Los Angeles County’s available hospital bed count has fallen to its lowest level in the pandemic, due not only to the ongoing threat of COVID-19 and resurgences of flu and RSV, but also to the needs of a population that isn’t postponed -emergency care.
Based on data collected from 90 hospitals, 242 adult beds were available statewide as of Monday, LA County public health director Barbara Ferrer told reporters Thursday. And she added: “The average number of available beds in December is the lowest we’ve seen in the last four years.”
Comparing current conditions to the darkest days of the pandemic is not easy considering hospitals have postponed many procedures and built additional surge capacity throughout 2020 and into 2021. But with operations now back to normal, the situation illustrates the pressures being exerted by the pandemic coronavirus and the broader respiratory virus season.
“It is reasonable to speculate that part of the reason for the small number of available hospital beds is due to many patients seeking treatment that may have been delayed in earlier months of the pandemic and the high circulating levels of respiratory viruses, which is what to a very high patient volume,” she said.
Additionally, healthcare workers are not immune to what is happening in their communities – meaning widespread transmission of respiratory viruses can lead to sick leave and affect staff availability.
“We’ve also heard anecdotally from some hospitals that they are struggling to fill beds due to high retirement rates and nurses giving up full-time positions for other opportunities,” Ferrer said.
However, there are some preliminary signs — at least on the COVID-19 front — that the metrics are improving.
On Thursday, the US Centers for Disease Control and Prevention said LA County hospitals are admitting 14.2 coronavirus-positive patients per week per 100,000 people, down 4% from the previous week. For the past three weeks, LA County has seen a week-over-week increase from 24% to 43%.
The reported coronavirus cases also flattened out. LA County recorded 2,991 new cases per day for the weekly period ended Thursday, down 24% from the seasonal peak that occurred in the first week of December. On a per capita basis, the latest rate is 207 cases per week per 100,000 population; a rate of 100 or more is considered high.
It’s important to note that the reported cases – coming from hospitals or clinics – are likely to underestimate the true extent of the infection. Many people are now self-diagnosing using rapid tests at home, the results of which are not reliably reported to authorities.
Nationally, there have been estimates that actual infection rates are perhaps five times higher than actual reported cases, Ferrer said. But total numbers can still be helpful; When you start seeing steep climbs, “you know you’re in trouble,” she said.
Surveillance data shows that the concentration of coronavirus in LA County’s sewage in the week ending December 3, the most recent for which figures are available, actually exceeded the peak of the summer Omicron wave.
“The high levels of sewage serve as a reminder that even with slightly declining case numbers, COVID transmission is still very high in LA County,” Ferrer said.
Recent improvements in case and hospitalization metrics likely mean respite from the prospect of a local indoor mask order, which could have come into effect just after the New Year. But such a mandate remains possible when transmission starts to shoot up again.
“Now we’ve reached a bit of a plateau. I think we might start gaining weight again after December 25th as more people are out of school, out of work, taking vacations, traveling and congregating. And I have no way of knowing exactly how high that will be,” Ferrer said. “A lot depends on how many protective measures people take.”
Meanwhile, COVID-19 deaths are rising. For the week ended Thursday, LA County reported 112 deaths, up 37% from the previous week and the highest since early August.
The total number of COVID-19 deaths in LA County is approaching 34,400. Included in that number is another tragic milestone as the county reported its 20th pediatric COVID-19 death this week, according to Ferrer.
Unlike the past two fall and winter seasons, hospitals are not only dealing with COVID-19, but also a significant spread of influenza, respiratory syncytial virus (RSV) and other health issues that have been put off in the first year of the pandemic.
“These are not normal times yet. There are many different viruses going around,” said Dr. Graham Tse, Chief Medical Officer, Miller Children’s & Women’s Hospital Long Beach.
RSV cases, which ” took off like wildfire ” in late summer, appear to have stopped, but the flu has also sent people to the hospital and COVID cases have crept up, Tse said this week.
“The flu is on the rise in many parts of the country, with what is likely the worst flu outbreak we have seen in a decade,” said Dr. Ashish Jha, the White House COVID-19 response coordinator. And across the country, COVID-19 is “on the rise, with [an] increasing number of cases.”
However, RSV appears to have peaked nationwide and is on the way down, Jha said on Thursday. However, there are areas of the country where levels remain high.
Children’s hospitals across California continue to report burdens of RSV and other respiratory illnesses, with some of the largest facilities unable to transport inbound patients due to capacity limitations in emergency rooms.
So far, Tse said, the surge hasn’t put a strain on his hospital’s intensive care unit in the same way as previous surges. If the numbers increase significantly, the hospital could double the number of patients in the rooms or expand the areas used for patient care.
With the strain on hospitals, health experts say residents should take extra precautions to protect themselves and those around them from serious illnesses.
People may have different assessments of their personal risk, “but washing your hands, social distancing, masking, not going out when you’re sick — all of these will help reduce stress in the hospital and protect your loved ones and family,” Tse said.
It’s also important to stay current on vaccines and get the updated booster formulated to protect against the original strain of coronavirus as well as the Omicron subvariants that dominated much of the year, officials say.
“We have the playbook. We just have to put the playbook into action, and it’s time to do that,” said Dr. Fresno County interim health officer Rais Vohra. “We know what to do. We just need everyone to literally roll up their sleeves.”
The last vaccination campaign was slow. Only 34% of eligible LA County seniors ages 65 and older have received their updated booster shot since it became available in September, and only 22% of 50- to 64-year-olds have received theirs. Of the youngest vaccinated adults – those up to 29 years old – only 9% have received the booster shot, as have 15% of those in their 30s and 40s.
Nationwide, 19.4% of eligible Californians received the bivalent booster shot.
The updated recording is now available in California for babies as young as 6 months, a move that came after the CDC’s action last week.
“The good news is that vaccines work,” Vohra said. “The bad news is we don’t have enough people getting their vaccine, especially their bivalent boosters.”
https://www.latimes.com/california/story/2022-12-16/l-a-hospital-beds-at-lowest-availability-since-pandemic-began L.A. County hospital beds drop to lowest availability of pandemic