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Gurneys in the Gift Shop: Inside the busy Southern California hospitals

LOS ANGELES – If it was another year, members of the Los Angeles Opera would have been singing Christmas carols this week in the neighborhoods of Martin Luther King Jr. Community Hospital, which serves largely poor and Latin communities from south Los Angeles. Instead, a Skid Row street choir stepped 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 flock to it that gurneys have been placed in the gift shop, and the entire lobby is now a space for treating 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. last week. patients per day.

In the high desert area northeast of Los Angeles, healthcare workers at a hospital receive their first coronavirus shots in a cheerful conference room adorned with holiday decorations. There is Christmas music and “Home Alone 2” is playing on a screen. Yet, as soon as the needle is out of their arms, there’s the next “code blue,” or the next FaceTime farewell to be arranged between a dying patient and a grieving family.

“Every day is scary,” said Lisa Thompson, intensive care nurse at Providence St. Mary Medical Center in Apple Valley. “We are all stressed before we even get to work. Tons and tons of patients. We cannot even track the number of patients arriving at the hospital.

In increasingly urgent tones this week, health officials and political leaders in Southern California have called on people to stay home for the holidays, in the desperate hope of preventing another outbreak of infections. , in addition to the current crisis that occurred after Thanksgiving.

Barbara Ferrer, director of the Los Angeles County Department of Public Health, said the only way to “honor the foundational spirit of the vacation” 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 recorded cases of the virus, brings a staggering new account of the unfolding tragedy – more cases, more disease, more deaths. Southern California, the most populous region in the most populous state, is on the brink of disaster. In Los Angeles County, a large area with a population roughly the size of Michigan, there are around 6,500 people hospitalized with Covid-19, a four-fold increase in the past month. The number of patients in intensive care units is close to 1,300, double what it was a month ago.

And the county reported 146 new deaths on Thursday, according to a New York Times database, the equivalent of about one every 10 minutes and its highest total in the pandemic. Almost all hospitals have exceeded their capacity, setting up new beds in any space they could find and preparing for the possibility that they will have to ration care – essentially making extremely difficult decisions about who dies and who lives.

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

“At first, in particular, you saw all those photos and videos of New York City and you’re like, ‘Oh my God, it can never get so bad in here,’ said Mendy Hickey, St. Mary’s Quality Manager. . “And although we have all the equipment we need, it’s so bad here and we don’t have the staff to take care of the patients.

Ms Hickey, a former nurse, recently took shifts caring for intensive care patients, in addition to her administrative duties, sometimes working 23 hours a day. She was planning to work late on Christmas Eve and hopes to spend at least Christmas morning with her three daughters before returning to the hospital.

As the holiday season collides with the peak of the pandemic in Southern California, healthcare workers on the front lines are scarcely rejoicing, bracing themselves with the virtual certainty that things will only happen. ‘to get worse. California Governor Gavin Newsom has predicted hospitalizations to reach nearly 100,000 in January if residents do not close for the holidays. California reported 351 deaths on Thursday.

“I can only imagine what will happen after Christmas and New Years if we don’t educate the community on how to stay home and be safe,” said Ms. Thompson, a nurse at St. Mary’s.

Judging by what she sees in her community after another traumatic day in intensive care, she is not optimistic.

“We’re all talking about mid-January for when we expect to see a big increase in both vacations,” she said. “It’s a little scary.”

California was the first state to impose a spring lockdown, and for a while it seemed to handle the pandemic much better than other places. But in the face of the crisis she had long dreaded, the pain spreads unevenly.

In South Los Angeles, where Martin Luther King Jr. Community Hospital serves low-income communities populated by grocery clerks and bus drivers who live in crowded households and are forced to mingle with the public every day , infection rates are much higher. In Los Angeles County, about 15% of coronavirus tests in recent days are positive; at a testing site on the hospital campus, the rate is around 25 percent.

As a result, the burden of the surge is much heavier in this hospital than in the wealthier areas of Los Angeles. According to recent statistics, 66% of the hospital’s capacity was occupied by Covid-19 patients – making it, in fact, the epicenter of the epicenter. Across the city, on the whiter, richer West Side, 11% of the bed capacity at Ronald Reagan UCLA Medical Center was filled with coronavirus patients.

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

“What we’re seeing is a significant difference between patients who have commercial insurance and Medicaid,” said Dr. Elaine Batchlor, CEO of the hospital. “Those with commercial insurance get out faster.”

She added, “We’ve 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 separation and inequality. And the Covid pandemic highlights the same patterns. “

Ms Thompson, who worked a few days from 7 a.m. to midnight, is grateful to have the Christmas day off and will be spending it with her four children. Her parents, who live nearby but with whom she did not meddle during the pandemic, will be on Zoom.

But the holidays will only be a brief respite, and she is expected to work over the New Year, giving an endless wave in sight.

“Trying to do all of that overtime and then trying to keep up with all the dead and dying and trying to keep a straight face and keep moving forward is exhausting,” she says.

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