Hospitals in California are so swamped by the coronavirus pandemic that the state has ordered those with room to accept patients from others that are out of intensive care beds.
The public health order issued on Tuesday night could result in patients being shipped to northern California from southern California and the agricultural San Joaquin Valley, where 14 counties were immediately ordered to delay non-essential “and non-life threatening” surgeries in order to provide beds. The order, which will last at least three weeks, also applies to any county where ICU capacity to treat Covid-19 patients is bottoming out.
“If we continue to see an alarming increase of Covid-19 patient admissions at hospitals statewide, some facilities may not be able to provide the critical and necessary care Californians need, whether those patients have Covid-19 or another medical condition,” said Dr Tomas J Aragon, the state’s public health officer.
The order could be a bellwether for California, where officials have warned that some hospitals may have to start rationing care if an expected post-holiday surge in Covid-19 cases overwhelms the healthcare system.
California on Wednesday reported its second-highest number of daily coronavirus deaths, with 459 lives lost. The total death toll in the state in the past week stands at 2,504, with more than a quarter-million new weekly cases portending a continued overwhelming crush on hospitals.
“The numbers are extraordinary,” said Carmela Coyle, president and CEO of the California Hospital Association. “We’re not going to dodge this math. We need the state’s help.”
It’s expected to take many more weeks to quell the contagion. Los Angeles continues to see hospitalizations rise day after day, setting a new record on Tuesday with almost 8,000 hospitalized and more than a fifth of those in ICU.
The county, which accounts for a quarter of the state’s residents, has more than 40% of the state’s 27,000 coronavirus deaths. One in five coronavirus tests now comes back positive, officials have said. One estimate suggests that roughly one in every 17 people in LA county currently has Covid.
Some hospitals in the region have had to close their doors at times because they have become so overwhelmed, leaving ambulances waiting up to eight hours and diverting others to different emergency rooms. Health officials recently began directing ambulance crews not to transport patients to the hospital if they have virtually no chance of surviving.
Exacerbating the stress on the hospital system are growing infections among medical staff. More than 2,200 people who work at LA county hospitals tested positive for the virus in December, the LA Times reports.
California on Tuesday formally requested that 500 federal medical personnel be deployed in California to help staff hospitals and skilled nursing homes after learning that the USNS Mercy Hospital ship, which docked off Los Angeles earlier in the year for overflow patients, was in dry dock and would not be returning.
Meanwhile, state officials are grappling with a rise in cases of the UK variant of the coronavirus, which research has shown is more contagious. San Diego county on Tuesday reported two dozen more cases of the strain. “The fact that these cases have been identified in multiple parts of the region shows that this strain of the virus could be rapidly spreading,” Dr Wilma Wooten, the county’s public health officer, said in a news release on Tuesday.
In the San Joaquin Valley, the top doctor in Fresno county said he was watching what is happening in LA county “very closely” as the region prepares for a seemingly inevitable surge stemming from people who ignored social distancing rules to gather for Christmas and New Year’s Eve celebrations.
“I’m very worried that we are going to see an uptick in the number of hospitalizations and deaths related to gathering that happened over the holidays,” said Dr Rais Vohra, the county public health department’s interim health officer.
Vohra said the county hoped to “scale up an army of vaccinators” to get as many people immunized as quickly as possible, starting with hospital staff, but one hurdle will be convincing people to get the vaccine.
There are some polls that show about 50% of people in the county “aren’t ready for the vaccine at this time” and are waiting to see if there are any side-effects, said Joe Prado, community health division manager for Fresno county.
Distribution hiccups and logistical challenges have slowed the initial coronavirus vaccine rollout in the state, setting a pace that Governor Gavin Newsom admitted was “not good enough”.
So far only about 1% of the state’s 40 million residents have been vaccinated, Newsom said this week. The 454,000 doses of vaccine that have been administered in California represent just a third of the more than nearly 1.3m received in the state so far, according to the California department of public health.
California is working to expand the list of sites where the vaccine can be distributed to include pharmacies, clinics and dental offices. Officials are also completing a survey of healthcare workers to find out how many of them do not want to take the vaccine, in response to anecdotal evidence that some are refusing it.
While the state wants to make sure no one is jumping ahead in the line, Newsom said he wanted to give providers the flexibility to distribute doses to people not on the priority list if doses are at risk of going to waste.
“We are working hard to make sure that 100% of what we get, we get out as quickly as possible,” Ghaly said.
