The days when outraged local mayors demanded the California governor reopen Disneyland seem a long time ago.
As Orange County continued to set new records for new Covid-19 infections and hospitalizations on Tuesday, a very different type of facility was being set up for visitors. Orange County officials were rolling out mobile field hospitals to accommodate the increase in the number of coronavirus patients.
Those field hospitals are housed in large trailers and include canvas tents with hard floors and temperature-controlled units with running water, toilets, showers and generators, as well as air purifiers.
Fountain Valley Regional Hospital will have 50 such beds, St. Jude’s in Fullerton will have 25 beds and UC Irvine will have 50 beds.
County Supervisor Doug Chaffee said he received a text message last night from a medical professional at St. Jude Medical Center indicating that the hospital has “99% capacity.”
The hospital’s 301 beds are full of 138 COVID-19 patients, Chaffee said.
“The ICU has a capacity of 105%,” said Chaffee. ‘They use every available bed. The emergency department has an overflow … All Orange County hospitals are in the same situation. It’s awful so they’ll be pitching a tent in the parking lot soon, probably for triage. I think what we are seeing is not a wave, but a tsunami. “
“I’m afraid,” said Dr. Clayton Chau, the county’s chief health officer and director of the Health Care Agency, of the increase in the number of patients. ‘I lose my sleep every night. I’m scared … I’ve never been so scared of Christmas and New Year in my entire life … I can’t imagine what it would be like after the holidays if people don’t listen and don’t obey.
In Los Angeles, hospitals have caught a massive Covid spike by canceling elective procedures. “Hospitals have started to slow down nonessential procedures to some extent,” said Dr. Christina Ghaly, LA’s director of Health and Human Services.
Another method of regulating bed capacity is “diversion”, where an ambulance is diverted to a hospital – possibly further away – with more beds. “We are aware that there are certain hospitals in the county where charging time can take more than four hours,” said Barbara Ferrer, LA County’s director of public health. “That’s why we need the diversion system.”
On Sunday, a day when the emergency department is traditionally less crowded, 81% of 112 receiving hospitals in LA requested that advanced life-support ambulance traffic be diverted to other medical facilities due to overcrowded emergencies. The average of the hospitals requesting diversion at this time of year is normally 10% to 15%, Ghaly said last week.
The next step for local hospitals, Ghaly said, would be to break the ratio or implement team-based nursing. The state mandates nurse-patient relationships, but in emergency situations the number of nurses per patient can be reduced.
On Friday, Governor Gavin Newsom did just that. He issued emergency clearance for ICU units to increase the number of patients per nurse from 2: 1 to 3: 1. Newsom also handled additional recruiting staff and requests for assistance sent to the federal government.
When asked about the USNS Mercy, which was sent to LA during the summer peak, Newsom said he had not made the request. “Beds are not one of the most important sources [on the ship], but the staff, ”said Newsom, echoing health officials who have argued for months that the ICU crunch is not about beds, but about nurses and doctors trained in acute care.
Ghaly said the Mercy had rules about patients making it difficult to get acute care patents on board, including restrictions for patients with substance abuse problems or mental disorders.
California’s top medical officer said on Tuesday that hospitals are also looking into the possibility of “rationing” care.
“We have been working with our hospitals for the past few months on what is called ‘crisis care’. We need to look into that in case we need to implement it, ”said the state’s director of Health and Human Services.
To dampen the excitement generated by the delivery of Covid-19 vaccines, Governor Newsom on Tuesday offered a grim reminder of the rising death toll, saying the state has ordered 5,000 additional body bags for distribution to morgues in three counties, including Los Angeles.
Los Angeles County reported the highest number of new coronavirus-related deaths since the summer, at 86 on Tuesday. California as a whole has lost an average of 163 people to the virus in the past 7 days. The very highest number of deaths related to the virus was the 225 reported Friday.
The province also reports 11,194 new cases of COVID-19. The number of people admitted to hospital because of the virus is now 4,403, of which 21% in intensive care beds.
