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The Los Angeles County health system was buckling on Wednesday amid the unprecedented surge in COVID-19 patients, with bodies piling up in mortuaries and medical professionals resorting to increasingly desperate measures as ‘They were bracing for worsening conditions in the coming weeks.
With hospitals overwhelmed with patients and no exit valves available, doctors, nurses and paramedics are forced to make heartbreaking choices about who receives care and at what level.
“Nobody would believe it’s in the United States,” said Scott Byington, an intensive care nurse at St. Francis Medical Center in Lynwood. “Everyone does what they can. It’s not that anyone is slacking off. It’s just that it’s too overwhelming for everyone.
Hospital mortuaries are so full that the National Guard is called in to help county employees as the corpses are stored in the LA County Department of the Medical Examiner-Coroner. Overcrowded crypts in hospitals are the result of a lack of space and staff to handle the unprecedented number of deaths from COVID-19.
The deteriorating conditions came when Gov. Gavin Newsom announced that a new, potentially more contagious variant of the coronavirus identified in the UK had been discovered in southern California, although officials said the results were not not unexpected and should not cause an undue alarm.
Los Angeles County recorded its 10,000th death from COVID-19 on Wednesday. On the same day, it recorded 262 deaths, breaking the record for one day of COVID-19 deaths for the second day in a row. LA County is currently recording an average of 129 COVID-19 deaths per day over the past week, a figure that has never been higher.
“ Unfortunate results ”
Although authorities have not provided details of the patients who suffered because resources were not available, it is clear that the crisis is having a terrible impact on care.
Dr Christina Ghaly, LA County Health Services Director, said Wednesday: “There have been unfortunate results from patients in county hospitals and ambulances who could not be unloaded in a timely emergency service.
County officials have expressed concern about patients with illnesses such as strokes, heart attacks and seizures who wait in ambulances outside hospitals, said Cathy Chidester, director of the Medical Services Agency. county emergency. “Early intervention, in some of these cases if you don’t get it, can lead to worse results,” she says.
The crushing of patients led the county to allow certain types of paramedics to be unloaded in the waiting room instead of the emergency room, according to memos released by the EMS agency.
In addition, 911 patients who have a do not resuscitate directive will not be taken to acute care facilities such as a hospital, nor will some trauma patients whose hearts have stopped.
The agency also allows emergency medical service providers to refuse to take low-risk patients to hospitals with mild respiratory illnesses.
Breathless patients
In Saint-François, an emergency intensive care unit made the emergency room a landing point for people who, under normal circumstances, would be admitted to intensive care, including patients with COVID-19 under fans. The corridors of the emergency room are lined with sick patients. The part of the hospital where gunshot and car accident victims are usually sorted is also often filled with people infected with the coronavirus.
On a recent shift, Byington, the intensive care nurse at St. Francis Medical Center, treated 12 crisis patients. Over the speakers he heard almost constant calls of quick response and code blues as the patients collapsed.
“I’m upstairs in a COVID room, he codifies, then I go down to a COVID room, he codifies, and then there’s a problem and I’m back and forth and back and forth,” he says. “It’s all night – it’s crazy.”
Watching COVID-19 patients suffer is horrible. Their eyes widen in panic as they struggle to absorb enough oxygen and gasp. It is a process that is very similar to suffocation.
“You are hoping for some of these patients who don’t survive that they’ll actually become unconscious before that, because it’s very scary,” Byington said. “It’s no different from drowning.”
On a recent shift, there were more than 40 patients in telemetry units – some with heart attacks and others with COVID-19 – but staff couldn’t find technicians to monitor their heart monitors, as employees also fell ill with COVID.
Some nurses and doctors have been hospitalized with severe cases of the disease, he said.
Die in the emergency hall
Hospital staff are also caring for non-COVID patients in crisis who have postponed emergency medical care for fear of contracting the coronavirus in hospital. A patient may have had shortness of breath and chest pain for a few days, but doesn’t come to the hospital for treatment for a heart attack until it’s almost too late, Byington said.
“We had a lady who walked in and had a stroke in the lobby,” he says.
On a recent shift, seven patients died in hospital within six hours, Byington said. The hospital morgue is often at full capacity. There have been deceased patients who were between 20 and 30 years old, he said. Recently, a sick patient was treated in the emergency hall because there was no room in the hospital.
The patient could not be saved and died there, Byington said.
“When the time came for them to pass, they went down the hall.
Lack of oxygen and critical machinery
Byington, who has worked at the hospital for almost 30 years, said medical staff were doing their best. The situation is just as grim in other nearby hospitals, he said.
“They give 110% and come back the next day to start all over again,” Byington added. “It’s like a MASH unit, all over the hospital. It’s a situation where people come in and it’s like rolling the dice.
At different times, the hospital ran out of high-flow oxygen as well as BiPap machines, a mask that helps push oxygen into the lungs, often a last resort before putting sick patients on a ventilator.
The choices are often bleak. A patient may need a BiPap machine, and there may only be one left, just returned by a deceased patient, Byington said. Once the machine is given to the patient in need, it may take a few minutes for another to need it, but there is none left.
“You have to choose,” he said. “This is where we really are – we really are.”
This sentiment was shared by health professionals in the region, who fear that no matter how bad the current conditions are, they will get worse.
‘It’s so scary’
“I’ve never been in the position in my career where I couldn’t provide life-saving care to someone who needed it,” said Dr. Marc Futernick, an emergency room doctor from Los Angeles who is also director regional medical center of VEP Healthcare. “This is literally what we are talking about. If there is no space, no ventilator and no oxygen. … We’re going to have to sit on our hands. Saying it out loud is so scary. None of us want to face it. “
At the Greater El Monte Community Hospital, staff were trying to squeeze out as much space as possible from the small facility, but conditions were getting more and more difficult.
“The chatter you hear… is very dark,” said Dr Victor Lange, clinical epidemiologist at the hospital and director of quality and risk management. “It’s quite common to see someone cry in the hallway.”
While California and LA County have seen some slowdown in the net daily increase in intensive care patients with COVID-19 – likely linked to the stay-at-home order that has started to roll out across the country. State Dec. 6 – LA County sees less relief than other parts of the state.
At its peak in mid-December, LA County averaged a net daily increase of 44 ICU patients for COVID-19; On Tuesday, LA County had an average of 35 additional net intensive care patients each day over the past week.
LA County Reports 20% Positive Test Rate
The rate at which coronavirus test results come back positive continues to climb. The daily positivity rate is now 20% – five times worse than the comparable figure from November 1, when the rate was below 4%.
“And we’re not even factoring in the coming Christmas wave,” said Hilda Solis, LA County Supervisor. “From what we’ve seen with so many people who have attended rallies and trips, we remain very concerned about a new wave in addition to the current wave.
Solis pleaded with the public to cancel New Years parties to reduce the intensity of the expected January surge.
Guard troops are stationed at 13 medical facilities across 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. As we know, widespread access to the vaccine is coming in a few months. And don’t be a victim of this pandemic.
Times editors Harriet Ryan, Laura Newberry, Andrew J. Campa, Jaclyn Cosgrove, Lila Seidman, and Melissa Gomez contributed to this report.
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