Advertisement
Science

Coronavirus Today: Triage in an overwhelmed system

Good evening. I’m Diya Chacko, and it’s Tuesday, March 17. Here’s what’s happening with the coronavirus outbreak in California and beyond now that all 50 states have confirmed cases of COVID-19.

Newsletter
Get our free Coronavirus Today newsletter

Sign up for the latest news, best stories and what they mean for you, plus answers to your questions.

You may occasionally receive promotional content from the Los Angeles Times.

As we end the first day of shelter-in-place orders in California, scientists are finding more evidence they’re a necessary measure to help prevent the spread of COVID-19. New research efforts suggest that infected people who are asymptomatic or pre-symptomatic have been instrumental in seeding local outbreaks, and that “stealth transmission” is a major driver of the coronavirus pandemic. In other words, people who have been infected but don’t appear sick play a key role in the coronavirus’ explosive spread.

Compounding the issue is the continued lag in coronavirus testing in the U.S. Some physicians in Los Angeles County said it is still nearly impossible to order a test because the process is slowed by bureaucratic hurdles and shortages of key materials. If widespread testing doesn’t accelerate, health experts fear more extreme safety measures, such as mandatory home isolation and city lockdowns, may be necessary. The Pentagon said Tuesday it has mobilized 1,500 National Guard troops to staff drive-through testing facilities and emergency operations centers, as well as to sanitize public areas and transport healthcare workers.

Overworked doctors and health officials must perform painful and exacting triage, while patients and their loved ones must navigate a maze of bureaucracy to make decisions about care. Times reporter Esmeralda Bermudez, who with her family was battling a cough and fever, waited on hold for nearly two hours to speak with a Kaiser advice nurse. After being told to “go to urgent care as soon as possible,” she entered a drive-through triage center for a battery of tests performed by health workers decked out in hazmat suits, surgery gear, protective eyewear and masks. Luckily, she was diagnosed with bronchitis. “I drove home feeling grateful for every one of those health workers,” she wrote.

In a much sadder incident, a man performed CPR on his dying wife who later tested positive for coronavirus. The man wanted to be tested himself, but because he was asymptomatic, officials would not give him one. Instead, they ordered him to self-quarantine and wait for symptoms to appear.

“We are learning so much so fast about what we need to have in place when a pandemic happens — only it has happened and a lot of us weren’t prepared,” writes columnist Nita Lelyveld.

The Trump administration has called for a $1-trillion economic stimulus package, including relief for small businesses and paychecks sent directly to workers, and the Treasury is pushing back by 90 days the April 15 deadline to pay taxes owed. The plans reflect the urgent need to flush cash into a society that is rapidly changing during the coronavirus outbreak: Some 18% of adults reported that they had been laid off or that their work hours had been cut, a new poll found.

By the numbers

Cases as of 4:30 p.m. PT Tuesday:

— At least 12 deaths and more than 470 confirmed cases of COVID-19 in California.
— At least 94 deaths nationwide, most in Washington.
— More than 190,000 cases reported globally and more than 7,500 deaths.
(Official COVID-19 numbers reported by the California Department of Public Health and Johns Hopkins CSSE.)

Track the latest numbers and how they break down by county and by state with our graphics.

Where is the coronavirus spreading?

Confirmed COVID-19 cases by country as of 4:00 p.m. Friday, March 27, 2020.
Compiled by L.A. Times Graphics from the Centers for Disease Control and Prevention, Johns Hopkins CSSE, California Department of Public Health and reports from county public health officials.
Your support helps us deliver the news that matters most.

Across California

California public schools are likely to be closed for the rest of the school year, Gov. Gavin Newsom said Tuesday. In Los Angeles, starting on Wednesday, parents and students affected by school closures can pick up food at 60 L.A. Unified School District sites. Here’s a map and list of locations from LAUSD’s website.

L.A. County officials have announced a moratorium on all no-fault residential and commercial evictions, dating retroactively to March 4 and lasting until May 31. Tenants will have six months after the end of the emergency proclamation to pay for lost rent, Supervisor Hilda Solis said.

Some Southern California supermarkets are establishing store hours exclusively for seniors, pregnant women and people with disabilities. Check your local supermarket’s website for more details.

