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Hospitals Bursting at Seams With COVID-19 Patients as Surge Continues

People wait outside the Emergency room of the Garfield Medical Center in Monterey Park, California on December 1, 2020. | FREDERIC J. BROWN/AFP via Getty Images
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LOS ANGELES (CNS) - Los Angeles County's dramatic surge in coronavirus cases and hospitalizations continued gobbling up the availability of intensive-care unit beds today, with the number of patients across the county predicted to exceed 5,000 by week's end.

To help ease strain on hospitals, Dr. Christina Ghaly, director of the county Department of Health Services, urged residents Monday not to visit emergency rooms for non-emergency care, but instead seek help through other means, such as contacting their health-care provider or going to an urgent-care center.

“Certainly if you need emergency services, you should call 911 or go to your nearest emergency department, and they are able to take care of you,” she said.

But Ghaly painted a dire picture of the situation at the county's 70 “911-receiving” hospitals, which have emergency departments and wind up treating COVID-19 patients. Last week, an average of 35%, or 874, of all patients in hospitals' available ICU beds were COVID-19 patients, while 27%, or 2,681, of patients in standard hospital beds were being treated for the coronavirus.

“Those numbers are absolutely astounding,” she said.

On Sunday, a day when emergency departments are traditionally not as busy, 81% of the 911-receiving hospitals asked to have advanced-life-support ambulance traffic diverted to other medical facilities at some point during the day due to overcrowded ERs. Ghaly said last week the traditional average of hospitals requesting diversion this time of year is 10% to 15%.

California temporarily lowered the required staffing requirements in ICU units, from the normal one staffer to every two patients, down to one staffer for every three patients. It also amended its quarantine requirements for health care workers exposed to COVID, lowering the requirement to just seven days, assuming the worker tests negative for the virus on day five or later of the quarantine.

According to the county DHS, as of last week, county hospitals were averaging a total of 2,522 staffed ICU beds — roughly equivalent to the county's overall licensed ICU capacity — with roughly 85 beds on average available on any given day. It was the second week in a row the average ICU bed availability averaged less than 100.

County hospitals last week averaged 874 confirmed or suspected COVID-19 patients in ICU on a daily basis, along with 1,563 non-coronavirus patients, leaving the average of 85 daily available beds, according to the DHS. The county averaged 411 standard available hospital beds last week, out of an average daily overall number of 10,360 staffed beds.

On Monday, the county reported 4,203 people hospitalized, with roughly 21% of them — about 882 — in ICU care.

Ghaly credited hospitals for their ability to implement “surge” plans and provide staffing for more than 2,500 ICU beds, a level 13% higher than the county saw during the COVID surge that occurred over the summer. But she warned, “that surge ability is not infinite.”

“It takes its toll on the dedicated men and women that staff our hospitals,” Ghaly said. “They are our most finite and valued resource.”

Gov. Gavin Newsom noted Tuesday that the strain on hospital staffing prompted the state to temporarily lower the required staffing requirements in ICU units, from the normal one staffer to every two patients, down to one staffer for every three patients. The state also amended its quarantine requirements for health care workers exposed to COVID, lowering the requirement to just seven days, assuming the worker tests negative for the virus on day five or later of the quarantine.

Despite nearing ICU capacity, hospital numbers are projected to get much worse before they get better. Ghaly said the county is averaging about 500 new COVID hospital admissions a day, and it is still projecting reaching 700 per day within a week. County Public Health Director Barbara Ferrer predicted the county will top 5,000 COVID-19 patients by the weekend.

The county reported another 7,344 newly confirmed COVID-19 cases on Monday, but Ferrer said that number is artificially low due to reporting delays from one of the county's largest processing labs. That backlog is expected to lead to an unusually large number of new cases on Tuesday.

The new cases, along with 378 announced by Long Beach health officials and 15 by Pasadena, lifted the countywide cumulative total from throughout the pandemic to 533,123.

The county also reported 48 new deaths, raising the overall number to 8,345.

Ferrer noted the excitement of the first batch of COVID-19 vaccine doses arriving in the county on Monday, but said there's a long way to go until the county emerges from the pandemic.

“In the meantime, we all do need to remain extremely diligent in reducing transmission of the virus,” she said. “We're continuing to see extremely high numbers of new cases, hospitalizations and deaths from COVID-19, and the surge we're experiencing is quite alarming. There's no way to stop this explosive surge except to use the tools we've had all along that really do work to reduce transmission of this deadly virus.”

Dwindling ICU capacity prompted the state to impose a regional Stay-at-Home order for the 11 county Southern California region earlier this month. The order was triggered when overall ICU capacity dropped below 15%. As of Tuesday, the state's estimated ICU capacity for the region — adjusted based on the percentage of current COVID-19 versus non-COVID-19 ICU patients — dropped to 1.7%

The state's regional Stay-at-Home order — which covers Los Angeles, Orange, Riverside, San Diego, Imperial, Inyo, Mono, San Bernardino, San Luis Obispo, Santa Barbara and Ventura counties — bars gatherings of people from different households.

Under the order, the following businesses/recreational facilities were forced to close:

  • indoor recreational facilities;
  • hair salons and barbershops;
  • personal care services;
  • museums, zoos, and aquariums;
  • movie theaters;
  • wineries;
  • bars, breweries and distilleries;
  • family entertainment centers;
  • cardrooms and satellite wagering;
  • limited services;
  • live audience sports; and
  • amusement parks.

Schools with waivers can remain open, along with “critical infrastructure” and retail stores, which will be limited to 20% of capacity. Restaurants are restricted to takeout and delivery service only. Hotels are allowed to open “for critical infrastructure support only,” while churches would be restricted to outdoor only services. Entertainment production — including professional sports — would be allowed to continue without live audiences.
The order will remain in effect until at least Dec. 28.

Top Image: People wait outside the Emergency room of the Garfield Medical Center in Monterey Park, California on December 1, 2020. | FREDERIC J. BROWN/AFP via Getty Images

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