With the increase in coronavirus, Los Angeles County can run out of beds in the ICU


Los Angeles County health officials issued a dire warning Monday that conditions amid the COVID-19 pandemic are rapidly deteriorating and that the highly contagious virus is rapidly spreading in the nation’s most populous county.

They said they now face one of their biggest fears: that the reopening of Los Angeles County will coincide with sudden leaps in the transmission of diseases that have the potential to overwhelm public and private hospitals.

Los Angeles County has long been the epicenter of the coronavirus in California, with nearly 98,000 confirmed cases and more than 3,300 deaths, but authorities said Monday the outbreak is getting worse.

Barbara Ferrer, Los Angeles County director of public health, said the new data shows “alarming increases in cases, positivity rates and hospitalization.”

“There is so much at stake, as these continued increases will result in many more people becoming seriously ill and many more deaths from COVID-19,” he said.

“We are seeing an increase in transmission. We are seeing more people get sick and go to the hospital. This is largely a change in the trajectory of the epidemic in recent days. It’s a change for the worse and a cause for concern, ”said Dr. Christina Ghaly, director of health services for Los Angeles County.

With an expected increase in hospitalizations, for the first time since the coronavirus crisis seemed to subside locally, Los Angeles County is now projecting the possibility of running out of hospital beds in two to three weeks. Similarly, the number of beds in the intensive care unit could run out sometime in July.

If the increase in the rate of disease transmission continues as it has in recent weeks, “it suggests that we are at risk of running out of hospital beds if we don’t take steps to increase that capacity in the next two to three weeks.” “Said Dr. Roger Lewis, biostatistician, director of the Los Angeles County Demand Models Unit COVID-19 and chairman of the emergency department at Harbor-UCLA Medical Center.

The county can meet hospital demand today, but many of the patients who have already been exposed to the virus will now fill beds in the coming weeks. It can take three to four weeks after exposure to the virus for infected people to get sick enough to be hospitalized, and four to five weeks after exposure for some of the most vulnerable patients to die from the virus. disease.

“So even if steps are taken immediately to reduce the spread in the community, we expect to see a continued rebound in the next two to four weeks,” Lewis said.

All public and private hospitals in Los Angeles County must be prepared to treat more patients based on these projections, Ghaly said. Hospitals can build new capacity by reducing elective procedures and surgeries and taking steps to quickly discharge patients who no longer need hospital care.

Hospitals can also add more beds beyond their normal authorized capacity, generally 20% to 40% more, by creating a space that they would not normally use for hospital care, such as emergency departments, recovery rooms, and before and after the operation. care units, Ghaly said. Some hospitals may also reopen pre-authorized or staffed wards.

The effective transmission rate of the coronavirus has now increased. Previously, until early May, for every infected person, less than an average person was infected, a testament to the success of the stay-at-home order. But in early June, as the reopening accelerated, the coronavirus transmission rate had risen above 1, meaning that for every infected person, an additional 1.26 people are infected on average.

“We expect the number of cases to increase rapidly,” said Ghaly.

Although this rate is lower than what Los Angeles County previously saw in the pandemic, when each infected person on average infects three other people, the current rate may still cause a much higher number of new cases “due to the base much broader number of infected people than we have today, “said Ghaly.

The increase in transmission probably occurred sometime around or shortly after Memorial Day week. At that time, Los Angeles County officials decided to gradually reopen the economy because the data was stable, with no increase in hospitalizations and a decrease in new deaths, Ferrer said.

But unfortunately, people and companies have not adhered to health orders to wear masks in public and stay away from crowded situations. Half of the restaurants visited by county inspectors don’t comply with the new rules, and officials have seen examples of overcrowding in public spaces.

“I have had an explosion of new outbreaks in the workplace. One that closed last weekend had more than 115 infections. Again, very little compliance with directives on how to operate a factory as safely as possible, ”said Ferrer.

“And we have had numerous examples of outbreaks because families are gathering with family and friends to celebrate weddings, things that they had postponed, and again, they created a higher risk and there was transmission,” said Ferrer.

Ferrer also said that according to Foursquare data, that the weekend after June 20, the day bars were reopened in Los Angeles County, 500,000 people visited nightlife spots. And the county has seen a 40% increase in coronavirus cases among younger people, ages 18 to 40, in the past two weeks.

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