Southern California hospital ICUs reach zero percent capacity as COVID-19 rips through state

A nightmare is unfolding in California as hospitals throughout the state report zero percent availability for intensive care unit (ICU) beds, and officials have warned that the situation will only worsen as the coronavirus pandemic spreads in the nation’s most populous state.

Ventilator tubes attached to a COVID-19 patient at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles, Nov. 19, 2020 [Credit: AP Photo/Jae C. Hong]

Just before falling to zero on Thursday, ICU beds throughout Southern California—which includes Los Angeles and San Diego, the state’s largest cities—were registering at 0.5 percent availability the day before. The San Joaquin Valley in central California has seen its ICUs repeatedly reach full capacity last week before climbing to a negligible 0.7 percent as of Thursday. Hospitals in the region that are already full are now operating at 20 percent overcapacity as health officials have been seeking help from training nurses and health care workers internationally to work in ICUs.

The two regions reported the worst rates of new COVID-19 cases on a per capita basis. Southern California listed 712 cases per 100,000 residents as of last week, followed by the San Joaquin Valley with 532 cases per 100,000 residents. The northern half of the state is faring little better, with the greater Sacramento area reporting 451 cases per 100,00 residents, and the Bay Area, with 335 cases per 100,000 residents over the same time frame.

California’s hospitalizations have broken records for 19 consecutive days. As of Thursday, 16,965 people were hospitalized with COVID-19, according to the state’s dashboard, more than six times more than the number on Halloween. State officials had previously estimated that 12 percent of new COVID-19 cases would likely require hospitalization, and 12 percent of these would end up in the ICU. These numbers, however, do not account for the new rates of infection, which will push hospitals and staff to the breaking point in the period leading to Christmas and New Year’s Day.

In Los Angeles County, more than 1,000 people with COVID-19 are currently in ICUs, four times the number from early November. Experts say that by early next month, there could be anywhere from 1,600 to 3,600 patients in need of ICU beds if current transmission rates remain the same.

As of this writing, there are only 2,500 licensed ICU beds in Los Angeles County. Every day, another 600 new patients with COVID-19 are being accepted into the county’s hospitals, and officials fear that by New Year’s Eve this could rise to 750 to 1,350 a day. Hospitals are now setting up overflow tents and field hospitals to help with the excess number of patients.

Dr. Christina Ghaly, Los Angeles County’s director of health services, told the Los Angeles Times, “There are simply not enough trained staff to care for the volume of patients that are projected to come and need care,” warning, “Our hospitals are under siege, and our model shows no end in sight.”

This was confirmed by Dr. Denise Whitfield, associate medical director with the L.A. County emergency medical services agency and an ER physician at Harbor-UCLA Medical Center, who told the Times, “If the numbers continue to increase the way they have, I am afraid that we may run out of capacity within our hospitals,” adding, “And the level of care that every resident in Los Angeles County deserves may be threatened just by the fact that we are overwhelmed.”

The lack of ICU beds means that the quality of patient care will decline for critically ill patients, including those suffering from other health emergencies, including strokes, heart attacks and injuries. The limited number of nurses per patient will also lead to increases in mortality. Patients that under normal staffing ratios would have been saved will now lose their lives.

The surge in COVID cases continues to break records. The state’s previous record of 42,088 new cases from Monday was shattered by Wednesday night, with 51,724 new cases reported. The 393 COVID-19 deaths reported on Wednesday set a new record, surpassing the previous record the day before, when 295 deaths were counted. Statewide, California has recorded 1.8 million COVID-19 cases and more than 22,000 dead since March.

The needless suffering and death unfolding in the fifth largest economy in the world are the deliberate outcome of the ruling class’s policy of “herd immunity,” whereby the virus was allowed to rampage throughout working-class communities with little or no concern for public health.

While nurses and hospital staff have pleaded for more resources and help to combat the pandemic and stave off fatigue, they have been met by a stony silence from the political establishment. Hypocritically called “heroes” by the ruling class when they are forced into deadly conditions in the hospitals, nurses and staff are turned into villains when they threaten to strike or take decisive action over these same inhumane scenarios.

