Hospital workers and other health care workers have been infected with coronavirus in increasing numbers as cases skyrocket in Los Angeles County, exacerbating staff shortages at medical centers amid the latest wave of pandemics.
“We have a very sophisticated healthcare system, but it’s made up of people,” said Dr. Kimberly Shriner, Medical Director of Infection Prevention and Control at Huntington Hospital in Pasadena. “And right now people are getting COVID.”
About 100 front-line workers at Pasadena Hospital are now out because of COVID-19, Shriner said. As cases increase, Huntington has experienced waiting times of over five hours in the emergency room. On Tuesday, it began to put elective operations on hold.
Staff shortages have plagued the health care system, not only in hospitals and clinics, but also “all the other parts of the health care system that need to work in a closely linked puzzle,” said Dr. Christina Ghaly, director of the LA County Department of Health Services.
Dialysis centers that are thin on staff send patients to hospitals instead, Ghaly said. Care facilities where DHS is operated hospitals would normally send discharged patients who are unable to take them in due to staff shortages. And ambulances have been delayed in getting to 911, which calls and faces longer waiting times in hospitals to unload patients, county officials said.
Emergency medical technicians call it “holding the wall” – waiting for a patient to be loaded by an ambulance. In LA County, a shortage of hospital staff has led some ambulances to wait hours to unload patients, making them inaccessible to other emergency calls.
In cases involving patients with less severe symptoms, “we have had ambulances tied up in hospitals for up to eight hours over the weekend while patients wait in open beds,” said Jeff Lucia, communications director for ambulance provider Falck. “To free up ambulances to respond to emergency calls, we have brought in camping beds and placed them in some hospitals, but clearly more needs to be done.”
Response times for ambulances, which are expected to reach people in less than nine minutes, are currently “ranging more from about 12 minutes, with some as long as 30 minutes,” the LA County Department of Health Services said Tuesday.
Lucia said that if Falck’s devices were not tied up in hospitals, they would have enough resources to reach those who call faster. But EMT Ryan Walters, president of International Assn. of EMTs and Paramedics Local R12-370, called the situation “a predictable outcome of the pandemic and the pay and working conditions of our members.”
Walters, who works in LA County for Falck, not only blamed rising COVID-19 cases – Falck said 5% of its labor force in LA County is now out of COVID-19 quarantine – but also wage levels and workloads that has made it harder to retain EMTs and paramedics.
Ambulance workers are being “just pushed to the limit,” said James Webb, treasurer of the same union.
The booming number of COVID-19 cases in LA County has so far not resulted in hospitalization numbers as violent as last winter. Health authorities believe it is the result of more people being vaccinated than in previous waves of the virus, and they have also been hopeful of early signs that Omicron can cause milder disease than other variants.
Healthcare professionals in LA County are vaccinated at high rates, making them much less likely to suffer from serious illness and be hospitalized.
But large increases in cases can nonetheless wreak havoc on hospitals if masses of healthcare workers become infected – even with mild cases – and have to stay home to prevent others from becoming ill.
In LA County, the number of hospital workers tested positive for COVID-19 began to rise in December, hitting numbers not seen since last January when the region was recovering from its winter rise, county data show.
The increase in coronavirus cases is not unique to healthcare professionals, but reflects the rapid spread of the highly contagious new variant throughout LA County, where the transmission rate has been estimated to be greater than at any time since the first months of the pandemic.
In the week leading up to Christmas, 323 hospital workers in LA County tested positive for the virus along with 426 health workers in other settings, including people working in nursing facilities and first aiders – a total of 749 health workers.
It was still a good chunk during the winter surge a year ago, with more than 2,800 healthcare professionals testing positive in a single week. But the latest rise in infections comes as LA County hospitals have already raised concerns about staff shortages. The Bureau of Labor Statistics has calculated that at the national level, employment in the health sector fell by 450,000 between February 2020 and November 2021.
“We’ve been at this now for two years and health care workers are tired. Exhausted,” said Adam Blackstone, vice president of external affairs and strategic communications for Hospital Assn. Of Southern California. “Many approaching retirement age have passed. retired, which has contributed to the shortage of labor. “
Hospitals may try to hire traveling nurses from agencies, but “everyone is looking in the same pool,” Blackstone said.
In addition to having to isolate themselves if they test positive, health care professionals must also stay home to take care of family members, said Larry Kidd, senior clinical officer at Henry Mayo Newhall Hospital.
“Many hospitals are seeing an increase in COVID infections among children – so parents also need to be at home to take care of them,” Kidd said.
Nurses make up the largest category among health professionals in LA County and first aiders who have tested positive during the pandemic show county data. Catherine Kennedy, one of the presidents of California Nurses Assn., Said that even before the recent rise, staffing problems among nurses are “a crisis that the health care industry has created.”
“Can it be remedied? I think so,” Kennedy said. “She argued that hospitals need to improve working conditions and ensure that nurses are properly provided for.” Give us optimal PPE. Make sure there are tests. “
Huntington and some other local hospitals are now warning on their websites to expect longer waiting times in the emergency room. Palm resident Megan Talmadge said she jerked her elbow off joints on New Year’s afternoon and waited five hours in a Culver City emergency room before being taken for an x-ray. After the x-ray, Talmadge said she asked for medication because “the pain was getting unbearable.”
“They said, ‘No, sorry, there are no nurses available,’ and just sent me back out to the waiting room,” Talmadge said.
It took about two hours more to get pain medication, Talmadge said. The 30-year-old eventually got a bed, was treated for his injury and left after 6 p.m. 1 – more than nine hours after arrival, she said.
“They were clearly understaffed,” Talmadge said. “There were times when it just seemed like no one was there.”
Deficiency also manifests itself in minor ways: Lisa Berry Blackstock, a private patient advocate, said one of her clients in the San Fernando Valley recently had to be moved into another room closer to the nursing station after falling out of bed. When she called to confirm that the patient had been relocated, Blackstock said she was told “they did not have enough staff to accommodate the transfer.”
At Kaiser Permanente in Southern California, the growing demand for coronavirus testing has collided with a declining number of employees to deal with them, slowing down turnaround times, said Dr. Nancy Gin, its regional medical director of quality.
Since several of its workers have tested positive for the virus, “it affects the number of staff available to process the tests,” Gin said. That, combined with “the great resignation” of workers both inside and outside the healthcare sector, means that “there are not as many individuals available, even on a seasonal basis as there have been in the past,” Gin said.
Testing positive generally means that health workers should stay home, even though federal and state officials have recently reduced the recommended minimum period for many coronavirus-infected people to isolate. The federal move alerted some public health officials and unions, including National Nurses United.
California made its own recommendations to health care workers to return to work, which vary depending on whether they have received booster shots, and allow the isolation period to be shortened if there is a “critical staff shortage.”
At Cedars-Sinai Medical Center, where nurses are picking up additional shifts and traveling nurses have been hired in anticipation of the increase, the revised rules are expected to help get employees back to work safely, Drs. Jeff Smith, its Chief Operating Officer. .
“We want to make sure we do it right and do not endanger our staff or our patients,” Smith said. He noted that with the latest variant of the virus, “infectivity appears to peak within the first few days and then decrease relatively quickly.”
Health authorities have urged people without symptoms not to go to the emergency room or urgently take care of COVID tests that can be found elsewhere. But Ghaly urged patients not to postpone the medical treatment they need.
Despite the growing pressure on hospitals, her department has riser sites to expand capacity and may encourage the state to ask for help with staff, she said.
“We are not in a crisis situation in Los Angeles County,” Ghaly said.
Times staff writer Rong-Gong Lin II contributed to this report.