Are LA County hospitals prepared for a potential winter COVID surge?

This winter, hospitals passim Southern California are connected watch: the Omicron variant of the enduring coronavirus outbreak, combined with an influx of Delta and “traditional” flu cases, could culminate successful a worst-case scenario for determination hospitals if preventative measures are not taken, officials warn.

the region’s aesculapian leaders doctors and attraction squads person learned overmuch from astir 2 years of pandemic and they judge they are acceptable for the caller question of cases. But they besides interest astir they unit members they mislaid successful caller months — and the squad members they fearfulness they volition suffer — arsenic stress, workload and burnout instrumentality their toll connected front-line healthcare workers.

On Dec. 22, Los Angeles County Public Health manager Barbara Ferrer reported 6,509 caller cases of COVID-19 crossed L.A. County — much than treble the reported cases from the erstwhile day.

“This steep increase, 1 of the steepest rises we’ve ever seen implicit the people of the pandemic, reflects the accrued circulation of Omicron,” Ferrer said. “These numbers marque it crystal wide that we’re heading into a precise challenging clip implicit the holiday.”

Omicron isn’t the lone concern: Hospitals person to beryllium prepared, successful addition, for a imaginable influx of Delta variant and “traditional” flu cases, the second of which thin to peak during the wintertime months.

Peter Chung, a aesculapian doc astatine UrgentMED successful Downtown L.A., said breakthrough cases could beryllium a occupation moving forward.

“I’m seeing patients who are afloat vaccinated with booster shots getting breakthrough infections and besides patients who are precocious infected with the Delta variant getting breakthrough infections with the caller variant,” helium said. “That’s the main concern.”

For nationalist wellness officials and aesculapian professionals, this infinitesimal feels similar déjà vu — and contempt being equipped with vaccines, masks, and societal distancing — immoderate person resounding concerns that hospitals volition erstwhile again beryllium caught flat-footed by an oncoming surge.

“It’s successful the forefront of everybody’s minds,” said Dr. Bernard Klein, main enforcement of Providence Holy Cross Medical Center successful Mission Hills. “We’re decidedly seeing a important increase.” The question: “How atrocious is it going to be?”

The microorganism is spreading, adjacent amongst the vaccinated 

Omicron’s dispersed is concerning, says the Centers for Disease Control and Prevention, who precocious announced that the variant is liable for an estimated 73% of caller reported cases successful the United States — a six-fold summation of Omicron infections successful conscionable 1 week.

News connected the #OmicronVariant: National genomic surveillance estimates Omicron accounts for astir 73% of #COVID19 cases. This crisp emergence is akin to what has been seen successful different countries. CDC continues to intimately show Omicron & respond to this surge. https://t.co/JcBaMq47bt pic.twitter.com/QEDinY23Uc

— Rochelle Walensky, MD, MPH (@CDCDirector) December 21, 2021

It’s more contagious than its second-wave COVID predecessor, Delta, and is capable to infect those who’ve developed immunity — either by mode of erstwhile infection, oregon vaccination — though officials enactment that those who person received vaccinations and boosters are much protected than those who person not.

The severity of corruption caused by Omicron, though, is inactive unclear.

The CDC says that adjacent if the variant’s infections crook retired to beryllium mostly mild, the sheer magnitude of radical that could beryllium infected successful a abbreviated play of clip could enactment a important load connected the healthcare system.

“Very precocious lawsuit numbers tin easy origin important accent to our healthcare system, if adjacent a tiny percent of those infected acquisition and necessitate infirmary care,” Ferrer said. “Stress connected our hospitals places each of america successful a unspeakable position, since attraction tin extremity up compromised” for non-COVID related care, including injuries, bosom attacks, and cancer.

Nurse manager Edgar Ramirez checks connected IV fluids portion talking to a COVID-19 diligent astatine Providence Holy Cross Medical Center successful Los Angeles, Monday, Dec. 13, 2021. At the aesculapian center, conscionable 17 coronavirus patients were being treated determination Friday, a tiny fraction of the hospital’s worst stretch. Nurse manager Edgar Ramirez said his co-workers are weary but amended prepared if a question hits. (AP Photo/Jae C. Hong)

Klein, who has seen the COVID-patient colonisation astatine Holy Cross triple successful the past 3 weeks, said helium thinks “it is alarming however rapidly the numbers are going up and however contagious Omicron is, adjacent to those who person been vaccinated.”

A cardinal vantage today, compared to past winter, is that truthful galore successful the region person been vaccinated. But contempt the extortion vaccines and boosters connection against terrible unwellness and death, Omicron’s breakthrough transmission rates are a origin for concern, according to wellness officials.

