received about
357,500 doses, including 189,995 doses of the Pfizer
vaccine that has primarily been used to inoculate
healthcare workers at 83 acute-care hospitals, Ferrer
said during Tuesday’s Board of Supervisors meeting.
As of Sunday, 60% of the Pfizer doses had been
administered to front-line healthcare workers at
hospitals, Ferrer said.
The county has received about 170,000 doses of the
Moderna vaccine, which will be given to residents and
staff at skilled nursing facilities, as well as
emergency medical technicians and paramedics, among
others.
Ferrer said it has been a challenge to vaccinate
healthcare workers who are busy contending with the
COVID-19 surge at their hospitals. Additionally, she
said, one vaccine site had to turn away a crowd of more
than 150 non-healthcare workers who showed up Monday.
“I think it’s a very positive sign that lots of people
are ready to be vaccinated,” Ferrer said, noting that
the public must be patient as the county works through
vaccinating healthcare and essential workers and other
priority populations.
The county this week will receive a “much smaller”
shipment of vaccine than the federal government had
originally indicated, only enough to allot to workers
at acute-care hospitals for their second doses, Ferrer
said.
“I think we were all expecting a lot more vaccine would
come to the state, and we would get our fair share of
that,” she said.
It’s unclear whether the shortfall is due to issues of
production, distribution or something else, Ferrer
added.
“If we get enough doses, we hope we would complete
vaccinating the healthcare workers and those in long-
term care facilities [by the] end of January, beginning
of February,” she said. “The ‘if’ there is really
dependent on getting enough vaccine.”
Times staff writer Andrea Roberson contributed to this
report.
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World & Nation
Hank Aaron, civil rights leaders get vaccinated in
Georgia
Hank Aaron, Andrew Young and other ‘trusted messengers’
get their COVID-19 vaccines, hoping to convey to Black
America that the shots are safe.
California
Palm Springs police exposed to coronavirus after man
spits on them
The man, who later tested positive for the coronavirus,
spat at police officers who responded to a call about
someone throwing things at vehicles.
California
Newsom proposes $4.5 billion in state help for
businesses and jobs affected by COVID-19
The proposal also includes money earmarked to subsidize
purchases of zero-emission vehicles and to build more
charging and fueling stations.
California
New, potentially more contagious variant of the
coronavirus spreads in California
Officials in San Diego County report 32 cases of the
potentially more contagious variant of the coronavirus
that has also spread rapidly in England.
Obituaries
Rose Ochi, trailblazer for civil rights and Japanese
American causes, dies at 81
Rose Ochi, a trailblazing Los Angeles attorney for
civil rights, criminal justice reform and Japanese
American causes, has died at 81.
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