AILSA CHANG, HOST:
The U.S. is setting the kind of shocking milestones that were once only dreamed of in worst-case scenarios. One in a thousand people in the U.S. has died of COVID-19. California has become the first state to surpass 2 million confirmed coronavirus cases, and more than 720,000 of those cases are in Los Angeles County alone. Christina Ghaly is director of the Los Angeles County Department of Health Services, and she joins us now.
Welcome.
CHRISTINA GHALY: Thanks for having me.
CHANG: So I'm in Los Angeles with you as well. Can you just describe for people how bad it has gotten in and around LA right now?
GHALY: Los Angeles is in a terrible situation right now. Many hospitals are at a point of crisis. There are 70 hospitals that operate emergency departments across the broad geography of Los Angeles County, and many of those are really at a breaking point. They have way too many patients coming in. They have patients stacked up in the emergency department, waiting for beds upstairs. Those beds upstairs are full, and they're not going to open any time soon just because of the high, high number of COVID patients that are continuing to come into the door and that continue to need care on top of already the baseline number of patients that don't have COVID that need hospital-level services.
CHANG: Right. Well, in your opinion, why have the numbers gotten so severe, particularly here in LA, the last several weeks?
GHALY: Certainly, we weren't starting at a good place when we went into this current surge, which was brought about by the Thanksgiving holiday. It's been 10 months of restrictions, and I think people are tired. And then finally, there's just some of the aspects of geography of Los Angeles County. We are densely populated, lots of people and a large number of low-income people. And that is helping to propagate transmission as well.
CHANG: So are there hospitals in LA right now that are rationing care?
GHALY: I do believe that there are. What we're hearing on the ground from hospitals across the county is that they're in a situation where they're not able to provide the high level of care to every single patient that walks in the door. And their providers are having to make very difficult decisions about who has the highest likelihood of survival and is making decisions about the allocation of resources based on that. I don't think all hospitals are there. I think some hospitals are doing that informally where others are doing it more formally. But many hospitals, we're hearing, are really at that point right now.
CHANG: Well, what about hospitals in Black and brown communities? Are they faring noticeably differently right now?
GHALY: Virtually all hospitals in Los Angeles County are affected right now. But yes, the hospitals that are located in lower-income communities and in communities of color, Black and brown communities, we are seeing have very high numbers of patients. Oftentimes, their census is above their licensed bed capacity. And they're often having overcrowded emergency departments. And many of these hospitals are putting patients into areas of the hospital that not just aren't traditionally used to care for inpatients - places like the recovery room or the emergency department - but they're often putting patients into areas that aren't traditionally used for patient care at all. There might be patients that are being put into conference areas or gift shop areas and really making room for patients in very non-traditional places within the hospital.
CHANG: That's so striking. I'm trying to imagine patients lying in former gift shops.
GHALY: It's sad. It is sad on so many levels. It's sad for the loss of life that's going to result, loss of life among patients with COVID as well as patients without COVID. And what's most just disheartening about this whole thing and frustrating on so many levels is that this really was avoidable.
CHANG: May I ask, though, how much of this lack of capacity in ICUs is also the result of some poor planning on the part of hospitals? There was a surge that was expected during these holiday months. To what extent could a lot of the lack of capacity we're seeing now - could that have been prevented to some extent with better planning?
GHALY: There's no doubt that some hospitals are better prepared for this surge than others. But the fact remains that even hospitals that were outstanding planners and that have redeployed large numbers of staff are still struggling. And that's because of just the sheer volume of patients that is coming in that is massively outstripping the resources that are available within the hospitals. Hospitals need highly trained staff to take care of very sick patients. And those staff can't be invented with the snap of a finger.
CHANG: So what is ultimately your message to people not just in Southern California, but across the state, across the country? As more surging is expected in various regions in the country, what do you think people need to keep in mind to get some of these numbers under control?
GHALY: My message to people is to stay home. The best way to show that you care for your health care workers and that you appreciate the value that hospitals bring to you is to stay home and follow those public health restrictions so that you don't need to rely on them for care for yourself or your loved ones.
CHANG: Dr. Christina Ghaly is the director of the Los Angeles County Department of Health Services.
Thank you very much for joining us today.
GHALY: Thank you very much. Transcript provided by NPR, Copyright NPR.
