California plans for possible rationing of COVID care

California’s overwhelmed hospitals are setting up makeshift extra beds for coronavirus patients, and a handful of facilities in hard-hit Los Angeles

County are drawing up emergency plans in case they have to limit how many people receive life-saving care.

The number of people hospitalized across California with confirmed COVID-19 infections is more than double the state’s previous peak, reached in July, and a state model forecasts the total could hit 75,000 patients by mid-January.

Plans for rationing care are not in place yet, but they need to be established because “the worst is yet to come,” said Los Angeles County’s health services director, Dr. Christina Ghaly.

While shipments of the vaccine are rolling out to many health-care workers and nursing homes across the country, it could be months before the shots are available to the general public. Until then, four hospitals run by Los Angeles County are weighing what to do if they cannot treat everyone because of a shortage of beds or staffers.

A document recently circulated among doctors at the four hospitals proposed that instead of trying to save every life, their goal could shift to saving as many patients as possible — meaning those less likely to survive would not get the same kind of care.

“Some compromise of standard of care is unavoidable; it is not that an entity, system or locale chooses to limit resources, it is that the resources are clearly not available to provide care in a regular manner,” said the document obtained by the Los Angeles Times.

Many hospitals in California already have implemented emergency procedures to stretch staff and space.

Corona Regional Medical Center southeast of Los Angeles has converted an old emergency room to handle nearly double the usual number of ICU patients. It’s also using two disaster tents to triage ER patients.

Overall, the state’s ICU capacity was just 2.1 per cent on Sunday. Some hospitals have cancelled non-essential elective surgeries, such as hip replacements, that might take up beds that could soon be needed for COVID19 patients.

Nurses say the crush of cases means they have less time to spend with patients, many of whom are sicker than they have ever been.

“The more patients we have, the more there’s a risk of making a mistake, especially if we’re rushing,” said Wendy Macedo. a nurse at UCLA Health Santa Monica Medical Center. ”Obviously we’re trying to avoid that, but we’re only human.”

California was experiencing “some of the darkest days of our COVID-19 surge,” Gov. Gavin Newsom said, but there was some light Sunday as a group of scientists and experts endorsed a vaccine developed by Moderna. The step clears the way for the drug to be distributed throughout California and other Western states that reviewed it separately from the Food and Drug