Dr. Nicole van Groningen is exhausted. Van Groningen, a hospitalist and assistant professor at Cedars-Sinai Medical Center in Los Angeles, has been on the front lines for eleven months fighting Covid-19, and now LA has the worst case rise since the start of the pandemic she would have spent the last two weeks of January in the hospital’s overwhelmed intensive care unit. Even as the cases started to level off, it’s morally bleak.
“Everyone is tense, it is a feeling that we are constantly bracing ourselves for things that are getting worse. And the patients in the ICU have been sick for so long, ”she says with a slight sigh. It’s the end of January and the area has an average of more than 40,000 cases per week. The hospital’s ICU is 33 percent past maximum capacity. “They’re getting worse, and they don’t bounce back like we usually see. We are used to having the skills we can use to make most people better. We know we’re doing everything we can, but it takes a psychological toll if we can’t heal these people. “
Dr. Van Groningen’s description of the fight against Covid is frightening. Patients come in fearfully, anxiously waiting to see if their symptoms eventually pass, or if they will rise enough to go to the ICU, where the survival rates are much lower. ‘Our patients come in terrified. They are really scared when they first come to the hospital and have trouble breathing, we get them better when they get some oxygen, ”she says. “Then they sometimes even start to make progress with that and become short of breath again. Once you start taking them to the ICU, it is noticeable how scared they are. “
A few miles away, the deadly toll of the virus is barely visible. A few days before my interview with Dr. From Gronigen, I had parked at the entrance to Runyon Canyon Park, a popular hiking spot with views of the city from the Hollywood Hills. It’s quiet, even peaceful. A few teens get out of a jeep, exposed and side by side as they prepare to hit the road. If there was such a thing as a sense of normalcy during the devastating Covid-19 health crisis, it would be this.
Across the country, the pandemic has exposed deep-seated divisions in our communities, with black and Latin populations contracting the disease and dying twice as fast as whites, according to the Centers for Disease Control and Prevention. Nowhere is that more evident than in Los Angeles, where, depending on someone’s zip code, the most recent wave of the coronavirus outbreak was either a slightly removed conversation during Zoom calls – something to wait for dinners and vacations to resume – or the cruel plague that destroyed families and communities. Ten of the richest neighborhoods in Los Angeles County combined, representing about 323,000 people, have about 700 confirmed cases of coronavirus fewer than just the town of Compton (95,000 inhabitants).
That is far from accidental. The wealthier, whiter cities are less populated, have less overcrowding and have more residents who can work from home and travel by car, crucial components in the infection rates. Meanwhile, the ones in poorer communities are more dependent on public transport and have been forced to leave their homes at work, bringing the virus back to their families. After two brutal months of infections and deaths over the holiday season, Los Angeles is on the mend, with confirmed cases, hospitalizations, and deaths continuing to fall from their highs in late December and early January. But as the city slowly returns, the disproportionate toll is evident.
It’s disorienting to see the daily Covid stats and hear anecdotes of horror on the front lines of the ICUs. While one LA resident died of the virus every 10 minutes during the peak of the wave, residents could still scream in malls during the holidays. The restored order for Safer Home in Los Angeles County didn’t begin until three days after Black Friday. As cases skyrocketed, the county took preventative action, stopped dining outside and closed businesses such as hair salons in late November, and residents were told not to leave the house when not essential. Yet Los Angeles never really entered a lockdown again.
Christopher Prado, EMT, left, and Jesse Lynwood, ED RN, right, work with a suspected Covid-19 patient in the emergency department of Martin Luther King, Jr., Community Hospital on April 23, 2020 in the South Willowbrook Ward Los Angeles, CA.
Francine Orr / Los Angeles Times / Getty Images
In stark contrast to the early beginnings of quarantine, where there was no traffic and the city seemed empty, during LA’s deadliest period, shopping malls, jewelry stores, bookstores, and most other types of stores were open with limited capacity. The city and state also had to support a significantly injured economy, with California having the third highest unemployment rate in the country in December, according to the Bureau of Labor Statistics, and it faced ongoing pressure from businesses that had been under pressure for months. Restaurants across the state have sued California Governor Gavin Newsom over the food restrictions, and Newsom is facing a small but remarkable recall effort of Republicans in California in light of the state’s response to the virus.
Limited capacity openings only added a new sense of normalcy, and what emerged was a confusing message to Angelinos about what was expected and allowed.
Martin Luther King Jr. Community Hospital in southern Los Angeles is surrounded by predominantly black and Latino neighborhoods such as Watts, best known for the Watts riots of 1965, and it has become a symbol of how the coronavirus disproportionately affected those communities. The relatively small 131-bed hospital has had ample capacity since December, and as MLKCH CEO Dr. Elaine Batchlor says her hospital has served more Covid-positive patients than hospitals four times the size. Although the increase has fallen significantly in February, the hospital’s IC department remains 100 percent full.
The community serving MLKCH was particularly vulnerable to a pandemic. Access to healthcare is more limited and underlying health problems are more common. For example, diabetics are one of the highest risk groups for severe Covid cases, and South LA has diabetes rates three times higher than any other part of the state, Batchlor says, and diabetic amputations and wounds are the hospital’s major surgery. “A lot of our patients are on the front lines, and if it continues to spread and are exposed to it on the spot, they live in crowded homes, they go home, and give it to the rest of the family. We see entire families getting sick and losing important family members. ”
The hospital has set up its gift shop to treat more patients, doubled rooms, converted an entire floor into an intensive care unit, and set up five triage tents outside the hospital where patients are treated and boarded until there is room in the hospital.
As Batchlor says, the neighborhoods her hospital serves have long been the most likely to suffer from a health emergency, and she hopes the pandemic in the future will increase the need for better resources for poor communities across the globe. country will underline. “Even before Covid came, we had a public health crisis in our community, and it’s an epidemic of poorly treated chronic disease. [Covid] subsequently hunted a vulnerable population and hit them much harder than any other, ”says Batchlor. “In the long run, we need to create better access and quality healthcare for disadvantaged communities. We are all connected. I hope the pandemic has shown us that we are all suffering. “
Batchlor and Van Groningen see both sides of the Covid story in Los Angeles every day. After treating the county’s sickest patients, they return to their homes in Westchester and Santa Monica, where incomes are higher and cases lower. Several times, Batchlor came home to watch her neighbors organize social events and ignore the city’s mandatory protocols, something she says was ‘demoralizing’.
“It feels really frustrating and sad that people are not taking it seriously enough and are not willing to make the smaller sacrifices necessary to keep other people in the community safe,” she says. And it pisses me off thinking about how hard we work to treat people affected by covid. Earlier in the pandemic, when I saw people walking without a mask, I said something. I stopped because it happened so often. “
Van Groningen goes to and from work along the beach of Santa Monica, where, in his own words, it is difficult to distinguish any difference from a pre-covid world, especially on weekends. Masklessness not rampant, but it’s still noticeable, she says, and she still sees enough people from different households getting too close for comfort. Finding a medium between curbing the cases to support the economy and residents’ declining mental health, nearly a year into a pandemic, is a difficult task, she says, but it is dangerous to be the first. renounce. Like many epidemiologists and health experts have the Los Angeles Times Fatigue and a decline in social distance practices were a frequently cited factor in the resurgence of the holiday season in cases. And yet Van Groningen is optimistic.
“I like to think we haven’t given up,” she says. “From my experiences with friends and people I’m close to, I want to say that most people are still trying to do the right thing. But there is a connection. I think sometimes people don’t know what is right. “