California hits new 1-day COVID-19 death record as hospitals plan for potential rationing,
LOS ANGELES — California broke the singleday record for COVID-19 deaths yet again Tuesday, logging 442 fatalities in a Times county-by-county tally of local health jurisdictions — a number equivalent to someone dying of the disease every three minutes.
More than half of those deaths — 242 — were of Los Angeles County residents, according to The Times’ survey. That’s a record high in a single day for the nation’s most populous county, a count boosted in part by a backlog of reports from the Christmas weekend.
At that rate, cumulative COVID-19 deaths will likely exceed 25,000 in California on Wednesday and 10,000 in L.A. County by New Year’s Day. As of Tuesday night, California had a cumulative 24,987 deaths and L.A. County, 9,806. Over the past week, the state averaged 240 deaths a day, and L.A. County, 111.
The climbing death toll has changed daily life throughout Los Angeles. In East L.A., the Continental Funeral Home has seen its typical caseload more than quadruple, with 80% of its services honoring people who died from COVID-19. The L.A. County College of Nursing and Allied Health is postponing the admission of nursing students for the spring semester because faculty and staff have been redeployed to county hospitals.
The “healthcare situation has never been this critical and the need for healthcare workers is at its peak,” Mildred Gonzales, dean and program director of the college’s School of Nursing, wrote in a letter, calling the current time an “unprecedented critical situation.”
With intensive care units across California overcrowded, healthcare providers have already been forced to take steps limiting how much hospital care is given.
“We certainly know that Southern California hospitals are in crisis,” said Dr. Mark Ghaly, the California health and human services secretary. And with some people likely to ignore pleas to stay home for New Year’s Eve, officials expect hospitalizations to worsen again in the coming weeks, particularly during mid- to late January.
Even now, paramedics and emergency medical technicians are declining to transport some less severely ill patients whom they might take to the hospital under ordinary circumstances.
In Los Angeles County, EMTS “are assessing patients and releasing them to stay at home, because they aren’t quite sick enough to need hospitallevel care. ... If they did come to the hospital, they may not get the type of attention that they might expect,” Ghaly said.
That’s an example of the unusual measures healthcare personnel have been forced to take amid a systemwide overcrowding of hospitals not seen in modern California history, a result of the worst pandemic in more than a century. For the first time, the number of people hospitalized for COVID-19 statewide has exceeded 20,000, a figure eight times higher than that on Nov. 1.
The overcrowding is already causing the quality of healthcare to suffer, Ghaly said.
A plan to triage and ration hospital carestate officials have yet to hear reports of the direst circumstances, such as a hospital having to choose who gets the last ventilator.
Nonetheless, some hospitals in L.A. County are running dangerously low on supplies of oxygen, treating patients in conference rooms and gift shops, and leaving patients waiting in ambulances for as long as eight hours until they can be taken into the emergency room.
Hospital systems are already coming up with triage plans, which entail prioritizing the time of highly trained staff — such as respiratory therapists, ICU nurses and critical care doctors — in a way to keep as many people alive as possible. That means that those less likely to survive might not receive the same level of care they would have otherwise.
Most hospitals in California are no longer able to offer regular hospital services, switching instead to “contingency care,” Ghaly said, in which staff are asked to work longer shifts, hospital rooms are reconfigured to hold more beds than originally intended, scarce supplies are conserved or even reused and the movement of patients within the hospital is delayed because of a lack of space or staff.