‘New York moment’: S. California reeling
LOS ANGELES — A sustained surge of coronavirus infections has locked Southern California in crisis, overwhelming intensive care wards, ambulance services, funeral homes and local officials.
Dozens of overcrowded hospitals have had to shut their emergency room doors to ambulances for hours at a time. Medical wards are running dangerously low on a vital necessity: oxygen, along with the portable canisters to supply it to patients. Los Angeles County has a coronavirus-related death every eight minutes, a grim toll accompanied in many neighborhoods by the soundtrack of shrieking sirens.
“We’re having our New York moment,” said Dr. Robert Kim-Farley, an infectious disease expert at the Fielding School of Public Health at the University of California at Los Angeles, referring to the weeks in March and April when New York City was the epicenter of the virus.
It took nearly10 months for Los Angeles County to hit 400,000 cases but little more than a month to add another 400,000, from Nov. 30 to Jan. 2. In the coming days, the county, which is the nation’s largest, will reach a level where 1 in 10 residents has tested positive for the virus.
“In the city of Los Angeles and in our county, COVID-19 is now everywhere and infecting more people than ever,” Mayor Eric Garcetti, whose 9-year-old daughter contracted the virus and has since recovered, told reporters Thursday.
Los Angeles County averaged 187 deaths a day in the seven-day period ending Friday, the most of any U.S. county and double the nation’s per capita rate. The county’s death toll, though awful, is far smaller than the one in New York City in the spring, when less was understood about the disease and treatment was not as sophisticated as it is now. At the peak of its crisis in April, New York City averaged around 800 deaths each day.
But there are similarities between the two in the strain on hospitals.
In the April peak, the virus patient count on one day in New York City was more than 12,000. On Friday, there were more than 8,000 people hospitalized with COVID-19 in Los Angeles County, a number that has sharply and quickly climbed. On Nov. 1, hospitalizations were at 799.
California reacted swiftly at the start of the pandemic, with the country’s first stay-at-home orders, and had largely avoided the widespread infection and death experienced early on in places such as New York. Now many epidemiologists, health officials and elected leaders are trying to understand what went so wrong.
Part of the reason for the new surge appears to be the Thanksgiving effect. Many Californians, particularly those in and near Los Angeles, held small gatherings for Thanksgiving with family and friends despite warnings from officials. Acting as a collective superspreader event, those gatherings multiplied the amount of virus circulating and sharply raised the risk of infection.
More broadly, experts say the state’s early success in the pandemic may have given Californians a false sense of security — in contrast to people in New York and New Jersey, where the early surge in cases left many petrified and extremely cautious.
“We really did suppress and flatten that first wave relatively successfully compared to others,” Kim-Farley said. “The very successes that we had built in a potential complacency from the part of people thinking it’s maybe not that severe.”
For months in the early stages of the pandemic, many residents and elected officials had embraced a mask-wearing and pro lockdown culture. As other states were hit hard by the virus, California had far lower infection rates, a phenomenon some infectious disease experts called “the California miracle.” A spike in new cases hit parts of California later in the summer but subsided.
The turning point, experts said, came in November, as that culture of precaution waned. Young people who had isolated themselves gathered in large groups and stretched the limits of what constituted outdoor dining to include rooms with large windows. The taboos of the first months of the pandemic, such as meeting friends in their homes, fell away. And in more conservative parts of Southern California, the resistance to lockdowns grew as cases skyrocketed throughout December.
The resistance in some parts of the state to the lockdowns has been so strong that it has even spurred a move to recall Gov. Gavin Newsom. The effort has drawn funding and support from conservatives opposed to restrictions on church services. Although recalling Newsom is considered a long shot in such a staunchly Democratic state, Republicans were encouraged by gains theymade in the November elections, winning back four congressional seats.
The worst may still be ahead. Health officials said they were only in the past couple days seeing the first cases from the Christmas and New Year’s holiday season from those who became infected after traveling or attending small gatherings.
“We anticipate that the numbers of hospitalizations and deaths will remain high throughout this month because of what occurred over the holidays,” Dr. Paul Simon, the chief science officer of Los Angeles County’s public health agency, told reporters Friday.
In some areas of Los Angeles, which with its 10 million county residents is more populous than most states, ambulances have been forced to wait for hours to offload patients. The surge of hospitalizations has caused problems for the oxygen delivery and supply system used by medical facilities. Newsom said last week that experts from the state and the Army Corps of Engineers were helping improve oxygen supplies.
In Huntington Park, a low-income city southeast of downtown Los Angeles, a hospital shut its front entrance and converted the back parking lot into an outdoor ward, treating patients feet away from rows of parked cars. Two white tents in the parking lot serve as an overflow site at the facility, Community Hospital of Huntington Park.
On a recent afternoon, several patients sat or lay down on gurneys in the tents, as nurses and health careworkers in blue or red scrubs ducked inside, wheeling IV carts or toting oxygen canisters. A cabana by the ambulance entrance was the front desk, while the rest of the uncovered lot became the waiting room for anxious relatives, who are unable to see their loved ones inside because the hospital is closed to visitors.
“It’s like a war in there,” said David Estrada, 26.
This lot has been Estrada’s home for nearly three weeks. When his grandmother, Marta Estrada, was hospitalized with the coronavirus days before Christmas, he drove over in his Hummer and has been sleeping in the vehicle at the Community Hospital lot ever since. He has returned home only to shower.
In Riverside County east of Los Angeles, nearly half of its more than 200,000 cases and more than a quarter of its 2,200 deaths came in the month of December alone.
Wendy Hetherington, the chief of epidemiology for the county’s public health department, receives a weekly log from the coroner that tallies all coronavirus-related deaths from the previous week. In September, the log had about 25 deaths per week. On Monday, it listed 323 deaths for the previous week.
“We all saw the refrigerated trucks in New York and then Texas earlier,” she said. “We don’t want to get to that stage here in Southern California, but it seems like we’re right there at the cusp.”
By nearly every major metric, the spread of the virus is profoundly more dire in Southern California. The San Francisco Bay Area has 4 percent of its intensive care beds still available, and the far north of California has 25 percent. Southern California reached 0 percent weeks ago.
Los Angeles County reported more cases last week than San Francisco has reported during the entire pandemic.
“It’s night and day,” said Dr. Bob Wachter, a professor and chair of the department of medicine at the University of California at San Francisco.
The reasons for the split, experts said, are complex, and many.
The Bay Area has among the highest average incomes in California, perhaps giving residents more means to protect themselves. Many in the north are employed in the technology industry, which early in the pandemic led the move to working at home. Compared with Southern California, the Bay Area also has a higher percentage of white and Asian households, groups that have had the lowest rates of infection in the state.
In the Los Angeles area, in the parking lot outside the Community Hospital of Huntington Park, Estrada has watched as more than a dozen bodies have been brought to an unmarked white refrigerated container, the makeshift morgue.
“Basically you’re waiting to see your family member come out in a bag,” he said.
His grandmother, who is 72, was recently placed on a ventilator.
“She’s in a fight right now,” he said. “So if she’s fighting, we got to stay out here fighting for her.”