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Hospitals could soon be overwhelmed by COVID-19 surge, L.A. County officials say

Nurses in protective gear and a patient
Nurses and a scrub tech prepare a pregnant patient for testing in an OB triage tent at Providence Holy Cross Medical Center in July.
(Brian van der Brug / Los Angeles Times)

The COVID-19 pandemic is hurtling toward crisis levels in Los Angeles County, with officials saying hospitals are in danger of being overwhelmed and significant new restrictions are possible.

The dire picture painted Wednesday illustrates the ferocity with which COVID-19 has roared back to life over the past few weeks, and underscores the grim consequences facing the county if that trend continues.

“Clearly, we are at a crossroads in the COVID-19 pandemic again, and are at a dangerous place with respect to our overall cases and hospitalizations,” Dr. Christina Ghaly, the county’s director of health services, said during a briefing.

At top of mind for many is how the significant spike in cases will strike the county’s healthcare system.

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The number of people hospitalized with COVID-19 countywide has shot up by more than 70% over the past month — from 722 on Oct. 17 to 1,238 as of Tuesday.

Officials warned that a new stay-at-home order would be imposed if coronavirus cases and hospitalizations continue to spike over the next few weeks.

Officials have long feared a wave of coronavirus patients large enough to overwhelm hospital and intensive care capacity, and Ghaly said that’s a distinct possibility if the current surge continues unabated.

Unless things change, and quickly, “demand for ICUs will outstrip the supply of beds, and hospitals will have to take drastic action to be able to meet the needs of those who require an ICU-level of care, whether it’s for COVID or non-COVID causes,” she said.

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“The message is very clear: It is highly likely that we will experience the highest rates of hospitalizations that we have seen in the COVID-19 pandemic to date within the next month, unless we take action immediately to substantially reduce transmission within our communities,” she said.

However, those immediate actions likely won’t yield immediate results, as there’s typically a lag of several weeks between when someone is infected and when they become ill enough to require professional care.

“Even if we do take decisive action today, even if everyone does their part, we will continue to see an increase in hospitalizations for at least the next two to three weeks,” Ghaly said.

While the hospitalization numbers may be alarming enough by themselves, Ghaly said everyone should also remember that those figures represent “real people — people, with families and loved ones, who are very, very sick.”

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The latest maps and charts on the spread of COVID-19 in Los Angeles County, including cases, deaths, closures and restrictions.

It’s also important to recognize that a beleaguered healthcare system has ramifications for everyone, not just those battling COVID-19, according to Barbara Ferrer, L.A. County’s public health director.

“For all of you out there that may be in a car accident or you may have a heart attack or you may, unfortunately, have a stroke or have a serious asthma attack, when the hospital system is overwhelmed, care for everyone gets seriously compromised,” she said. “So we owe it to each other, we owe it to our healthcare workers most importantly, to not keep transmitting this infection.”

So far, the weeks-long surge that has sent shockwaves through the county shows no signs of slowing down. According to The Times’ independent tally, Los Angeles County recorded 3,795 cases Wednesday, the highest single-day total since late July and the fifth biggest total for a single day so far in the pandemic.

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The number of daily cases in the county over a five-day average has more than tripled in the last month, from about 930 cases a day to more than 3,100 for the five-day period that ended Wednesday, a Times analysis shows.

As holidays approach and COVID-19 figures rise, California shows the danger of a lack of discipline and a yearning to get back to normal.

Should cases and hospitalizations continue to climb, county officials warn they may impose additional restrictions on businesses — and possibly even a new stay-at-home order — to thwart transmission.

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“The only effective path forward,” Ferrer said, “requires immediate action and, unfortunately, additional sacrifice.”

If the county’s five-day average of new daily coronavirus cases reaches 4,500, officials said they will institute a stay-at-home order for at least three weeks, as well as a 10 p.m.-to-6 a.m. curfew that only exempts essential workers.

If cases continue to climb at the rate seen recently, Ferrer said the county could top an average of 4,000 per day by early December, a rate L.A. County has never seen before. Hitting that threshold would force the closure of restaurant outdoor dining areas, forcing eateries to serve food by takeout and delivery only.

L.A. County could see an average of 4,000 new coronavirus cases a day by early December.
If L.A. County continues to see its current rate of increase in daily coronavirus cases, the region could see an average of 4,000 new coronavirus cases a day within three weeks, Barbara Ferrer, the director of public health, said, which would force outdoor restaurant dining areas to close.
(Los Angeles County Department of Public Health)
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“I don’t think it’s inevitable that we do get there,” Ferrer said. “I hope with every single bone in my body that we don’t get there. We put the thresholds out so that everyone knows what triggers additional actions. The hope is that we do every single thing we can starting right now — we’re a little behind, to be honest.”

Officials and experts have said the recent surge striking L.A. County, California and the nation as a whole should inspire residents to double down on the steps they can take to prevent coronavirus transmission.

Those include wearing masks in public, regularly washing your hands and staying home when you’re sick; as well as keeping physical distance from, and avoiding gatherings with, those outside your household.

Health officials issued new rules this week requiring residents to wear face coverings whenever they’re outside of their homes, with few exceptions.

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That last point could be a particularly difficult pill to swallow with Thanksgiving and the rest of the winter holiday season just around the corner.

Officials and experts have recommended residents not travel for next week’s holiday, and instead make plans to celebrate virtually with those they don’t live with.

As part of a slate of new coronavirus-related measures announced earlier this week, L.A. County on Friday will begin to generally cap the number of people allowed at outdoor gatherings to 15 people who are from no more than three households.

Even in those limited circumstances, officials say attendees need to take precautions, such as physically distancing and wearing face coverings. Indoor gatherings are not allowed.

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Also on Friday, new rules will go into effect requiring restaurants operating outdoor dining areas and nonessential stores to close their doors between 10 p.m. and 6 a.m.; pick-up and delivery services may continue outside those hours.

Though the prospect of skipping the food and fellowship that traditionally mark Thanksgiving may strike some as a bridge too far in a year already marred by sacrifice, Ferrer said the community needs to come together and, collectively, do what’s necessary to keep the pandemic from spiraling out of control.

“This has been a community that has rallied before and done the right thing,” she said. “And if there ever was a time to get back to doing the right thing, it’s right now.”

Times staff writers Rong-Gong Lin II, Jaclyn Cosgrove and Alejandra Reyes-Velarde contributed to this report.


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