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LA County Hospitals Begin To Ration Care Amid Coronavirus Surge

NOEL KING, HOST:

In Los Angeles County now, someone dies of COVID-19 every 15 minutes. Here's NPR's Leila Fadel.

LEILA FADEL, BYLINE: It took this county 9 1/2 months to reach 400,000 cases of COVID-19. But in the last month, that number has doubled to over 840,000 cases.

LA County Supervisor Hilda Solis.

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HILDA SOLIS: That is a human disaster and one that was avoidable. But I need to underscore that it could be worse. The situation is already beyond our imagination, but it could become beyond comprehension if the health restrictions in place are not fully obeyed.

FADEL: That number will likely go up after a weekend of New Year's celebrations despite lockdown rules.

Again, Solis.

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SOLIS: Hospitals are declaring internal disasters and having to open church gyms to serve as hospital units. Our health care workers are physically and mentally exhausted and sick.

FADEL: Dr. Anish Mahajan heads Harbor-UCLA Medical Center.

ANISH MAHAJAN: We are overrun. And our emergency room - we are taking care of patients literally in the hallways sometimes because there is just no beds available. We have equipment that's, you know, almost running out. And so it is a really unbelievable situation here.

FADEL: They only have a few ventilators left - only a handful of high-flow oxygen, a setup that pushes high pressures of oxygen through the nose.

MAHAJAN: We're ordering more, and we will borrow, if we need to, from our sister hospitals. But every hospital is struggling with this.

FADEL: The ICU is at 150% capacity, and the staff is getting exposed, not at work, but because there's so much community transmission. Meanwhile, so many hospitals' ERs and ICUs are so full, it's prompted new directives from the Los Angeles County Emergency Medical Services Agency. If an EMT can't get a pulse from a person who's had a cardiac arrest after 20 minutes of trying to resuscitate them, the ambulance shouldn't bring them into the hospital because there's basically no chance of survival. And that ambulance and bed are needed for someone else. Dr. Marc Eckstein is the medical director and EMS bureau commander for the Los Angeles City Fire Department.

MARC ECKSTEIN: This is not hyperbole. We are truly in a crisis right now in Los Angeles. And even if you're fortunate enough not to get sick with COVID, if you have a heart attack, if you get into a car accident and you need emergency services or, heaven forbid, you're sick or injured severely enough to require an ICU bed, no matter who you are and how good your insurance is, there's no beds.

FADEL: Eckstein says they're the first line of defense, and the system is strained. They face situations where 90% of the hospitals were on diversion status, meaning they were telling ambulances not to come to them. He says ambulances are waiting hours, sometimes days, to get a patient into the hospital. And with oxygen in short supply, EMTs and paramedics are now under orders not to use it unless the patient's oxygen saturation level falls below 90%.

ECKSTEIN: Well, we've actually had unprecedented situation. We've had hospitals actually turn ambulances away, where they refused to accept them.

FADEL: John Van Aalst is an EMT. He's been doing this 27 years, and he says he's never seen anything like this.

JOHN VAN AALST: What's tough for us is transporting these patients to these hospitals and having to, you know, sit there and hold walls for hours at a time, babysitting the patients.

FADEL: For hours, they sit in the ambulance or wait in a hallway with a sick patient on a gurney, unable to respond to other 911 calls. On one 24-hour shift, they are constantly transporting sick people.

VAN AALST: We're running, easily, 22, 23 hours out of those 24 hours with very little downtime. So it's very stressful and, you know, trying to find time to just grab some sort of food to stay sharp and to be out there to respond.

FADEL: This isn't even the peak. They expect that after New Year's transmissions in the next couple of weeks. The message from Aalst, from Dr. Eckstein and from Dr. Mahajan is stay home because the system is under unprecedented strain.

Leila Fadel, NPR News, Los Angeles.

(SOUNDBITE OF TAKENOBU'S "DREAMS") Transcript provided by NPR, Copyright NPR.

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