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It was the first day of a new year, and yet, in much of California, the numbing realities we wanted to put behind us – hospitals at full capacity, rising death tolls and massive rallies. and without a mask – followed us until 2021.
As of Friday, the number of Californians who have died from complications from COVID-19 rose to 26,000 – roughly the same number of Californians who in recent years have died from complications from the flu, diabetes, high blood pressure and combined liver disease.
In LA County, where hospitals backed up so much that patients had to wait up to eight hours outside in ambulances, hope for respite finally arrived on Friday: The Corps of Engineers of the The army was planning to send specialist teams to the area to update oxygen delivery systems in a handful of aging hospitals.
Days earlier, several hospitals declared internal disasters and temporarily refused all ambulance traffic as their internal oxygen systems began to warp under the high demand for airflow needed by patients whose lungs had been ravaged by the coronavirus.
As county emergency rooms and intensive care units remain overwhelmed with patients with respiratory illnesses, hospitals continue to give in to the dangerous ripple effects that have impacted nearly every aspect of medical care .
With 700 nurses from primary care clinics diverted to hospitals and other critical needs, county officials have been forced to temporarily close five public primary care clinics across the county and cut hours in most others, who provide children with vaccinations and where people with chronic illnesses have their medications managed.
“We have kept a small team to continue working in our outpatient clinics,” said Dr. Christina Ghaly, Los Angeles County Director of Health Services. “But overall, our ability to provide outpatient services is much lower than it normally is.”
This means that patients with chronic diseases will be more at risk of needing go to the emergency room if they become more seriously ill due to lack of outpatient care.
And it also means that hundreds of procedures and surgeries have been put on hold.
For Matt Howard – a 44-year-old high school teacher who was due for a kidney transplant at Cedars-Sinai on Jan.15 – that meant receiving a disappointing phone call on a recent afternoon.
“We’re sorry,” said the voice from the other line. “There are no beds available in the ICUs, so we have to postpone the surgery.”
When he told his wife, she broke down in tears. Her two daughters, 20 and 22, were also devastated. But Howard, who lives in Lakewood, said he was comforted to know his donor – his older sister – was not going anywhere. The situation would have been much worse, he said, if he had been scheduled to receive a new kidney from a recently deceased donor.
Hospitals are doing their best under impossible circumstances, he said, and he doesn’t blame them for the cancellation. Still, he says, he can’t wait to have the transplant. The last time he had his kidneys checked, doctors told him they were working at 3%, said Howard, who undergoes nine-hour dialysis treatments at home every night.
“It’s a waiting game,” he said, noting that he does not yet have a new surgery date scheduled.
The situation in many Southland medical establishments remains dire.
Paramedics now routinely decide not to transport low-risk patients to overcrowded hospitals, hoping to free up space for those who need it most, forcing people who might otherwise surrender in emergencies to seek care elsewhere.
Hospitals strive to find sufficient staff and sometimes emergency medical technicians have been called upon to work in hospitals. Meanwhile, older hospitals are being reconfigured to accommodate far more patients than they ever imagined, resulting in oxygen issues.
Dr Christina Ghaly, director of LA County Health Services, said the demand is so great for high flow of oxygen and the pipes in buildings are so old that they cannot maintain sufficient pressure and , sometimes began to freeze. In a rush, Ghaly said, some hospitals have been forced to move patients to lower floors because it is easier to deliver oxygen there without needing pressure to push it up to the upper floors.
Another oxygen-related problem – the chronic shortage of portable tanks – has also hampered the capacity of hospitals in recent days, county officials said. To free recovering patients as quickly as possible and to free up space for other sicker patients, hospitals often send patients home with oxygen tanks.
The Corps Design and Construction team will evaluate six hospitals – Adventist Health White Memorial in Boyle Heights, Beverly Community Hospital in Montebello, Emanate Health Queen of the Valley Hospital in West Covina, Lakewood Regional Medical Center, Mission Community Hospital at Panorama City and PIH Health Hospital in Downey – then oversee upgrades where they are deemed necessary.
Mark Ghilarducci, director of the California governor’s office of emergency services, said in a statement that the upgrades “will improve the ability to provide life-saving medical care to those in need.”
Assessments are expected to begin as early as Saturday, state officials said.
The fundamental problem is that patients, suffocated by inflamed lungs, demand such a high flow of oxygen that some hospitals cannot meet the demand with existing infrastructure.
“Lack of oxygen and oxygen tanks is a problem,” said Cathy Chidester, director of the LA County Emergency Medical Services Agency.
And LA County Director of Public Health Barbara Ferrer said she expects these trends to continue for several weeks.
“We are experiencing extreme conditions in LA County,” she said. “Our hospitals continue to be overwhelmed. As more people are rushed to hospital, the tragic fact is that hundreds more people will die from COVID-19 every week. These trends, unfortunately, will continue in January. “
And yet there was a hopeful little piece of news published on New Years Day. For the first time in 50 days, the net number of people hospitalized in LA County for COVID-19 has declined – albeit by just one. Still, he broke the consecutive daily streak of 32 days of record hospitalizations for COVID-19 in LA County.
On New Years Eve, 7,627 COVID-19 patients were hospitalized in LA County, up from 7,628 the day before, according to data released Friday.
The slower increase in the number of daily patients is a sign that the stay-at-home order in Southern California for nearly four weeks is having an impact.
“There is no doubt in my mind that if we had not been ordered to stay home, the situation would be much more serious than it is now,” said Dr Robert Kim-Farley , a medical epidemiologist and infectious disease expert at UCLA Fielding School of Public Health, who described the current situation as a “viral tsunami.”
“However, I think the scale of the numbers shows that when faced with the stay home order many people are choosing to ignore it,” he said, adding that any slight slowdown in new hospitalizations will be. probably canceled soon due to the number of people traveling over Christmas and New Years.
For Howard, the teacher waiting for a transplant, it’s deeply frustrating that people refuse to wear masks or go to New Years parties.
“It’s disappointing,” he said.
When Howard was diagnosed with IgA nephropathy four years ago, his kidney function was 30%. When he fell below 10% last year, he started dialysis through a catheter in the lining of his stomach. Even with the treatments, he says, he constantly feels exhausted.
A high school football coach, he said he yearns to regain the level of energy and drive he once felt. He dreams of getting back on his bike to work and, when the pandemic is behind us, of one day traveling with his wife.
For her sister, Gail Houseweart, a labor and delivery nurse in Colorado, the news of the delayed surgery was heartbreaking.
After numerous blood tests – involving 33 vials in all, she recalls – and after undergoing a full day of testing, including a mammogram and chest x-ray, she finally got the go-ahead about a month ago. : she was a match, and they were all ready. She was thrilled. When people told her that she was a hero, she said no, in fact, she felt selfish. She needed her little brother.
“I want it for myself, his children and his wife,” she says.
She bought a plane ticket to Los Angeles and booked an Airbnb after the procedure, but then received a call regarding the cancellation. She’s been doing funk for a few weeks, she said, but she’s trying to focus on the future.
“2021 is our year,” she says, pausing. “I guess, I hope.
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