“Things are worse than people think”: Los Angeles County official on new directives for EMS, US
Los Angeles health officials have told first responders to stop bringing adult patients who cannot be resuscitated to hospitals, citing a shortage of beds and staff as the latest COVID-19 surge threatened to overwhelm healthcare systems in America’s second-largest city. The order, issued late on Monday, 4 January 2020 and effective immediately, marked an escalation of measures being taken by state and local officials nationwide in the face of alarming increases in COVID-19 infections, hospitalisations and deaths. Ambulances have been forced to wait several hours to unload patients at some Los Angeles hospitals, causing delays throughout the county’s emergency response system. “Patients in traumatic full arrest who meet current Ref 814 criteria for determination of death shall not be resuscitated and shall be determined dead on scene and not transported,” Marianne Gausche-Hill, medical director of the Los Angeles County Emergency Medical Services Agency, said in the directive. Ref 814 refers to the county’s policy on determining and pronouncing death in a patient who has not been transported to a hospital. California, the most populous US state, has been hit particularly hard by the latest coronavirus surge, which some public health officials attribute to Thanksgiving holiday gatherings in November. Los Angeles is one of two California counties reporting a shortage of intensive care unit beds. California reported 72 911 COVID-19 cases on Monday, a single-day record since the start of the pandemic.
More than 20,8 million people have been infected with the virus across the United States since March and the death toll stands at 357 000. A record 129 000 COVID-19 patients were in hospitals as of Tuesday. The worsening situation has ramped up pressure on state and local officials to speed up distribution of the two coronavirus vaccines so far approved for emergency use.
Federal health officials said on Monday that more than two-thirds of the 15 million coronavirus vaccines manufactured by Pfizer Inc and Moderna Inc and shipped within the United States have yet to be administered.
But some healthcare workers began getting their second shots of the Pfizer vaccine this week. Both vaccines require two doses three or four weeks apart.
The governors of New York and Florida have said they would penalise hospitals that fail to dispense shots quickly. “It’s a matter of life and death,” New York Governor Andrew Cuomo said at a news conference on Tuesday. “If a hospital has done all their healthcare workers, fine, we will take that supply back and go to essential workers.”
Another three million doses of the two vaccines were sent to US states on Tuesday, acting Secretary of Defence Christopher Miller said in a statement, bringing the total to more than 19 million in 21 days.
The US Government is considering halving the doses of Moderna’s vaccine to free up supply for more vaccinations. But scientists at the National Institutes of Health and Moderna said on Tuesday it could take two months to study whether the halved doses would be effective.