Angelenos Urged To Avoid ER As COVID-19 Patients Crowd Hospitals

LOS ANGELES, CA — Angelenos are being asked to avoid hospital emergency rooms as the surge of coronavirus patients overwhelm the region's hospital system. Patients with non-emergency needs should seek help from urgent care centers and similar clinics.

The dire situation comes on the same day COVID-19 vaccinations finally began in Los Angeles County. The conflux of events is a sign of hope on the horizon as well as a reminder that the vaccine can't stave off the current crisis. Los Angeles continued its dramatic surge in coronavirus cases and hospitalizations Monday, driving down the availability of intensive-care unit beds and pushing emergency rooms to capacity limits.

It's a fine line for health officials who have to urge some patients to stay away from hospital emergency rooms, but not the ones who need emergency care.

"Certainly if you need emergency services, you should call 911 or go to your nearest emergency department, and they are able to take care of you," said Dr. Christina Ghaly, director of the county Department of Health Services,.

But Ghaly painted a dire picture of the situation at the county's 70 "911-receiving" hospitals, which have emergency departments and wind up treating COVID-19 patients. Last week, an average of 35%, or 874, of all patients in hospitals' available ICU beds were COVID-19 patients, while 27%, or 2,681, of patients in standard hospitals beds were being treated for the coronavirus.

"Those numbers are absolutely astounding," she said.

On Sunday, a day when emergency departments are traditionally not as busy, 81% of the 911-receiving hospitals asked to have advanced-life-support ambulance traffic diverted to other medical facilities at some point during the day due to overcrowded ERs. Ghaly said last week the traditional average of hospitals requesting diversion this time of year is 10% to 15%.

According to the county DHS, as of last week, county hospitals were averaging a total of 2,522 staffed ICU beds, with roughly 85 beds on average available on any given day. It was the second week in a row the average ICU bed availability was less than 100.

County hospitals last week averaged 874 confirmed or suspected COVID- 19 patients in ICU, along with 1,563 non-COVID patients, leaving the average of 85 daily available beds, according to the DHS. The county averaged 411 standard available hospital beds last week, out of an average daily overall number of 10,360 staffed beds.

On Monday, the county reported 4,203 people hospitalized, with roughly 21% of them -- about 882 -- in ICU care.

Ghaly noted that the 2,522 average staffed ICU beds last week is "hovering right around the licensed bed capacity for adult ICU beds in the county."

"This ability to surge, while impressive in terms of where we're at today -- 13% higher in total ICU bed capacity versus where we were at in July -- that surge ability is not infinite," Ghaly said. "It takes its toll on the dedicated men and women that staff our hospitals. They are our most finite and valued resource."

Despite nearing ICU capacity, hospital numbers are projected to get much worse before they get better. Ghaly said the county is averaging about 500 new COVID hospital admissions a day, and it is still projecting reaching 700 per day within a week. County Public Health Director Barbara Ferrer predicted the county will top 5,000 COVID-19 patients by the weekend.

The county reported another 7,344 newly confirmed COVID-19 cases on Monday, but Ferrer said that number is artificially low due to reporting delays from one of the county's largest processing labs. That backlog is expected to lead to an unusually large number of new cases on Tuesday.

The new cases, along with 378 announced by Long Beach health officials and 15 by Pasadena, lifted the countywide cumulative total from throughout the pandemic to 533,123.

The county also reported 48 new deaths, raising the overall number to 8,345.

Ferrer noted the excitement of the first batch of COVID-19 vaccine doses arriving in the county on Monday, but said there's a long way to go until the county emerges from the pandemic.

"In the meantime, we all do need to remain extremely diligent in reducing transmission of the virus," she said. "We're continuing to see extremely high numbers of new cases, hospitalizations and deaths from COVID-19, and the surge we're experiencing is quite alarming. There's no way to stop this explosive surge except to use the tools we've had all along that really do work to reduce transmission of this deadly virus."

Dwindling ICU capacity prompted the state to impose a regional stay at home order for the 11-county Southern California region earlier this month. The order was triggered when overall ICU capacity dropped below 15%. As of Monday, the state's estimated ICU capacity for the region -- adjusted based on the percentage of current COVID versus non-COVID ICU patients -- dropped to 2.7%

The state's regional stay-at-home order -- which covers Los Angeles, Orange, Riverside, San Diego, Imperial, Inyo, Mono, San Bernardino, San Luis Obispo, Santa Barbara and Ventura counties -- bars gatherings of people from different households.

Under the order, the following businesses/recreational facilities were forced to close:

-- indoor recreational facilities;

-- hair salons and barbershops;

-- personal care services;

-- museums, zoos, and aquariums;

-- movie theaters;

-- wineries;

-- bars, breweries and distilleries;

-- family entertainment centers;

-- cardrooms and satellite wagering;

-- limited services;

-- live audience sports; and

-- amusement parks.

Schools with waivers can remain open, along with "critical infrastructure" and retail stores, which will be limited to 20% of capacity. Restaurants are restricted to takeout and delivery service only. Hotels are allowed to open "for critical infrastructure support only," while churches would be restricted to outdoor only services. Entertainment production -- including professional sports -- would be allowed to continue without live audiences.

The order will remain in effect until at least Dec. 28.

City News Service and Patch staffer Paige Austin contributed to this report.