Facing an increasing surge in coronavirus cases and hospitalizations, health officials in California are looking at changes and emergency orders to treat as many people as possible.
In Southern California, where ICU bed availability has been at 0% for weeks, health officials are considering how to ration care as vital resources like oxygen and ventilators become scarce.
Los Angeles County’s four public hospitals are reportedly preparing to designate “triage officers” who would decide which patients can benefit from continued treatment and which are beyond saving, according to the Los Angeles Times.
The county has not yet declared a crisis level of care, which would trigger these “triage officers” and a rationing system, but hospitals are preparing.
“There will likely come a point when we simply don’t have sufficient staffing or critical supplies to care for all our patients in the way we normally would,” reads a letter from the leader of the public hospitals, according to the LA Times.
Once the crisis designation is made, the “triage officers,” typically emergency room or critical care doctors, would be empowered to decide which patients at county hospitals would get access to resources, equipment, therapists and nurses if those items and staff become too scarce to go around.
The California Department of Public Health recommends using a clinical scoring system evaluating patients' organ functions and survival changes to decide tough life-and-death triage choices.
State officials have told hospitals outside the Los Angeles County system to prepare triage plans should a crisis designation be made.
Surging coronavirus cases are happening all around the state, and more than half of California’s 400 hospitals have been issued a 60-day waiver to increase strict nurse-to-patient ratios.
The waivers allow ICU nurses to care for three patients instead of two, and emergency room nurses to oversee six patients instead of three.
Nurses say that being forced to take on more patients is pushing them to the brink of burnout and affecting patient care.
Several hospitals in California have erected mobile field facilities to help with the patient overflow, as well as utilizing space in hallways, gift shops and other areas not necessarily meant for patient care.
Almost 23,000 Californians are in the hospital receiving care for coronavirus symptoms, of those, about 4,800 are in ICUs.
California has recorded more than 2.5 million cases of the coronavirus since the pandemic started almost a year ago. More than 28,000 Californians have died from the virus.
