Los Angeles ambulance crews told not to transport patients who stand little chance of survival

 edition.cnn.com  01/04/2021 05:00:05 

2 hr 19 min ago

From CNN's Alexandra Meeks

Los Angeles County paramedics load a potential Covid-19 patient into an ambulance before transporting him to a hospital in Hawthorne, California on December 29.
Los Angeles County paramedics load a potential Covid-19 patient into an ambulance before transporting him to a hospital in Hawthorne, California on December 29. Apu Gomes/AFP/Getty Images

With intensive care units at Southern California hospitals nearly full because of the Covid-19 pandemic, the Los Angeles County Emergency Medical Services Agency (EMS)has directed ambulance crews notto transport patients with little chance of survival to hospitals,and toconserve the use of oxygen.

Los Angeles and Southern California are dealing with one of the country's worst outbreaks of the novel coronavirus. ICU bed capacity plunged to 0% in Southern California last month, as more and more people were admitted to hospital seeking treatment for Covid-19.

Now, manymedical facilitiessimply do not havethespace to take in patientswhodo not have a chanceof survival, according to the agency.

As of Monday evening, there were 7,544 people hospitalized in Los Angeles due to Covid-19 and just 17 available adult ICU beds, according to county healthdata. Due totheshortage of beds, thecountyEMS said patients whose hearts have stopped, despite efforts of resuscitation, should no longer be transported to hospitals.

If there are no signs of breathing or a pulse, EMS will continue to perform resuscitation for at least 20 minutes, the EMS memo said. If the patient is stabilized after the period of resuscitation, the patient would then be transported to a hospital. If the patient isdeclared dead at the scene or if no pulse can be restored, paramedics will no longer transport the body to the hospital.

Oxygen shortage: A shortageof oxygen in Los Angeles and the nearby San Joaquin Valley, thanks to Covid-19, is putting immense pressure on the system and forcing paramedics to conserve the supply.

In order to maintain normal circulation of the blood to organs and tissue needed for the body to function, EMS said anoxygen saturation of at least 90% will be sufficient.

California Gov. Gavin Newsom formed a task force to address the issue last week. It is working with local and state partners to help refill oxygen tanks and mobilize them to hospitals and facilitiesmost in need.

2 hr 51 min ago

From CNNs Rebekah Riess

In this November 13 file photo, a nurse works at the Hackley Community Care Covid-19 curbside testing site in Muskegon Heights, Michigan.
In this November 13 file photo, a nurse works at the Hackley Community Care Covid-19 curbside testing site in Muskegon Heights, Michigan. Cory Morse/The Grand Rapids Press via AP

More than 500,000 people in the US state of Michigan have contracted Covid-19, Gov. Gretchen Whitmer said Monday.

Despite the rise in cases, Whitmer said the fact that vaccine distribution has begun means there is "hope on the horizon."

However, Whitmer cautioned that "it will take some time for the vaccine to be widely available to all Michiganders, and until then, we must continue to do our part to keep ourselves and our fellow Michiganders safe."

Covid-19 didnt end with the new year. There is still more work to do to beat this virus, but I know that Michiganders are up to the challenge. Lets harness our Michigan grit and eliminate this virus once and for all, she said.

Track US cases here:

3 hr 18 min ago

From CNN's Michael Nedelman and Andrea Kane

In this August 5 file photo, a lab technician prepares a solution that will be used to process coronavirus test samples at Advagenix, a molecular diagnostics laboratory, in Rockville, Maryland.
In this August 5 file photo, a lab technician prepares a solution that will be used to process coronavirus test samples at Advagenix, a molecular diagnostics laboratory, in Rockville, Maryland. Chip Somodevilla/Getty Images

The United States should be sequencing 10% of its confirmed Covid-19 cases to monitor for mutations, experts told CNN Monday -- yet current figures put the country at less than half a percent.

Angela Rasmussen, a virologist at the Georgetown University Center for Global Health Science and Security and an associate research scientist at Columbia Universitys Center for Infection and Immunity, said that the US sequences a "dismal" 0.3% of detected cases.

US labs have submitted only about 57,700 sequences of the coronavirus to the genomic database GISAID. In comparison, the UK has submitted more than 146,000, despite having far fewer confirmed cases. Rasmussen said a lack of public funding for surveillance was a "big problem," because it's important that officials continually sequence detected cases in order to monitor for mutations to the virus that render vaccines less effective.

The UK sequences about 10% of its detected cases. Rasmussen said in an email that the US "should shoot for at least half of what the UK does, but ideally we should be at 10% or better, Rasmussen said via email.

Variants detected in Britain and in South Africa both have patterns of mutation that trouble scientists and appear to make the virus more easily transmitted. Only a handful of these variants have been reported in the US so far although experts believe the mutation first found in Britain is likely fairly widespread.

Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, also said the US should aim to sequence 10% of its confirmed cases.

We should have 2 million genomes completed by now, he said by email.

Over the next two weeks, the US Centers for Disease Control and Prevention hopes to double the number of samples it genetically sequences to 6,500 per week, according to an agency official, who also noted that the UK has a more centralized system for genetic sequencing while the US relies on a patchwork of federal, state, academic and private labs.

3 hr 57 min ago

From CNN's Maggie Fox

A health worker administers a vaccine to a patient in their vehicle during the first day of mass Moderna COVID-19 vaccinations at the Kentucky State Fair and Exposition Center on Monday, January 4, in Louisville, Kentucky.
A health worker administers a vaccine to a patient in their vehicle during the first day of mass Moderna COVID-19 vaccinations at the Kentucky State Fair and Exposition Center on Monday, January 4, in Louisville, Kentucky. Jon Cherry/Getty Images

Anyone who receives the Moderna or Pfizer vaccine must get both doses, two top US Food and Drug Administration officials said Monday.

They said people who are speculating about the possibility of making do with just one dose are misinterpreting the data.

We have been following the discussions and news reports about reducing the number of doses, extending the length of time between doses, changing the dose (half-dose), or mixing and matching vaccines in order to immunize more people against COVID-19, FDA Commissioner Dr. Stephen Hahn and Dr. Peter Marks, who heads FDAs vaccine division, said in a statement.

These are all reasonable questions to consider and evaluate in clinical trials. However, at this time, suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the available evidence. Without appropriate data supporting such changes in vaccine administration, we run a significant risk of placing public health at risk, undermining the historic vaccination efforts to protect the population from COVID-19, they added.

The available data continue to support the use of two specified doses of each authorized vaccine at specified intervals. For the Pfizer/BioNTech COVID-19 vaccine, the interval is 21 days between the first and second dose. And for the Moderna COVID-19 vaccine, the interval is 28 days between the first and second dose.

British officials have said they will allow more than 21 days between doses of Pfizers vaccines and would consider allowing people to get vaccinated with two different vaccines. Hahn and Marks dismissed these ideas for the US, saying while there is speculation that a single dose offers protection, there is not enough hard evidence to show it will.

What we have seen is that the data in the firms submissions regarding the first dose is commonly being misinterpreted. In the phase 3 trials, 98% of participants in the Pfizer-BioNTech trial and 92% of participants in the Moderna trial received two doses of the vaccine at either a three- or four-week interval, respectively, they wrote.

Those participants who did not receive two vaccine doses at either a three-or four-week interval were generally only followed for a short period of time, such that we cannot conclude anything definitive about the depth or duration of protection after a single dose of vaccine from the single dose percentages reported by the companies.

Its understandable that people may want to stretch the vaccine supply, they said. But its not advisable.

If people do not truly know how protective a vaccine is, there is the potential for harm because they may assume that they are fully protected when they are not, and accordingly, alter their behavior to take unnecessary risks, they said.
2 hr 3 min ago

From CNNs Jenn Selva

Motorists wait in long lines to take a coronavirus test in a parking lot at Dodger Stadium on Monday, January. 4, in Los Angeles.
Motorists wait in long lines to take a coronavirus test in a parking lot at Dodger Stadium on Monday, January. 4, in Los Angeles. Ringo Chiu/AP

A feared holiday surge of coronavirus infections has begun in Los Angeles County, where about one in five residents getting tested for Covid-19 are now testing positive, officials in the hard-hit region announced Monday, calling the situation a human disaster and predicting the death toll could soar to more than 1,000 people per week.

L.A. County Public Health Director Barbara Ferrer said Covid-19 hospitalizations in the county have reached an all-time high with 7,697 patients, 21% of whom are in intensive care, a figure she called distressing.

The anticipated surge from the winter holiday gatherings has begun, said Ferrer. The increases in cases are likely to continue for weeks to come as a result of holiday and New Years Eve parties and returning travelers.

County health officials reported 77 new deaths on Monday, raising the total number in the county to 10,850, and an additional 9,142 cases. Ferrer pointed out Mondays lower than average numbers reflect a lag in reporting from the holiday weekend and the closure of some testing sites.

According to Ferrer, one person is now dying from the virus every 15 minutes in L.A. County.

"We're likely to experience the worst conditions in January that we've faced the entire pandemic, and that's hard to imagine, she said.

According to the L.A. County Department of Medical Examiner-Coroners office, with hospitals and mortuaries full of bodies, the county coroners office has been storing additional victims, a growing toll that has risen to 757 bodies, a coroners spokesperson told CNN.

