California's overwhelmed hospitals are setting up makeshift extra beds for coronavirus patients, and a handful of facilities in hard-hit Los Angeles County are drawing up emergency plans in case they have to limit how many people receive life-saving care. The number of people hospitalized across California with confirmed COVID-19 infections is more than double the state's previous peak, reached in July, and a state model forecasts the total could hit 75,000 patients by mid-January. Plans for rationing care are not in place yet, but they need to be established because "the worst is yet to come," said LA County's health services director, Dr. Christina Ghaly, per the AP. While shipments of the vaccine are rolling out to many health care workers and nursing homes across the country, it could be months before the shots are available to the general public.
Until then, four hospitals run by Los Angeles County are weighing what to do if they cannot treat everyone because of a shortage of beds or staffers. A document recently circulated among doctors at the four hospitals proposed that instead of trying to save every life, their goal could shift to saving as many patients as possible—meaning those less likely to survive would not get the same kind of care. "Some compromise of standard of care is unavoidable; it is not that an entity, system or locale chooses to limit resources, it is that the resources are clearly not available to provide care in a regular manner,” said the document obtained by the Los Angeles Times. Many hospitals in California already have implemented emergency procedures to stretch staff and space. (In Southern California, available ICU capacity hit 0% last week.)