Mark McDermott

Dispatch from an ICU: “We see no end in sight.”  

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An ICU team at Providence Little Company of Mary work on a patient battling COVID-19. Photo by Anita Sircar MD MPH

by Anita Sircar, MD, MPH

 EDITOR’S NOTE: Dr. Sircar is an infectious disease specialist who spent the last two decades working internationally, including work with the Center for Disease Control fighting Ebola in Africa. She works at three area hospitals, including Providence Little Company of Mary Medical Center in Torrance, and at a clinic. At one point during the pandemic, she worked 155 days straight. 

Today is about 10 days post-Christmas and we have already seen an implacable surge of cases coming in. By day 14, which will be this Friday, we expect to see even more. By the time this weekend is over, we will start to see the New Year’s celebration surge in cases and deaths. It is relentless.

To be honest, the post-Thanksgiving surge never really died down, which came on the heels of an uptick in cases post-Halloween, so we’ve never really had any time between back-to-back-to-back holidays to try and catch our breaths. We just keep going.

Yesterday, Los Angeles County Public Health estimated that 1 in every 5 Angelenos is now COVID positive. That is a frightening statistic. California, Arizona and Rhode Island now have the worst infection rates of anywhere in the world, NOT the COUNTRY, the WORLD. California estimates 658 per 100,000 people are infected. The numbers are staggering. California hospitals are running out of space, out of resources and out of oxygen.

We have spilled beyond the designated units inside our hospital and are now putting beds in the OR, the PACU, the pediatrics floor and even a staff break room. We have even spilled beyond the walls of the hospital now with an outdoor surge tent and an additional freezer truck to hold bodies as the morgue is beyond capacity.

We have 171 COVID patients admitted in the Torrance campus and 71 in San Pedro (the highest number of cases ever admitted during this pandemic). We are admitting faster than we can discharge. The majority of COVID patients continue to be Hispanic. The demographic is now younger. 40-60 year olds are the majority of cases. Most live in homes with 5 to 11 other people who are also sick. Many are still working up until they get sick.  Families are being admitted at the same time or in rapid succession of each other. Most patients will tell us they traveled during the holidays, attended Thanksgiving or Christmas celebrations or visited friends and family locally. Then we have patients who have traveled here from other states during the holidays and are now hospitalized in California because they are too sick to travel back home. 

The new normal for us in the hospital are unrelenting days of COVID admissions, multiple CODE BLUES, multiple daily deaths a day and a rare successful discharge home. There isn’t one department from food services, to EVS, to the chaplaincy, to laundry, maintenance and engineering services that isn’t working overtime, full time, all the time, non-stop. We work and work and work, and we see no end in sight. 

What is still unbelievable to me is this naive, almost arrogant certitude that people still have that they are the ones who will beat the odds. That they are special, different, that they are the ones that won’t get COVID, or that if they do get it, they will be the ones who will survive it. That they are not the statistics. They believe they know more than public health officials, that they are smarter than the science, that the statistics don’t pertain to them. 

In the first wave of this, at the start of the pandemic, when this virus ripped through nursing homes and prisons, those were innocent lives lost. It was unexpected, fast, out of nowhere, we weren’t ready or prepared. We didn’t see it coming. We didn’t have a lot of information to go on, tools to work with.

But in this wave, in this wave we are almost a year in now, it’s getting a lot harder to be sympathetic. The public has had a year’s worth of information, data, guidelines, guidance, resources, websites, hotlines, experts, you name it, available to them to help guide and protect them from this, but they STILL choose to ignore it. Some even still believe it’s not real. At this stage, it’s getting harder to find forgiveness.

COVID-19 hospitalizations at the South Bay’s major medical centers increased from 48 on November 1 to 638 on January 4. Source: Los Angeles County Department of Public Health. Chart by Bernard Wong, SubliminalMachine.com

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