Over the past week, Dr. Thomas Yadegar, ICU aesculapian manager astatine Providence Cedars-Sinai Tarzana Medical Center said, “we’ve seen a important summation successful calls from outpatients who tested positive.

Although Yadegar’s unit has been dealing with a bid of COVID-19 waves, helium expected caller challenges this twelvemonth owed to dealing with not conscionable one, but 2 highly-contagious variants.

Dr. Thomas Yadegar, ICU aesculapian manager astatine Providence Cedars-Sinai Tarzana Medical Center. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

“The information that these 2 variants are truthful overmuch much transmissible, we’re inactive going to person a important magnitude of patients who are going to request attraction successful the hospital,” helium said. “If you haven’t gotten your vaccine, some Delta and Omicron are going to find you.”

In Torrance, Dr. Brad Balridge, manager of the Emergency Department for Providence Little Company of Mary, said the pandemic has been a agelong learning curve arsenic the aesculapian and technological assemblage tried to find however champion to respond.

“This illness is precise hard due to the fact that we haven’t seen thing similar this earlier and we didn’t person the infrastructure successful place,” Baldridge said. “We’ve fumbled successful a assortment of ways, which is to beryllium expected if you instrumentality the agelong view. Advice has changed, but we truly didn’t cognize thing astir this virus.”

Along with opening caller overflow attraction areas, the infirmary has a surge program successful spot that was implemented past time, on with a bid halfway with regular meetings connected staffing and furniture availability.

Dr. Brad Baldridge, left, with Dr. Jorge Vournas extracurricular the exigency section astatine Providence Little Company of Mary Medical Center Torrance. (Photo by David Rosenfeld/SCNG)

“We are vigilant astatine this constituent and I deliberation it’s understood this whitethorn get worse earlier it gets better,” helium said.

In the South L.A. area, however,  infirmary officials are assured that vaccines volition forestall hospitals from being overwhelmed similar they were past year.

“With truthful galore members of our assemblage present vaccinated, diligent volumes are precise improbable to scope the situation level experienced during past winter’s surge,” said Jennifer Bayer, the communications manager for Lakewood Hospital and Los Alamitos Hospital. “We tin safely and appropriately attraction for our patients.”

And successful Long Beach, Dr. Graham Tse, the doc successful complaint of COVID-19 effect astatine Long Beach Medical Center and Miller Children and Women’s Hospital, said helium and his unit are monitoring the caller emergence successful Omicron cases, but agrees this surge whitethorn not beryllium arsenic atrocious arsenic past winter’s.

“We person the acquisition and guidelines successful our practices engrained to grip COVID patients,” helium said successful a Wednesday telephone interview.

Even if cases bash spike, helium said helium believes his hospitals volition beryllium prepared to grip a abrupt influx of caller COVID-19 patients.

“We expect immoderate summation successful cases, though astir of america consciousness it is not apt to scope the levels of past December and January,” helium said. “We are optimistic and prepared to grip immoderate comes our way.”

Harbor-UCLA Medical Center successful Torrance (File photograph by Robert Casillas/Daily Breeze)

LaVasha Floyd, an adjunct infirmary head astatine Harbor-UCLA Medical halfway — an integrated wellness attraction strategy consisting of 4 flagship hospitals and implicit 26 clinics successful L.A. County — said aesculapian professionals are doing everything they tin to hole for a imaginable surge.

“The world is we can’t spend a repetition of past year’s surge,” wrote Floyd successful an email Wednesday. “Past surges successful COVID-19 hospitalizations person provided america with the accidental to rapidly make and activate protocols to assistance summation beds disposable crossed each our hospitals and the staffing indispensable to supply attraction to each who whitethorn request it.”

Floyd added: ““There is nary crushed wherefore we request to revisit what we experienced past year. The champion mode to enactment our doctors and nurses is for everyone to get a vaccine if they haven’t already, to get a booster shot, and travel masking regulations truthful we tin mitigate a imaginable wintertime surge.”

Staffing concerns and burnout 

Several infirmary officials, successful interviews Wednesday, said staffing shortages and idiosyncratic burnout could play a cardinal relation successful shaping the effect to the surge.

“Our unit is exhausted,” said Holy Cross Executive Director of Critical Care Elizabeth Chow. “Some near aft our large COVID surge. Some were burned out.”

While officials astatine Holy Cross accidental they’ve done amended than galore successful retaining staff, COVID-19 has taken its toll connected its infirmary unit passim the region.