To add insult to injury, on Tuesday, the state announced it would increase the mandatory nurse-to-patient ratio from one nurse to every two ICU patients to one nurse for every three. Some hospitals are reportedly even increasing this workload.

It is under these conditions that 2,450 nurses and licensed healthcare professionals with SEIU Local 121RN at three hospitals in Riverside, Los Angeles and Thousand Oaks are preparing to strike beginning on Christmas Eve after an authorization vote of 92 percent last week. The nurses are facing a flurry of slander from the media, hospital, and state officials.

Elizabeth, a nurse from Long Beach, told the WSWS she supports the strike and the wider mobilization of the working class in defense of healthcare workers. “The conditions at hospital pre-COVID-19 were already dangerous from understaffing, unavailability of beds and violating ratios and patient acuity law... They have had 9 months to prepare and are still understaffed all across the country.

“Nurses have always worked under enormous amounts of pressure and stress before COVID-19 hit but now with the surge of patients nurses are likely facing extreme pressure and stress which puts them at risk for injuries, near misses and being infected with COVID-19. Another issue that is not talked about enough is the high risk of suicide that nurses face when placed under a lot of pressure and trauma.

“In a national study, researchers at UC San Diego School of Medicine found that nurses are at higher risk of suicide than the general population. And female nurse suicide rates from 2005-2016 were much higher than the general female population. This is very common when nurses face burnout that is caused by repeated exposure to traumatic events. And now with Governor Newsom giving the greenlight to hospital corporations to violate ratio laws we could see more nurses become infected with COVID-19, sustain more muscular injuries and/or commit suicide from the added pressure of trying to care for seriously ill patients.”

She added that “the danger of violating these ratios is that nurses and other healthcare workers will not be able to care for the added patient workload and patients will suffer because they will not receive the care they deserve. This was already happening pre-COVID-19 because patients were already very sick and trying to care for 5 patients that are very sick is almost an impossibility, but now with the added patient load it will definitely be impossible. If 1-2 patients are added to a nurse’s workload, it will be difficult to assess and monitor their symptoms and cause nurses to miss signs of impending demise.”

Though the recently approved vaccines developed by Pfizer and Moderna are being portrayed as the current “light at the end of the tunnel,” officials warn that they will not be administered to enough people to lower the death toll until after April 2021. According to the Institute for Health Metrics and Evaluation (IHME), vaccinations will only prevent 9,000 deaths by April 1, while tens of thousands more continue to die.

The response of the ruling elite to the cries of healthcare workers has been the full acceptance of mass casualties, which are taken as inevitable by the ruling class and there has been zero talk of imposing a second lockdown that would save lives. Instead, rows of refrigeration trucks are being lined up outside hospitals for storing the bodies of the dead. In addition to 63 refrigerated trucks, California Governor Gavin Newsom ordered 5,000 body bags this week.

Meanwhile, the majority of schools, businesses and other public venues in the Democratic Party-controlled state have not been ordered to close and no emergency relief has been given for workers to stay safe and at home to limit transmission of the virus and ease the pressure on the hospitals.

While the Democrats and Republicans in Washington haggle over the most minimal aid for the unemployed, the working class must make its own demands. Emergency action must be taken immediately to save lives. This includes:

  • The immediate shutdown of all nonessential businesses and schools. Compensation must be given to all workers and unemployed to remain home until it is safe to return to work.
  • A full mobilization of the country’s resources geared toward saving lives through the production and distribution of vaccines, manufacture of PPE and ventilators, and the hiring and training of medical staff. To fund this, the billions of dollars in profits pocketed by the financial elite and major corporations since the start of the pandemic must be expropriated.

These efforts must be part of a reorganization of the for-profit health industry to satisfy human need and protect life. All of this is inseparable from the fight against capitalism and the establishment of socialism on a world scale.