As COVID-19 cases continue to climb in Los Angeles County, local hospitals are running out of space. Patient’s are being put in waiting rooms, conference rooms, and even gift shops, according to the Los Angeles Times, as frontline medical staff work tirelessly to save lives. In addition to bed space for people in need of critical and intermediate care, hospitals are also running low on critical items such as oxygen. Then there’s the issue of overworked medical personnel—and all this is happening as doctors, nurses, and other staff brace for a possible post-holiday COVID wave.
Los Angeles spoke with Dr. Thomas Yadegar, a pulmonologist and medical director of the intensive care unit at Providence Cedars-Sinai Tarzana Medical Center, about the dire situation, frontline fatigue, and how to get the virus under control.
Los Angeles is currently a COVID-19 hotbed, and we’re already hearing about a potential surge on top of the surge. You’re predicting it will get much worse before it gets better, is that right?
It’s unsustainable. We’ve had to expand our ICU. Our ICU is significantly above 100 percent capacity and 90 percent of all ICU patients are COVID. We’re not seeing the effects of Christmas or New Year’s gatherings yet, but we fear that the numbers are only going to increase. With our current surge and unfortunate anticipated increase, healthcare workers become overwhelmed and our system becomes strained. Back in March and April, L.A. County had 700 COVID-19 patients in ICU beds. Today we are at 1,400. We simply cannot fathom what a huge spike will do to our system.
In addition to being short on hospital beds, you’re short staffed and working long hours.
Nurses and doctors are all working extra shifts. I just got off the phone with the wife of one of my physicians who has worked without a day off for three months. Despite his exhaustion, perseverance and unyielding dedication continue to fuel his drive to care for these patients. But I told his wife to hide his car keys and keep him at home for some desperately needed rest.
Has most of your team received the vaccine?
Of the 20 physicians I oversee, more than 90 percent of us have received the vaccine. It’s not uncommon to experience minor side effects such as soreness at the injection site, headaches, or body aches. These are good indicators that our body is mounting the anticipated immune response to the vaccine.
Unfortunately, we have had members of our team that were unable to receive the vaccine, as one of them developed symptoms two days prior to receiving the vaccine. It’s a testament to the elusive nature of this virus, and how widespread vaccination efforts are equally predicated on continued adherence to stay at home orders. The vaccine will help slow the spread, but it’s essential to remember that while we continue to vaccinate, physical distancing, frequent hand washing, wearing a mask, and avoiding socialization with other households continue to be best practice in slowing the spread.
The vaccine rollout has been slower than expected. We were supposed to be at 20 million by the end of the year, but the U.S. has vaccinated just over 2 million people so far, and it could be months before the vaccine is widely available. Is that rate troubling?
At that rate, herd immunity is more likely to be achieved through natural infection more than vaccinations. That involves a tremendous loss of life that would unnecessarily devastate thousands of souls. This is not something that should happen.
What about monoclonal antibody treatment, which is the same treatment Donald Trump received? If given early, wouldn’t it cut down on hospitalizations?
Monoclonal antibody therapy is best used early in the disease course, within the first days of symptom appearance. Their goal is to bolster the body’s immune system to fight the virus. These therapies require IV access, and are currently available at several institutions throughout Los Angeles. Patients should always speak with their primary care provider first in order to form a treatment plan best tailored to their specific case.
How can we get this situation under control?
Stay at home, avoid unnecessary travel, and don’t socialize with other households. We need to turn Los Angeles into a ghost town again like we did in the early days of the pandemic. I know many people are fatigued, but with vaccines slowly rolling out, there is hope in sight. Please continue to bend, so that we do not break as a whole.
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