In a caller survey obtained by this newspaper, SEIU 121RN, a national representing 9,000 nurses and licensed aesculapian professionals successful California, recovered that 72% of registered nurses and aesculapian professionals polled successful L.A., Riverside and Ventura County, accidental that burnout is simply a “very serious” problem.

Mary Lou Samora, a 71-year-old COVID-19 patient, writes connected a achromatic board, “I’m going to beryllium OK,” portion utilizing the committee to pass with her agelong clip friend, Becky Gonzalez, 67, astatine Providence Holy Cross Medical Center successful Los Angeles, Friday, Dec. 17, 2021. (AP Photo/Jae C. Hong)

It besides recovered that astir 70% person earnestly considered leaving the assemblage successful the past year, overmuch successful portion due to the fact that of the pandemic’s toll.

Dr. Nancy E. Gin, determination aesculapian manager of Quality for Kaiser Permanente — which serves 4.8 cardinal members and operates 15 hospitals passim Southern California — said staffing is simply a interest going forward.

“What’s antithetic astir this twelvemonth is facing this situation of staffing,” Gin said, referring to the “great resignation” inclination that has seen galore permission the workplace during the pandemic. “It’s a precise existent challenge.”

And, she said, unit has had a precise hard 2 years already.

Travelers hold successful enactment to get tested for COVID-19 astatine Los Angeles International Airport successful Los Angeles, Monday, Dec. 20, 2021. The Los Angeles County Department of Public Health reported much than 3,500 caller cases of COVID-19 connected Sunday arsenic the fig of regular caller cases tripled implicit the week. (AP Photo/Jae C. Hong)

“Staff is truly tired, they truly are,” she said. “In the autumn it looked a small much hopeful that with bully vaccines we mightiness person a amended wintertime (than 2020-21). But past Omicron came to town.”

For now, she said, Kaiser facilities are doing “OK” and person the indispensable staff. Still, Gin said, Kaiser could beryllium challenged should determination beryllium different surge successful California.

Currently, the infirmary is astatine astir 85% capableness and contingency plans are ever successful place, Gin said. “We’ve learned a batch from past twelvemonth and however to (create much wards) precise quickly.”

Dr. Thomas Yadegar leads a captious attraction squad successful the ICU astatine Providence Cedars-Sinai Tarzana Medical Center during the coronavirus pandemic. (Courtesy of Providence)

Yadegar says he’s seen the impacts of idiosyncratic burnout archetypal hand.

“After 18 months of warring with this virus, a batch of healthcare providers and healthcare unit are exhausted,” helium said. “We’ve had rather a spot of turnaround successful our nursing unit arsenic good arsenic physicians. And these are radical with years and decades of acquisition dealing successful captious attraction units and they can’t beryllium replaced.”

He added that it’s been hard to regenerate physicians, nurses and respiratory therapists who decided to alteration their careers oregon transferred from intensive-care units to different areas of the infirmary owed to burnout and exhaustion.

“Everyone is bushed of going, ‘Oh man, an summation successful cases,’” Tse added, saying that his hospitals person intelligence wellness programs to assistance unit cope, including in-person counseling, online enactment and radical sessions.

Becky Gonzalez, left, and her agelong clip friend, Mary Lou Samora, a 71-year-old COVID-19 patient, enactment their palms unneurotic aft they shared immoderate encouraging words astatine Providence Holy Cross Medical Center successful Los Angeles, Friday, Dec. 17, 2021. (AP Photo/Jae C. Hong)

Chow, Holy Cross’ enforcement nurse, reflected connected an exhausted staff, who truthful often implicit the past 2 years served arsenic the past constituent of interaction for patients dying of Covid, holding up iPads truthful families could accidental their past goodbyes oregon holding their hands successful the last moments.

“My lone plea to the nationalist is…please get vaccinated,” Chow said. “Please beryllium cautious successful societal gatherings. Your healthcare workers truly can’t instrumentality the further load. We privation to instrumentality attraction of radical who are sick. But we besides privation to spell location to our ain families.”

Looking forward

Ferrer said fully-vaccinated and boosted individuals, successful tiny groups, should consciousness harmless capable to bask their vacation celebrations. But, she added, vigilance is required — enactment location if you’re sick, get tested often, and deterioration a disguise erstwhile necessary.

Like galore successful the aesculapian field, Gin said vaccination and booster rates request to increase.

And beyond that, she said, determination “will always” beryllium different variant.

“That’s what viruses do,” Gin said, “they are designed to past and they volition proceed to find ways to alteration and evade (immunity). Our extremity is to effort to support 1 measurement up of that.”

Staff writers Ryan Carter, Pierce Singgih, Olga Grigoryants and Donna Littlejohn contributed to this report.