Los Angeles limits ambulance services as COVID-19 infections skyrocket in California and nationwide

As of Monday, ambulance workers in Los Angeles, California have been instructed that, “adult patients in blunt traumatic … cardiac arrest shall not be transported,” [emphasis in original] if they cannot be revived by the emergency responders themselves.

The directive was issued by the Los Angeles County Board of Supervisors in response to the lack of intensive care unit beds caused by the ongoing surge of COVID-19 cases in the second largest city in the United States. There have been more than 400,000 cases recorded in Los Angeles since November 30, bringing the total number of coronavirus cases the region has suffered to more than 827,000.

Since mid-December, there have been no spare ICU beds available in the region and are generally only freed up if a patient dies. This has produced scenes of ambulances lined up at hospitals for hours, unable to deliver their patients and acting as makeshift overflow units attempting to keep their charges alive. And of course, when paramedics cannot discharge their patients to hospitals, they are unable to respond to further emergency calls, creating an even greater crisis.

Now, ambulances are being told that if they cannot resuscitate patients using their limited resources within up to 20 minutes “or until futility is reached” in the field, those people should be declared dead.

A Los Angeles County fireman who works in the cities of Paramount and Compton told the World Socialist Web Site that in many instances first responders are not following the order, both the most recent one issued Monday and an earlier similar order from December 28. “These directives can seem so abstract but we are working on patients way past 20 minutes. Our team works on patients for 45 minutes, even now. We break our backs trying to save lives and we are trying to send in everyone we can. We are doing the best we can with a horrible situation.”

He said that if they do call a death in the field or the home of a patient, the Sheriff's Office takes over and calls the coroner.

Further instructions have been issued to the public as a whole to not call 911 unless it is an absolute emergency. Those who do are often forced to wait in emergency rooms for up to 18 hours to receive treatment. Hospitals have been forced to set up cots in parking lots to take in patients. It is also proving difficult to transfer patients, as hospitals across the entire state of California are facing similar circumstances and are unable to take any overflow.

The latest orders to first responders reflect the increasingly dire crisis in Los Angeles, exacerbated by the refusal of officials at the local, state and federal level to initiate medically necessary lockdowns to bring the raging pandemic under some semblance of control. Hospitalizations have tripled to 7,697 in the past month. Deaths have similarly rocketed to nearly 11,000. The number of those testing positive for the coronavirus now exceeds 19 percent.

At the same time, testing for the disease has dropped from 100,000 per day to less than 80,000 per day. Not only is the pandemic spiraling out of control in the city, officials have all but given up on any measures to contain the spread of the virus, much less even track its extent.

The nightmare in Los Angeles is a precursor of what is to come in the United States nationally. There have already been more than 760,000 cases nationwide since the start of the new year, bringing the total number of cases in the country since March to a staggering 21.6 million. More than 10,000 people have died in the past five days, sending the total number of dead from the coronavirus past 365,000.

Worldwide, the current confirmed coronavirus case count stands at more than 87 million. The dead officially number 1.87 million at a rate of more than 10,000 deaths each day.

The latest projections for the trajectory of the pandemic are equally grim. The Institute for Health Metrics and Evaluation (IHME) predicts that, at best, at least 89,000 more people will die by February 5. It is more likely, however, that between 105,000 and 143,000 lives will be lost during the next month, indicating that half a million people will be dead from COVID-19 in the United States alone sometime in February.

One month ago, the IHME predicted that the death toll in the US would cross the half-million threshold in March, a further indication of an accelerating pandemic.

Other areas of the country are seeing similar spikes in their coronavirus caseload. In New York, a worldwide epicenter of the pandemic last spring, the daily case counts have reached more than 13,000, 25 percent more than the pandemic’s previous peak in April. The number of active cases is at a similar high, 547,000, almost double what it was before a sharp falloff in early June.

Daily deaths have so far reached 150, up thirty-fold from when the pandemic was most suppressed in the beginning of September. As of now, there are 8,590 COVID-19 patients hospitalized, including 1,392 in an ICU.

Similarly in Florida, a second wave of coronavirus cases has engulfed the state. With a 7-day average of nearly 14,000 new cases recorded each day, there are now more than 600,000 active cases, up from about 220,000 cases in mid-October. The death rate has also risen from a low in November of 50 to more than 110 dead each day.

At the same time, Governor Ron DeSantis is doing everything in his power to suppress the data from being widely accessible. Florida State Police carried out a fascistic raid on the home of whistleblower Rebekah Jones, putting guns in the face of Jones and her family in order to seize data she had collected on COVID-19 outbreaks in the state. She was targeted for her outspoken criticism of the homicidal school reopenings pushed by DeSantis and US President Donald Trump.

There has also been a sharp increase in cases, hospitalizations and deaths in Arizona. The number of cases in the state has doubled to 567,000 since mid-October. The number of deaths has also risen sharply, and now stand at a total of 9,300, with about 85 being recorded each day. There are currently 40,300 hospitalized in the state with hundreds of new hospitalizations each day.

These case count and death toll records are also known to be undercounts. A study published in the Journal of the American Medical Association on Tuesday found that there are likely at least four times the known number of cases in the United States and likely 35 percent more deaths than reported. This agrees with other studies looking at the excess death counts in the US, bringing the real toll of the pandemic up to about 85 million infections, 492,000 deaths, and millions suffering the long-term effects of the disease.

And as the study notes, “there remains a substantial gap between the estimated proportion of the population infected and the proportion infected that is required for herd immunity.” In other words, even if these estimates are true, allowing the homicidal policies of school and workplace reopenings to continue will produce ever greater death tolls for months to come.