As the state of California finds itself in the midst of a full-blown Covid-19 crisis, medical workers in Los Angeles are being faced with some stark choices. According to County Supervisor Hilda Sollis, a memo issued by the county’s Emergency Medical Services instructs ambulance workers not to pick up patients who’ve suffered a heart attack if their chances of surviving the journey to hospital are slim. The order comes as LA healthcare workers themselves fighting to cope with unprecedented numbers of hospital admissions. According to a CNN report, Sollis has described the unfolding crisis as a “human disaster”.
“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.”
CNN reports that LA county now has nearly 7,900 hospitalised Covid patients, with 21% in intensive care. Yesterday, another 224 patients died, meaning the county’s death toll now stands at over 11,000.
Dr. Jeffrey Smith from the Cedars-Sinai Medical Centre says heart attack patients deemed unlikely to survive the journey to hospital may not be picked up by paramedics.
“This order that was issued by the county emergency medical services really is very specific to patients who suffered from a cardiac arrest and are unable to be revived in the field. Those patients have a very low rate of survival each if they are transported to the hospital. So, at this time, it is deemed to likely be futile.”
It’s not just beds that are in short supply, the crisis has also placed unprecedented demand on supplies and equipment, meaning patients picked up by EMS and in need of extra oxygen may not get it.
And as Thailand holds its breath to see the effect of inter-provincial travel over the New Year holiday, officials in the US are in little doubt that year-end festivities have contributed to the huge number of cases. However, it’s the significant spike in hospitalisations that is giving cause for concern, due to the pressure it is placing on healthcare workers and hospital resources.
Barbara Ferrer, Public Health Director for Los Angeles County, expects numbers to continue rising as a result of the recent holiday gatherings.
“The increases in cases are likely to continue for weeks to come as a result of holiday and New Year’s Eve parties and returning travelers. We’re likely to experience the worst conditions in January that we’ve faced the entire pandemic. And that’s hard to imagine.”
Meanwhile, Smith says medical personnel are doing their best to get ambulances to facilities with space to accept patients, but despite this, many will find themselves having to wait.
“The Emergency Medical Services are working very hard to divert ambulances or send them to hospitals that do have potential capacity to receive those patients. There are situations where patients are made to wait in ambulances under the care of the paramedics. We want to make sure that time is as short as possible so they can receive the necessary care.”
Dr. Marc Eckstein from the Los Angeles Fire Department EMS bureau is appealing to the public to only call 911 if absolutely essential.
“One of our biggest challenges right now is getting our ambulances out of the emergency department. When our paramedics and EMTs transport a patient to an emergency department, there’s a transfer of care that has to take place. Patients who are unstable or unable to be safely transferred to the waiting room or to a chair need a bed in the emergency department to be transferred to. And those beds are lacking right now.”
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