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COVID-19 overvoltage pushes LA hospital to 320% occupancy

While new COVID-19 admissions have been leveled recently in Los Angeles County, many medical facilities are still overwhelmed. The intensive care unit at a hospital in South Bay, Memorial Hospital of Gardena, has 320% occupancy, officials said Wednesday.

The 172-bed medical center has been at various levels of “internal disaster status” since March, and the latest rise in coronavirus is manifesting itself in alarming but increasingly familiar ways – including a lack of oxygen supply in the home, delaying the discharge of many COVID-1

9 patients and keep beds occupied.

Demand for oxygen within the hospital has also risen sharply, according to the hospital’s spokeswoman Amie Boersma.

“Bulk oxygen delivery has gone from once a month to every third day and narrowing,” Boersma said in an email. “We have to monitor every single day.”

But it is the lack of staff that poses the biggest challenge. In a region besieged by COVID-19 “it is still very difficult to find enough ICU nurses,” said Boersma, adding that the hospital is looking for travel nurses from all over the country and has also requested nursing resources from the National Guard.

While the hospital awaits extra help, it has implemented a team structure that allows staff from closed wards, such as outpatient surgery the same day, to help ease the workload and allow ICU nurses to focus on the most critical tasks.

The hospital also uses advanced, registered nurse practitioners and paramedics to supplement 10-bed ICUs and emergency departments and provide “another set of hands and eyes,” Boersma said, along with hiring last year’s nursing students to serve as nursing assistants.

Nearly two dozen patients in need of intensive care are also being treated on the telemetry floor and in recovery rooms, she said.

And even though ambulances with critical advanced life-support patients are being diverted because most would require ICU admissions, Boersma said the request for redirection can only do so much.

“When the majority of hospitals are undergoing ALS redirection, no one is redirecting,” she said.

LA County hospitals have reported an average of 750 to 800 new COVID-19 admissions a day – an astonishing number that has been largely stable since Christmas Eve. The count has led to ICUs being efficient over capacity, and morning rooms at hospitals are so full that the National Guard has been called in to help move corpses to the county coronation office until funeral homes and gazebos can work through the backlog.

There are still fears that new admissions may increase again, a result of transmission during the winter holidays. Should this happen, hospitals throughout LA County may need rationing of care, activation of teams of triage officials who will have to decide which patients get nurses, respiratory therapists and access to ventilators, and which patients get palliative care when they die.

Dr. Christina Ghaly, director of health care in LA County, said the number of hospital admissions has increased somewhat in recent days – just under 8,000.

While they did not increase at the rapid rate seen earlier in the wave, “they have leveled at a rate that is really unsustainable,” she said during a briefing Wednesday. “This high plateau does not leave enough open beds to take care of the patients.”

This is especially the case, Ghaly said, because the county has not yet determined the full consequences of potential post-holiday exposures. Any increase in transmission, she warned, “would be absolutely devastating to our hospitals.”

“In order for there to be any meaningful relief for healthcare providers, we need a rapid and marked drop in admissions for at least one to two months,” she said.

The county still reports an extremely large number of new infections – more than 15,000 a day on average – and officials say some of those who test positive will always require hospital treatment two to three weeks later.

As of Tuesday, the most recent day of complete data from the state, there were 7,906 coronavirus-positive patients admitted to LA County with 1,699 in intensive care.

Although both of those numbers have remained relative or even dropped slightly, Ghaly stressed that they remain “unprecedented during this LA County pandemic, and everyone should remain concerned about what might happen” if they continue to go up. .

Any optimism must also be covered by the reality that transmission after the holidays remains unclear, she added.

“If our number of cases continues to be so high and even rising, it’s very bad for hospitals,” said Barbara Ferrer, director of public health in LA County.

Unless conditions improve, Ferrer said it is possible the county will pursue further restrictions – especially given the looming threat from the new variant of coronavirus first discovered in the UK and considered even more contagious.

“We are considering all options at this time,” she said. “We are very, very concerned about the continuing high number of cases and feel that there really is not a big window here to try to get the wave under control.”

The effort, she said, is literally life and death for many – and all Angelenos must redouble their efforts to protect themselves.

“Make it look like your life or the life of a loved one depends on it,” she said. “Because it just can.”

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