COVID-19 Surge Pushes Los Angeles Hospital to 320% Occupancy

While new hospitalizations related to COVID-19 stabilized recently in Los Angeles County, many medical facilities remain overwhelmed. The intensive care unit at a South Bay hospital, Gardena Memorial Hospital, is at 320% occupancy, officials said on Wednesday.

The 172-bed medical center has been in varying levels of ‘internal disaster status’ since March, and the latest wave of coronavirus is manifesting itself in alarming but increasingly familiar ways – including shortages of home oxygen supplies that delay the discharge of many COVID-19 patients and keep beds occupied.

The demand for oxygen within the hospital has also exploded, according to hospital spokesperson Amie Boersma.

“Bulk oxygen delivery has gone from once a month to every three days and is declining,” Boersma said in an email. “We have to watch every day.”

But it is the staff shortages that present the greatest challenge. In a region besieged by COVID-19, “it remains very difficult to find enough intensive care nurses,” Boersma said, adding that the hospital was looking for mobile nurses from all over the country and had also requested nursing resources. to the National Guard.

As the hospital awaits further assistance, it has put in place a team structure that allows staff in closed departments, such as same-day outpatient surgery, to help alleviate the workload and allow nurses to the ICU to focus on the most critical tasks.

The hospital is also using nurse practitioners and advanced medical assistants to complement the 10-bed intensive and emergency care services and provide “another set of hands and eyes,” Boersma said, in addition to hiring. final year nursing students to serve as practical nurses.

Nearly two dozen patients requiring intensive care are also being treated on the telemetry floor and in recovery rooms, she said.

And although ambulances with advanced survival critical patients are being diverted because most would require intensive care admissions, Boersma said the diversion request could do little.

“When the majority of hospitals are diverted from ALS, no one does,” she says.

LA County hospitals reported an average of 750 to 800 new COVID-19 hospitalizations per day – a startling number that has remained largely stable since Christmas Eve. The tally has led intensive care units to effectively exceed capacity, and hospital mortuaries are so full that the National Guard has been called in to help move bodies to the county coroner’s office until homes funerals and mortuaries can overcome the backlog.

There are still fears that new hospitalizations will increase again as a result of transmission during the winter holidays. If this happens, LA County hospitals may need to ration care, activate teams of triage workers who will have to decide which patients will benefit from critical care nurses, respiratory therapists, and access. ventilators, and which patients will receive palliative care upon death.

Dr Christina Ghaly, director of health services for LA County, said the number of hospitalizations had stabilized somewhat in recent days – at just under 8,000.

While not increasing at the rapid pace seen earlier in the push, “they have stabilized at a rate that is really not sustainable,” she said in a briefing Wednesday. “This high plateau does not leave enough beds open to care for patients.”

This is especially the case, Ghaly said, as the county has yet to determine all the ramifications of potential post-holiday exposures. Any increase in transmission, she warned, “would be absolutely devastating for our hospitals.”

“For there to be meaningful relief for healthcare providers, we need a rapid and significant drop in hospitalizations for a period of one to two months at a minimum,” she said.

The county continues to report an extremely high number of new infections – more than 15,000 a day, on average – and officials say a portion of those who test positive will invariably require hospital care two to three weeks later.

As of Tuesday, the most recent day for which full state data is available, 7,906 coronavirus-positive patients were hospitalized in LA County, including 1,699 in intensive care.

While both of those numbers have remained relatively stable, if not slightly diminished, Ghaly stressed that they remain “unprecedented during this pandemic in LA County, and everyone should continue to be concerned about what could happen. If they continue to increase.

Any optimism must also be expressed by the fact that the transmission after the holidays remains unclear, she added.

“If the number of our cases continues to be this high, and even increases, it bodes very badly for hospitals,” said Barbara Ferrer, LA County Director of Public Health.

Unless conditions improve, Ferrer said it was possible the county could apply new restrictions – especially given the looming threat posed by the new variant of the coronavirus which was first detected in UK and is considered even more contagious.

“We are considering all options at this point,” she said. “We are very, very concerned about the still high number of cases and we feel like there really isn’t a big window here to try to bring the outbreak under control.”

The stakes, she said, are literally life or death for many – and all Angelenos must redouble their efforts to protect themselves.

“Act as if your life or the life of a loved one depends on it,” she says. “Because it can be fair.”

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