According to LA County Health officials, “In this day and age of extraordinarily high rates and hospitalizations and increasing deaths, it is more important than ever that County businesses closely monitor public health requirements and fully comply with safeguards and changes to the ordinance and protocols. the health officer. “
Orange County set new records on Monday for new coronavirus-related infections – 3,250 – and hospitalizations, with the adjusted capacity of the intensive care unit reaching zero.
On Tuesday, the province registered 2,173 new COVID-19 infections. Hospital admissions rose from 1,287 Monday to 1,371 Tuesday, another record. There were 296 IC patients, against 288 the previous day, a new record. That has become a daily occurrence since last week.
In fact, the availability of the county’s Covid-adjusted ICU beds rose from zero to 1.4% on Tuesday. That likely reflects efforts to increase capacity – possibly through the mobile field hospitals – as the number of ICU patients actually increased. The state created the adjusted number to reflect the difference in available beds for COVID-19 patients and non-coronavirus patients.
The overall percentage of ICU beds available in Southern California’s 11-county region was 1.7% as of Monday night.
Orange County’s positivity rate rose from 10.6% to 13.2% on Tuesday. Officials reported that another fatal accident was reported in Orange County on Tuesday, bringing the death toll to 1,695.
Prior to this month, the record for ICU patients in Orange County was 245 at a peak in mid-July. Overall hospital admissions have been breaking records daily since December 2.
As has been the case for months, dozens of residents appealed to the board of supervisors on Tuesday to defy the state’s house arrest. Leon Page, counsel for Orange County, explained that Governor Gavin Newsom’s executive branch is the last word and there is nothing the county can do to change it.
Dr. Chau made an emotional appeal to residents to adhere to physical distance and face covering mandates to stop the spread of the coronavirus.
The province’s health officials are particularly struggling to accommodate elderly people with dementia, who are infected but show no symptoms, Chau said.
“We can’t send them to a hospital … They don’t need that care,” Chau pointed out. “And we can’t send them to a nursing home … and we can’t send them to a hotel.”
Those patients are likely to be housed at the Fairview Developmental Center in Costa Mesa, which is expected to open Thursday.
“But we only have 50 beds available,” said Chau. “We will run out of options to care for these people.”
“Right now we are feeling the effects of the Thanksgiving wave,” said Lisa Bartlett, Orange County supervisor. “And with Christmas holidays and New Years we have to plan for more cases to come.”
“The message is very simple,” added Chau. “In the United States today, there are two people who are killed every minute in the United States by COVID-19. Every minute we talk, someone lost a loved one … It’s an amazing number and just an embarrassing number from an American perspective, because we are supposed to be the best at what we have in terms of medical care. “
Orange County Supervisor Andrew Do, whose father died unexpectedly over the weekend, noted
crush of patients he saw in the hospital where his father was being treated.
“I can tell you from personal observation that every bed is taken,” said Do. “When I contacted funeral homes for my father, they said their business is up 300% this year. The waiting time and lack of availability of services, whether for viewings or cremations, is unbelievable. They have never experienced such scarcity. “
Newsom said 142 deaths from the coronavirus have been reported in the past 24 hours. In the past week, there were an average of 163 deaths a day in the state, up from 41 a day a month ago.
“Think if we are continuing on the path we are following, what that January 14th issue might look like if we don’t do what we have to do, and that’s not just to use ourselves when we can, but to keep going to wear these face covers and minimize mixing because of what happened in the last 30 days, ”said Newsom.
According to the governor, the state has 60 53-foot refrigerated storage units on standby in California counties for use when local facilities become overwhelmed with virus deaths.
“We just had to order 5,000 extra body bags … and we just distributed them to San Diego, Los Angeles, Inyo counties,” he said. That should be sobering. I don’t want to scare people, but this is a deadly disease. And we must be aware of where we are on this current journey together towards the vaccine. We’re not at the finish yet. “
City News Service contributed to this report.
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