L.A. County Supervisor Hilda Solis called the situation in the county, which has doubled its total number of Covid-19 cases since the start of the pandemic in the last month alone, a human disaster.

Hospitals are declaring internal disasters and having to open church gyms to serve as hospital units. Our health care workers are physically and mentally exhausted and sick, she said.

With infections continuing to surge out of control in the nations most populous county, Solis warned the situation, which is already beyond our imagination, could become beyond comprehension.

This post has been updated to reflect that one in five LA residents who were tested for the virus tested positive.

4 hr 37 min ago

From CNNs Virginia Langmaid

The United States reported128,210current Covid-19 hospitalizations onMonday, setting a new record high since the pandemic began, according to the Covid Tracking Project (CTP).

This is the 34th consecutive day that the US has remained above 100,000 current hospitalizations.

According to CTP data, the highest hospitalization numbers were recorded on these days:

  • Jan. 4: 128,210 people hospitalized
  • Jan. 3: 125,544 people hospitalized
  • Dec. 31: 125,379 people hospitalized
  • Dec. 30: 125,218 people hospitalized
  • Jan. 1: 125,047 people hospitalized
4 hr 56 min ago

From CNNs Jen Christensen

A pharmacy technician holds a dose of the Johnson & Johnson COVID-19 vaccine before it is administered in a clinical trial on December 15, in Aurora, Colorado.
A pharmacy technician holds a dose of the Johnson & Johnson COVID-19 vaccine before it is administered in a clinical trial on December 15, in Aurora, Colorado. Michael Ciaglo/Getty Images/FILE

Johnson & Johnson tells CNN its Janssen Covid-19 vaccine trial is still on track and the company should have enough data toward the end of January to determine if the vaccine is safe and if it provides protection against the novel coronavirus, according to company spokesperson Lisa Cannellos.

The vaccine trial was fully enrolled Dec. 17. With the high number of infections in the US, the company determined it could enroll 45,000 volunteers and generate enough data.

If the trial shows the vaccine is safe and effective, the company has said it expects to submit an emergency use authorization application to the US Food and Drug Administration in February.

Unlike Moderna and Pfizer, the Janssen vaccine is a single dose shot. The vaccine uses a certain subtype of the adenovirus (a virus that causes cold symptoms) that is altered to carry the proteins for the novel coronavirus. Both viruses have been deactivated but exposure causes the immune system to create protective antibodies.

5 hr 36 min ago

From CNN's Nada Bashir

An almost-deserted Bank junction in the heart of London, seen on the first business day of the New Year, Monday, January 4.
An almost-deserted Bank junction in the heart of London, seen on the first business day of the New Year, Monday, January 4. Luciana Guerra/PA Wire/AP Images

The United Kingdom recorded a record 58,784new coronavirus cases on Monday  the highest daily increase since the beginning of the pandemic and the seventh day in a row in which the UK has recorded more than 50,000 new cases.

According to the latest government data, the total number of cases recorded across the UK since the pandemic began now stands at 2,713,563.

A further 407 deaths have also been registered over the last 24 hours, bringing the total number of people who have died within 28 days of a positive coronavirus test in the UK to at least 75,431.

The staggering figures come as England enters a third national lockdown, which is expected to last until mid-February, according to Prime Minister Boris Johnson.

"It is clear that we need to do more to bring this new variant under control," Johnson said during an address to the nation on Monday. "That means the government is once again instructing you to stay at home."

In a statement, Yvonne Doyle, medical director for Public Health England, urged citizens to adhere to government guidance in order to stem the spread of the virus.

The continuous rise in cases and deaths should be a bitter warning for us all, Doyle said Monday.

We must not forget the basics  the lives of our friends and family depend on it. Keep your distance from others, wash your hands and wear a mask. This virus will transmit wherever you let your guard down, she added.

6 hr 46 min ago

From Sandrine Amiel

A group of 30 French citizens will be selected at random to represent the concerns of members of the public and advise the countrys government on its vaccination strategy, the French Economic, Social and Environmental Council said.

A group of 30 citizens, selected at random, whose composition is intended to be as representative as possible of French society, will be formed, the council said, adding that the groups purpose will be to take into account the concerns, observations and interrogations of citizens across the country.

Its members will be invited to raise issues relating to vaccination, whether they are about scientific, health, technical or financial matters. Fears, resistance or questions surrounding the ethics of the national vaccination campaign may also be expressed, the council added.

In an interview with French newspaperLe Journal du Dimanche, the council said that the draw would be held on Monday, with the group expected to begin working on Jan. 16.

A broader digital consultation platform will also be set up, the council said on its website, in order to collect on a large scale the expression of citizens on their concerns, their expectations or their information needs regarding the vaccination campaign."

« Go back