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A Glimpse at Hell On Earth

While Mendocino County is experiencing a pandemic surge, it’s nowhere close to the dire circumstances in other parts of the state. So let’s take a quick look at how C-19 is ravaging the state of California, which is now the number one state in the Union in COVID contraction and deaths.

Southern California hospitals are so overwhelmed that gift shops, conference rooms, and storage areas have been converted to makeshift rooms for patients.

Los Angeles County confirmed another 274 COVID-19 deaths Wednesday, Dec. 30, bringing the total to 10,056.

With this new, unprecedented surge of patients into hospitals, there has also been a “large volume” of dead bodies that many mortuaries across the county don’t have space for.

“This is causing a backup of dead bodies at a variety of facilities and hospitals across the county,” Health Services Director Dr. Christina Ghaly said.

There’s help on the way according to L.A. County Supervisor Hilda Solis: Members of the National Guard will be deployed next week to the Coroner’s Office to help with operations.

“Most heartbreaking is that if we had done a better job reducing transmission of the virus, many of these deaths would not have happened,” L.A. County Public Health Director Barbara Ferrer said at a media conference.

Ferrer, the architect of California’s most restrictive local lockdown orders, has been the target of protestors for months, as angry business owners and laid-off workers allege the orders are over-broad, draconian, and do almost nothing to reverse the actual cause of the surge: too many people who ignore public health orders to stay at home, don’t gather with people outside of family bubbles, and don’t-travel advisories, especially during holiday celebrations.

At a Tuesday, Dec. 29 press conference, state Health and Human Services Secretary Dr. Mark Ghaly (husband of Dr. Christina Ghaly) said some Southern California hospitals have begun making choices that affect patient care, as in life-and-death decisions.

He said the “state is working to keep hospitals from operating in crisis care mode for “as long and as much as possible,” and that the state has not seen instances in which health care providers have to decide how to care for two patients with just one ventilator.

Ghaly said hospitals are diverting ambulances and making decisions about whether to provide certain treatment for patients who are likely to die. He said more than 95% of Los Angeles hospitals have diverted ambulances in the last 24 hours.

“Some hospitals in Southern California have put in place some practices that would be part of crisis care, whether those are decisions about how ambulances are received into the facility or how stretched staff become to care for patients, looking at the effectiveness of certain treatments for certain patients who are unlikely to survive,” he said during a press conference. “That is happening in facilities in Southern California.”

He said SoCal hospitals are running out of staff and wait times are much longer than normal — “a critical difference” between Northern and Southern California, Ghaly said.

“We need to be prepared for some hospitals to resort to crisis care,” where certain supplies and medical care are rationed, he said. “Medical professionals have to make hard choices and relocate resources.”

Ghaly also provided new guidance to hospitals under a crisis care continuum.

It includes three levels: conventional care, contingency care, and crisis care.

Ghaly said most hospitals are operating under contingency care now.

Under this guideline, space in the hospital starts to be used for other types of care, such as COVID patients, single occupancy rooms are converted to double, supplies are conserved or reused and the level of care may be delayed.

“We do have to acknowledge that we need to be prepared that some hospitals will have to resort to crisis care,” Ghaly said.

The state does not determine when a hospital resorts to crisis care standards, it will be determined by the hospital, based on the need for hospitalization and available resources.

According to Ghaly, care must be guided by ethics, equity, and transparency.

Ghaly said the state has also issued guidance to achieve four goals:

• Hospitals are able to remain in conventional or contingent care as long as possible;

• All hospitals in a region work together to support each hospital to remain in contingent care as long as possible;

• Hospitals have prepared plans for crisis care if needed as a last resort;

• The public has clear and transparent information regarding the crisis care continuum as well as the hospital’s approach to crisis care during this surge

And, of course, Ghaly said hospitals are preparing for even worse conditions into late January as cases surge and people become sicker after the holidays.

“We are worried about a rapidly accelerating increase and pressure on our hospitals,” he said.

Looks to me like the time to worry is over as hospitals, at least those in Los Angeles County, are already coming apart at the seams.

Hopefully, Mendocino County officials are paying strict attention to events in SoCal and have made plans accordingly.

Our county has only three hospitals and approximately 45 ICU rooms, and it won’t take much to overwhelm them, especially within the next 3-to-4 weeks when everything is supposed to hit the fan.

(Jim Shields is the Mendocino County Observer’s editor and publisher, and is also the long-time district manager of the Laytonville County Water District. Listen to his radio program “This and That” every Saturday at noon on KPFN 105.1 FM, also streamed live:

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