As new cases spread across the state, several more counties and the city of Palm Springs issued shelter-in-place rules, and Orange County imposed restrictions on public meetings, restricting all public gatherings, closing bars that don’t serve food and limiting restaurants to take out service.

Even with safety measures deployed across the state, Immigration and Customs Enforcement officers are continuing their daily arrests. “We just have to continue to go with the same game plan that we’ve been doing,” said one ICE director for L.A. operations.

With growing worries over an outbreak in L.A.'s large homeless population, three members of the L.A. City Council called for the city to temporarily stop enforcing a law requiring tents belonging to homeless people to come down during daytime hours. The proposal also calls for installing portable toilets, hand-washing stations, dumpsters and vermin-proof trash cans at major encampments, and providing a weekly shower service.

In the Bay Area, compliance with shelter-in-place orders began on an uneven footing Tuesday. Businesses and residents are subject to citation for violating the orders, but elected officials said law enforcement was much more likely to issue warnings than citations.

We want to hear about how the outbreak has affected you. Share your stories here.

How to stay safe

Wash your hands for at least 40 to 60 seconds.
—Stop touching your face, and keep your phone clean.
— Watch for these symptoms of possible infection: fever, cough, shortness of breath.
— If you’re sick, stay home. If you’re worried you might be infected, call your doctor or urgent care clinic.
— Know your labor rights, from working from home to paid sick leave. In California, employees who meet certain requirements are entitled to at least three days of paid sick leave; several cities provide more.
— Experts still aren’t sure whether pets can get the coronavirus. Pet owners who contract the coronavirus should isolate themselves from their animal companions out of an abundance of caution.
— Wondering whether you should self-quarantine? Here’s our guide, along with tips on how to stock up in advance. You can also watch our video guide on YouTube.

Around the nation and the world

Voters in Florida, Illinois and Arizona cast ballots Tuesday in presidential primaries marked by confusion and lower in-person turnout than expected. “If it wasn’t so tragic, it would be comical, the numbers of errors we’re seeing today,” said one lawyer for a civil rights group. Ohio postponed its primary just hours before the polls were set to open after the state’s health director declared a public health emergency.

Officials from Central America have expressed fears that Trump’s focus on immigration enforcement could worsen the coronavirus pandemic. Guatemala became the first Central American nation to block deportation flights from the United States “as a precautionary measure.”

A mass prayer event in Malaysia has been identified as a key driver of a surge in cases across Southeast Asia. Health officials said that they had traced more than 400 infections and one death to the four-day gathering, and worry that many more infections could still emerge.

Las Vegas is falling quiet; all casinos, bars and restaurants in Nevada must shut down for 30 days as of midnight on the governor’s orders. Few other U.S. cities are as dependent on dining and drinking to drive tourism and the local economy. In New Orleans, the coronavirus arrived during peak tourist season, postponing the French Quarter Festival and casting Jazz Fest into doubt. Restaurants and bars are closed, leaving hundreds of chefs, bartenders, waiters and kitchen staff out of work.

Your questions answered

Today’s reader question comes from Barbara Sheret, who wants to know: What’s the difference in the words coronavirus, COVID-19 and other names for this virus?

Reporter Ron Lin created a glossary of terms you may hear often as the outbreak progresses. Here’s an excerpt:

Coronavirus: The term coronavirus refers to a group of viruses that circulate in a variety of animals, including humans. There are many known types of coronaviruses. Some cause the common cold. Others found in bats, camels and other animals have evolved into more severe illnesses such as SARS (severe acute respiratory syndrome) or MERS (Middle East respiratory syndrome).

SARS-CoV-2: The scientific name of the coronavirus causing the outbreak. This coronavirus is brand new, so researchers are starting from square one to develop a vaccine.

COVID-19: Short for Coronavirus Disease 2019. It’s the official name of the disease, a pneumonia-like illness, caused by the new coronavirus SARS-CoV-2.

Got a question? Our reporters covering the coronavirus outbreak want to hear from you. Email us your questions, and we’ll do our best to answer them. You can find answers to other common questions in our morning and midday roundup.

For the most up-to-date coronavirus coverage from The Times, visit our live updates page, visit our Health section and follow us on Twitter and on Instagram.


Newsletter
Get our free Coronavirus Today newsletter

Sign up for the latest news, best stories and what they mean for you, plus answers to your questions.

You may occasionally receive promotional content from the Los Angeles Times.
Advertisement