ICU beds are scarce, patient numbers can go up quickly: Dr. Christina Ghaly on COVID stressing LA hospitals

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People attend a protest for nurses demanding more PPE, coronavirus testing, and staff, as the outbreak of the coronavirus disease (COVID-19) continues, in West Hills, Los Angeles, California, U.S., November 30, 2020. Photo by Lucy Nicholson/Reuters.

LA County has issued a new stay-at-home order that takes effect today and lasts for the next three weeks. It will prohibit people from different households from congregating — with the exception of religious gatherings and political protests. And it will shut down playgrounds and reduce capacity inside retail stores. 

The order is the result of a big surge in COVID-19 infections that has stressed local hospitals. Dr. Christina Ghaly, director of the LA County Health Services Department, says current numbers are close to what she saw during the summer surge. 

“In mid-July, late-July, which was the highest rates of hospitalization that we've seen so far in this pandemic, the hospitalization numbers peaked at just over 2,200. We're very close to that number, and we have yet to see the highest rates of hospitalization.”

With 4,000-5,000 cases being logged daily and with a time lag on top of that, Dr. Ghaly expects hospitalizations to rise over the next couple of weeks. She anticipates the county will exceed July’s peak numbers, meaning there will be an increased demand for hospital beds and intensive care units.

“Right now, about 20% of patients who are in the ICU have COVID. And overall about a quarter or sometimes almost a third of patients with COVID-19 need to be in the ICU. Those ICU numbers can go up very, very quickly and they're a scarce resource. They require highly trained nurses, respiratory therapists, physicians. And hospitals can't as easily ramp up those ICU beds as quickly as they can make available some of their lower acuity bed types.”

But there are ways to offset hospitals being at capacity right now. For example, one way to free up beds is by restricting or reducing admissions among patients who are scheduled for an elective procedure. Hospitals can also work to discharge patients who are ready to safely return to their communities or into lower levels of care. 

Aside from bed availability, Dr. Ghaly also worries about health care workers. “This is why we need the stay-at-home order. … There is a finite number of people who have the necessary skill set to take care of patients in a hospital and particularly in the ICU. And we need to take care of those resources and make sure that they're available for those who need them,” she says.

Credits

Guest:

  • Dr. Christina Ghaly - Health Services Director for the LA County Department of Health Services