‘We’re Getting Crushed’: L.A. County Hospitals in Crisis

LAC+USC Medical Center. | Photo courtesy of County of Los Angeles

It should come as no surprise by now that Los Angeles County hospitals are struggling under a rising surge of COVID-19 cases and hospitalizations. As the number of beds continue to dwindle, staffing is becoming an even more pressing concern for officials.

“We’re getting crushed,” said Brad Spellberg, chief medical officer at LAC+USC Medical Center, during a press briefing Friday. “I’m not gonna sugarcoat this. We are getting crushed.”

For most of the last week, LAC+USC had zero ICU beds open in the morning and healthcare workers have had to scramble to move patients around. Post-op and recovery areas are now taking critically ill patients, he said. “We’re already expanding care into areas of the hospital we don’t normally provide that type of care in.”

And it’s not just COVID-19 patients that will be affected, though that’s alarming enough. “If you have a heart attack, if you get into a car accident, if you fall from a ladder or have a stroke, we may not have a bed for you,” Spellberg forewarned.

“We need the public to listen to these mitigation strategies to slow the spread or we will completely run out of beds,” a clearly emotional Spellberg implored. “The amount of moral courage it takes to run towards the danger makes it very frustrating for our heroes every day to come to our hospitals and care for patients when we see video and hear people not taking the public health strategy seriously.”

Ana Leon, an emergency room nurse who says she has had to become an ICU nurse because there are not enough beds, explained what it’s like for her and patients inside hospitals. “Yes, we’re scared. Our patients are scared,” she said.

The top two concerns for many are the dwindling number of ICU beds — 69 were left in the county as of Friday — and an increasingly exhausted workforce that is stretched thin.

“To be clear, the problem is staff,” explained Dr. Christina Ghaly, director of L.A. County Health Services. And simply adding more space and beds is not a solution to the current crisis.

“A field hospital doesn’t solve that problem,” she said. “When hospitals can’t staff their wards, or they don’t have enough staff to take care of the patients, it doesn’t help to try to go set up a field hospital which doesn’t have all of the infrastructure or connections to an acute care facility because either there’s no one to staff that field hospital or if you do staff that field hospital, you’re pulling away staff that would’ve otherwise gone to an acute care hospital. And the safest place for a patient to receive care is in an acute care hospital.”

The press briefing came a day after ICU capacity dropped to 0% in the Southern California region.

“In general, I think the system is in crisis,” Ghaly said. “When ambulance offload times are up to four hours, six hours, eight hours, that’s a crisis. When hospitals’ emergency departments are full, that’s a crisis. When there’s not sufficiently available beds at the appropriately staffed ratio, that’s a crisis.”

Ghaly maintains that hospitals will respond to the best of their ability but urges residents to stay home.

As 96 new deaths and 16,504 new cases of COVID-19 were reported Friday, the Los Angeles County Department of Public Health again confirmed the highest number of coronavirus hospitalizations reported in a day, 5,100, and four additional MIS-C cases in children. Since Monday, L.A. County has reported more than 71,000 new COVID-19 cases; an acceleration of cases never seen before in the community.

COVID-19 hospitalizations continue to accelerate at alarming speed. Of the 5,100 people with COVID-19 currently hospitalized, 20% of these people are in the ICU, an increase of nearly 1,500 patients in just one week; on Dec. 11, the daily number of people hospitalized with the virus was 3,624.

“The hospitalization numbers that we’re experiencing today are really from the surge and the activity that surrounded the Thanksgiving holiday,” Ghaly explained. “The more recent case counts that are exceeding 10,000, exceeding 15,000, we haven’t yet seen that hospitalization volume yet. Those patients are still getting to the point where they might need hospital level care and that will continue to put strain on the entire healthcare system across Los Angeles County.”

Ghaly’s statement echoed Public Health Director Dr. Barbara Ferrer’s assessment on Thursday. “The devastation we are experiencing now is in part because many people ignored warnings and made the decision to travel or visit with people from outside of their home over the Thanksgiving holidays,” she said. “We are now learning a very painful lesson that, despite how much we want things to go back to normal, this virus is relentless and will continue to spread, make people very ill, and tragically lead to people passing away. We can’t afford another holiday season surge that will further overwhelm our already strained hospitals and healthcare staff.”

December 18, 2020

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Fabiola Diaz

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