California hospitals consider rationing care because they get overwhelmed


California hospitals are battling to find beds for home patients amid fears that coronovirus infection rates will destroy resources and health care workers.

As of Saturday, about 17,400 people were hospitalized with confirmed or suspected COVID-19 infections – the previous peak had doubled in July – and a state model that uses current data to forecast future trends Does, indicating that the number may reach an immature 75,000 mid. -January.

More than 3,600 confirmed or suspected COVID-19 patients were in intensive care units.

The country’s top infectious disease specialist, Dr. “Some areas of California” have sprung up, Anthony Fauci said during an event organized by the California State University System.

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Corona Regional Medical Center, southeast of Los Angeles, has replaced an old emergency room to help double the normal number of ICU patients. It is using space in two disaster tents to try out ER patients because the emergency room is filled with patients who need to be hospitalized.

Ambulances can sit for up to two hours unless they are bringing patients with severe, life-or-death emergencies.

“There is no place in the inn, so to speak,” said the hospital’s chief executive, Mark Ufer. “Actually every nook and cranes of the hospital are being used.”

This is a view from outside California. According to state data, on Friday, all of Southern California and the 12-county San Joaquin Valley in the north had exhausted their regular intensive care unit capacity and some hospitals have started using “increased” space.

A new 50-bed alternative care site opened on Friday near the Community Regional Medical Center, in hard-hit Fresno County in central California. The county’s Emergency Medical Services Director Dan Lynch said COVID-19-beds for negative patients would free up space in area hospitals, where only 13 of the 150 ICU beds were available on Friday.

Lynch said he hopes to use the Fresno Convention Center, which can accommodate 250 patients, given the current demand.

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Fresno and three neighboring counties have taken the unprecedented step of sending paramedics on emergency calls to evaluate people. Lynch said he would not be taken to the emergency room if he could go to an urgent care facility or wait a few days to talk to his doctors.

Some hospitals have canceled non-essential elective surgeries, such as hip replacements, which may require beds that may soon be necessary for COVID-19 patients. Others are increasing staff hours or increased patients to free up space.

The Chief Medical Officer of Los Angeles County-USC Medical Center, Drs. Brad Spellberg said, “I’m not putting it in sugarcane. We’re being crushed,” with more than 600 beds and one of the county’s largest hospitals. .

Spellberg said his hospital for the past week has not started with intensive care beds available every day and scramble to find room in places that typically handle critical patients such as recovery areas after surgery Are not.

“And it’s not just the patient,” he said. “These are victims of car accidents and heart attacks and violence. They need a place to receive critical care.”

The ever-increasing demand can also sabotage human resources.

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“We still have physical beds available, but we need staff to care for patients. It doesn’t do very well to sit in a bed with no one to take care of you,” Dr. Amy Harold, chief medical officer for Queen of the Valley Medical Center in Napa, told the San Francisco Chronicle. “People are doing overtime repeatedly and they are tired and it’s just getting worse.”

John Chapman, president and chief executive officer of Upland’s San Antonio Regional Hospital, said that telemetry nurses monitoring vital signs of patients should not supervise more than four people, but they may wind up five or six as cases crush. can give.

“It definitely increases the risk of something going wrong,” he said.

Many emergency rooms are already using outdoor tents to create more space, Drs. Said Mark Futernik, an emergency room physician in Los Angeles who is on the board of the California chapter of the American College of Emergency Physicians. He said that a hospital has expanded its outdoor overflow tent to a maximum gym.

Yet cases of coronovirus have not reached their peak in this third and most destructive wave, and this means that there are more drastic measures on the horizon.

Many hospitals are preparing for the possibility of ration care. A document recently circulated among doctors at four hospitals operated by Los Angeles County, in which he asked for a strategy change: Instead of trying to do everything to save one life, his goal during the crisis was more and more Patients have to be saved.

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The document obtained by Loss states, “Any compromise of the standard of care is unavoidable; it is not that an entity chooses to limit the system, system, or resource, that the resources are not explicitly available.” The Angeles Times reads.

The county’s Director of Health Services, Drs. Christina Gali, said the guidelines were not in force until Friday night, but required them to develop that the increase had arrived and that “the worst is yet to come.”

As of Saturday, the nation’s most populous state had more than 43,000 new cases reported and 272 deaths, both being the highest single-day totals during the epidemic. In the past week, there have been more than a quarter million cases and 1,500 deaths in California.

California has started receiving new COVID-19 vaccines. But the doses available are very small and very late have any immediate effect on increasing infection rates.

The latest explosion cases have been tied up for people who ignore social-disruptive rules during the Thanksgiving holiday. Health care officials and workers expressed dismay that many are not following state-mandated safety regulations designed to slow that rate.

“Whatever is coming, I don’t think either of us is going to be able to manage it,” Uffer said. “You have a dam that is about to break, and you have to stop pouring water into the dam.”

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If people do not hold off on upcoming holiday trips and live together, the state may see “growth on the rise”.

“I’m afraid it will be worse than what we saw in New York,” Futernik said. “When New York hospitals were overwhelmed, health care providers from around the country poured water.”

“Nothing is happening, and there’s no way for it, because everywhere is busy,” Futernick said. “No cavalry is coming.”

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