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Hospitals in Southern California are overwhelmed, and it could get worse



LOS ANGELES – If this was any other year, members of the Los Angeles Opera would have sung Christmas carols this week in the wards of Martin Luther King Jr. Community Hospital, which serves the largely poor and Latino communities of South Los Angeles. Instead, a street choir from Skid Row came in with a video to bring holiday cheer to the growing number of dying coronavirus patients and traumatized staff.

Inside the hospital, so many patients are pouring in that pimples are located in the gift shop, and the entire lobby is now a place to treat patients. The waiting room is a tent outside.

“Everything is backed up to the street,” said Dr. Oscar Casillas, medical director of the hospital’s emergency department, which is set up to serve around 30 people at a time but has seen more than 100 people in the past week. patients per day.

In the High Desert region northeast of Los Angeles, health workers at a hospital get their first pictures of a coronavirus vaccine in a cheerful conference room adorned with festive decorations. There is Christmas music, and “Home Alone 2” is played on a screen. As soon as the needle is out of their arms, the next “code blue”, or the next FaceTime farewell to arrange between a dying patient and a grieving family.

“Every day is scary,” said Lisa Thompson, an intensive care nurse at the hospital, Providence St. Mary Medical Center in Apple Valley. “We are all stressed before we even get to work. Tons and many patients. We can not even keep track of how many patients are admitted to the hospital. ”

In increasingly pressing tones this week, health authorities and political leaders in Southern California have asked people to stay home for the holidays, and are desperately hoping to prevent a further increase in infections, on top of the current crisis that came after Thanksgiving.

Barbara Ferrer, director of the Los Angeles County Department of Public Health, said the only way to “pay homage to the basic spirit of the holiday” was to stay home.

But so far very little has slowed the spread of the virus.

Every day in California, which this week became the first state to reach two million registered virus cases, brings an astonishing new account of the tragedy – more cases, more disease, more deaths. Southern California, the most populous area in the most populous state, is on the brink of disaster. In Los Angeles County, a large region with a population about the size of Michigan, there are about 6,500 people hospitalized with Covid-19, an increase over the past month. The number of patients in intensive care units is close to 1,300, double what it was a month ago.

And on Thursday, the county reported 146 new deaths, according to a New York Times database, equivalent to about one every 10 minutes and the highest number of pandemics. Almost every hospital has stepped past capacity, placed new beds in any place they find, and prepared for the possibility of rationing care – in essence, it makes it difficult to make decisions about who dies and who lives.

But the availability of beds is not even the most pressing concern. With so many employees becoming ill or taking leave after months of treating coronavirus patients, hospitals are struggling to find enough workers.

“In the beginning, especially, you saw all these pictures and videos from New York, and you think, ‘Oh my God, it can never get that bad here,'” said Mendy Hickey, quality director at St. Mary’s. “And while we have all the supplies we need, it’s so bad here, and we do not have any staff who can take care of patients.”

Mrs. Hickey, a former nurse, has recently taken turns caring for patients in intensive care, on top of her administrative duties, and sometimes she worked 23 hours a day. She planned to work late on Christmas Eve, hoping to spend at least Christmas morning with her three daughters before returning to the hospital.

As the holiday season has collided with the height of the pandemic in Southern California, there is little joy for health professionals on the front lines, who support the near certainty that things will only get worse. California Governor Gavin Newsom has estimated that hospital admissions would reach close to 100,000 in January if residents do not lock themselves in during the holidays. On Thursday, California reported 351 deaths.

“I can only imagine what will happen after Christmas and New Year if we do not get the local community educated on how we can be at home and be safe,” said Thompson, the nurse at St. Mary’s.

From what she sees in her community after another traumatic day in the intensive care unit, she is not optimistic.

“We’re all talking about mid-January when we expect to see a sharp increase from both holidays,” she said. “It’s a little scary.”

California was the first state to introduce a lockout in the spring, and for a while seemed to handle the pandemic much better than elsewhere. But when it faces the crisis it has long feared, the pain spreads unevenly.

In South Los Angeles, Martin Luther King Jr. Community Hospital serves low-income communities populated with grocery workers and bus drivers who live in overcrowded households and are forced to mingle with the public every day, the rate of infection is far higher. In Los Angeles County, about 15 percent of coronavirus tests in recent days are positive; at a test site on the hospital’s campus, the frequency is about 25 percent.

As a result, the burden of the wave is much heavier in the hospital than in richer areas of Los Angeles. According to recent statistics, 66 percent of the hospital’s capacity was taken up by Covid-19 patients, which actually made it the epicenter of the epicenter. Across the city, on the whiter and richer West Side, 11 percent of Ronald Reagan’s UCLA Medical Center bed capacity was filled with coronavirus patients.

Officials at Martin Luther King Jr. Community hospitals, where most patients are on Medicaid or uninsured, say they struggle to transfer patients to larger hospitals when they need a high level of care, such as neurosurgery or a heart procedure.

“What we see is a significant difference between patients who have commercial insurance compared to Medicaid,” said Dr. Elaine Batchlor, the hospital’s CEO. “Those with commercial insurance get out faster.”

She added: “We have talked a lot about systemic racism and social justice, and everyone says they want to do something about it, but our health care system is a huge reflection of separate and different. And the Covid pandemic highlights the same patterns. ”

Thompson, who has been working for a few days from 7 a.m. to midnight, was grateful to have a day off on Christmas Day and planned to spend it with his four children. Her parents, who live nearby but did not intervene during the pandemic, were at Zoom.

But the holiday was just a short respite, and she is scheduled to work over the New Year, giving an endless wave in sight.

“Trying to work all this on overtime and then trying to keep up with all the death and dying and trying to keep a straight face and keep moving forward, it’s exhausting,” she said.


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