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 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.
"Hospitals are declaring internal disasters and having to open church gyms to serve as hospital units," she said. "Our health care workers are physically and mentally exhausted and sick."
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.
Record fatalities as virus infection rates soar
The United States broke its own record for the number of daily deaths from COVID-19 yet again on Tuesday, recording 3,936 fatalities in 24 hours, according to a tally kept by Johns Hopkins university.
The worst-hit country in the world by the pandemic also recorded 250,173 new cases in the period up until 8.30 pm Tuesday local time, the Baltimore-based university's records showed.
That brings the US to more than 21 million cases and 357,067 deaths in total since the start of the pandemic.
The number of people hospitalised is also at its highest since the beginning of the pandemic, with more than 131,000 patients occupying beds due to COVID-19, according to data from the COVID Tracking Project.
The situation is particularly dire in the south and west of the country.
The United States has been facing a spectacular surge in cases in recent months. Since the end of November, the number of daily deaths has increased dramatically, regularly exceeding 2,000 and often 3,000 deaths per day.
An expected surge driven by holiday gatherings is expected to aggravate the situation further.
The world's wealthiest country is ultimately counting on the vaccination campaign, which began in mid-December, to overcome the epidemic.
But less than two percent of the population has so far been covered, with 4.8 million people having received a first injection.
On Tuesday, President-elect Joe Biden, who will take office on January 20, spoke with his future team in charge of the health crisis.
Vaccine delivery 'a matter of life and death'
A number of options for accelerating vaccine delivery - including the possibility of increasing the role of the federal government - were discussed, according to a statement.
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 Defense 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 andModerna said on Tuesday it could take two months to study whether the halved doses would be effective.
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