Omicron Stressing Hospitals

First published in the Jan. 14 print issue of the South Pasadena Review.

Hospitals in Los Angeles County continue to contend with an Omicron variant-driven wave of COVID-19, which is not yet proving as deadly as last year’s winter surge but is nevertheless putting pressure on medical system functions.
Early into the wave, hospitals in the county were reporting that many of their inpatients with COVID-19 were found to have the disease during the admittance screening process — in other words, they didn’t seek hospital care because of the coronavirus. With the results of Christmas gatherings starting to show, and the subsequent New Year’s Eve gatherings due, the picture is starting to change, officials are saying.
“Most of our COVID patients that we have admitted are sick with COVID,” said Dr. Kimberly Shriner, director of infection prevention and control at Huntington Hospital in Pasadena. “The vast majority of those that have severe disease are unvaccinated — same old story — but we are seeing some people who have been vaccinated and boosted and are hospitalized because of, for example, an immune system disorder.”
According to Huntington’s online dashboard, the hospital had 107 inpatients with COVID-19 on Wednesday, an increase by five from the prior day; 60% of them were unvaccinated. The hospital had 12 patients in the intensive care unit with COVID-19, a decrease by two from the prior day and of whom 10 were unvaccinated.
With ERs being inundated with patients concerned about the COVID-19 symptoms or diagnoses, officials are urging those people to avoid seeking emergency care unless they’re experiencing breathing difficulties, severe weakness or severe fevers. Hospitals are not public testing centers, so those seeking tests should consult
And if you do get a positive test result, with mild or no symptoms?
“Hunker down, stay home, drink fluids. Isolate yourself. Don’t spread it,” said Dr. David Tashman, the emergency department director at USC Verdugo Hills Hospital in Glendale. “Reserve the emergency department really for emergencies.”
The Omicron variant has caused daily confirmed cases in Los Angeles County to skyrocket past previous records, with numbers ranging from 32,000-47,000 for much of the past two weeks. Daily new deaths — a lagging indicator — are now increasing after falling for much of the past month. Hospitalizations are also a lagging indicator, given the incubation time for the disease.
“Illness just started spiking two weeks ago,” said Tashman, “so we’re just starting to see hospitalization numbers now. It’s still relatively small — this time last year, we had 80 hospitalizations, so it’s a lower magnitude. But the curve is basically the same. We might have 80 next week. Who knows?”
On Wednesday, USC-VHH had 32 inpatients with COVID-19, three of whom were in intensive care.
Shriner described Omicron — known for its high infectiousness, often breaking through vaccinations, but for also producing a less aggressive disease — as “the match that lit the fire.” Emergency room visits this week were in the low 100s each day, and there was a day last week with 242 ER patients.
“It’s still brisk, but it’s a little tamer,” Shriner noted.
Although ICUs have not yet been pushed to the edge as they were a year ago, medical centers are now contending with staffing shortages on account of doctors, nurses and technicians catching the disease and having to quarantine anywhere from five to 10 days, depending on whether they have symptoms. The Los Angeles Times reported Wednesday that some hospitals are bringing asymptomatic personnel back prior to their recommended five days simply because of the dire straits.
“We’re dealing with health care professionals, who love what they do, but they’re exhausted because they’ve been doing this for two years,” Shriner said. “Now they’re being stretched even more thin because of workers being out sick with Omicron.”
There was some hope, at least in Shriner’s eyes. The doctor, who made a career of HIV research and treatment before COVID-19 consumed her life, speculated that L.A. County could reach its peak within the month, based on data from nations such as South Africa that are emerging from their own Omicron waves.
“I think we’re beginning to approach the summit,” she said. “We kind of bob around at the top — it goes up, down, then up and then we go over the edge and we’re on the other side.”
Shriner added that Huntington’s trauma center — the primary such center for the area — remains relatively uninhibited, for now, from the situation. Huntington took in six trauma patients on Monday, she said.
“[Our staff] knows how to do this, they’re really good at it and they’re doing it,” Shriner said. “They’re tired and kind of annoyed by people who won’t get vaccinated, but they’re doing their job.”