First published in the Jan. 13 print issue of the Outlook Valley Sun.
The latest chapter of the coronavirus pandemic — currently driven by the Omicron variant raging throughout the nation — has local hospitals feeling the pressure of its surge.
Although this variant is spreading at a much more rapid clip than prior ones, it is — so far — not filling intensive care beds at nearly the same rate as last winter’s surge which frequently put Los Angeles County at a zero-percent ICU availability. However, the sheer number of people becoming infected is beginning to stress emergency rooms.
USC Verdugo Hills Hospital on Tuesday issued a plea to the public, advising those who are not experiencing COVID-19 symptoms to seek testing for the virus elsewhere.
“Our Emergency Department is not equipped to offer COVID-19 testing to the public at large,” the hospital said in a statement. “Thank you for helping us keep our emergency room available for those with emergent medical situations. We understand that these are very challenging times for everyone, and we appreciate your understanding.”
Meanwhile, hospital leaders said they are working hard to combat the surge in sick patients.
“We’re definitely in the same boat as all the other surrounding hospitals,” said Dr. David Tashman, the emergency department director at USC-VHH. “We’re all kind of feeling pretty much exactly the same situation. It’s really hitting the ER the hardest.”
Tashman said patients concerned about their COVID-19 symptoms have spiked ER volume by about 30%. Even though fewer of these patients are being admitted, they still require visits and screenings by medical personnel before they’re given a direction.
“We’re sending a lot more home [after seeing them], but we’re just as busy,” he said. “The EMS and 911 system are just as overwhelmed as they were a year ago.”
To complicate matters, dealing with the volume of patients is being exacerbated by the fact that doctors, nurses and technicians are also catching the disease. Although Omicron’s propensity to successfully infect vaccinated people is offset by typically cold-like or nonexistent symptoms, those workers must still isolate at home for five-to-10 days.
The Los Angeles Times reported Wednesday that some hospitals are bringing asymptomatic personnel back prior to their recommended five days simply because of the dire straits.
“This would be difficult under normal circumstances, but on the back end, our staff are getting sick now,” Tashman said. “We are short-staffed pretty much every shift and I know every hospital is in the same situation. We’re trying to do more with less, and it’s definitely stressful for everybody. Wait times are actually worse than last year because of the staff shortage. It’s pretty tough right now.”
At Adventist Health Glendale, it was a similar picture this week. Although not yet seeing a surge of intensive care patients, the hospital is admitting more COVID-19 patients into its telemetry unit, where they are hooked up to an electrocardiogram and monitored regularly. After having two outdoor tents last winter for its ER, Adventist Health currently has three and is using a floor in one of its towers as an outpatient ER observation wing.
“Our emergency room is absolutely swamped,” said Dr. Elizabeth Maslow, an infectious disease specialist at Adventist Glendale.
In addition to contending with medical staff catching COVID-19, Maslow said the hospital is down to about a third of its on-staff nurses from last year. Most departures, she said, have arisen from employees that have elected to become travel nurses, who are typically paid substantially more, while others have left nursing altogether. A very small number left as a result of the vaccine mandate, Maslow added.
“[Travel nursing] is great for a young person, but it has left the hospital in dire straits,” she said. “We knew this was coming. We did our very best to get travelers, to get nurses from other places. We did everything humanly possible to ensure that we had a nurse staffing a bed.”
Throughout Los Angeles County (and elsewhere), public health agencies have reported that COVID-19 hospitalization numbers are being inflated by patients who are admitted for different reasons but test positive for likely asymptomatic COVID-19 in the inpatient screening. This has created a distinction of being hospitalized either “for” or “with” COVID-19.
Tashman said although the Omicron wave for the most part had not yet produced a worrisome level of hospitalizations, that luck may be changing. Hospitals are beginning to see the results of Christmas gatherings, and New Year’s Eve’s fallout is predicted to be close on its heels. Additionally, there is a significant observance of Orthodox Christmas — which was last week — in the region. For the most part, hospitalizations at USC-VHH have been either among unvaccinated patients or those vaccinated who have severe comorbidities or compromised immune systems.
“Illness just started spiking two weeks ago so we’re just starting to see hospitalization numbers now,” Tashman said. “It’s still relatively small — this time last year, we had 80 hospitalizations, so it’s a lower magnitude. But the curve is basically the same. We might have 80 next week. Who knows?”
As of Wednesday, USC-VHH has 32 inpatients with COVID-19, of whom three were in intensive care. Adventist had 78 inpatients with six ICU patients, according to the U.S. Department of Health and Human Services.
Huntington Hospital, home to the area’s sole trauma center, reported this week that ER visits had returned to being in the low 100s each day after peaking at 242 patients one day last week. Speaking Tuesday, Dr. Kimberly Shriner — director of infection prevention and control at Huntington — said hospitalizations there are beginning to reduce availability of some procedures but are not yet inhibiting the trauma center.
“[Our staff] know how to do this, they’re really good at it and they’re doing it. They’re tired and kind of annoyed by people who won’t get vaccinated, but they’re doing their job,” she said. “I think we can squeak by without a collapse. Huntington is really a robust hospital.”
Emergency departments are urging people who think they may have COVID-19 to avoid ERs unless they begin experiencing breathing difficulties, severe weakness or significant fevers. Those with milder symptoms should reach out to doctors via telehealth appoints or seek an urgent care facility as needed. Hospitals are not giving public tests right now, but various clinics, drug stores and popups continue to offer them for free.
So what to do if you test positive for COVID but only have mild or no symptoms?
“Hunker down, stay home, drink fluids,” Tashman said. “Isolate yourself and don’t spread it.”
Maslow, at Adventist Glendale, speculated on Tuesday that the peak of this wave could occur anywhere between five and 21 days. Shriner was similarly optimistic, based on reports from nations like South Africa that are already moving past their Omicron wave, that Southern California may see reduced spread soon.
“I think we’re beginning to approach the summit,” she said. “We kind of bob around at the top — it goes up, down, then up and then we go over the edge and we’re on the other side.”
For a list of COVID-19 testing locations, visit covid19.lacounty.gov/testing.