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Los Angeles Hospitals Plan to Ration COVID-19 Care Amid Surge

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File: Check-in tents at the Martin Luther King Jr. Outpatient Center. Hospitals are making plans to start triaging patients if infections continue to increase. (Chava Sanchez/LAist)

Hospitals across Los Angeles County are preparing to ration care and prioritize treating patients who are most likely to survive — a dire but necessary step as coronavirus continues to spread widely in Southern California.

To make those decisions, hospitals are designating teams made up of people not directly involved in patient care.

Those steps are needed because the number of COVID-19 patients in hospitals has been exploding, with more than 7,100 people now being treated. ICU bed availability also has plummeted.

Huntington Hospital in Pasadena is among the facilities preparing for a continuously worsening situation. The hospital has released a plan that describes how the process would work.

“It's a committee that's formed by a bioethicist, a clinician, a nurse, a community member, and sometimes an administrator or a fourth person," said Dr. Kimberly Shriner, speaking Wednesday on KPCC's public affairs show, AirTalk. "It's not anybody who's actually taking care of any of the patients.”

Shriner, who is an infectious disease specialist at Huntington Hospital, said her facility has so far been able to manage the surge, but she cautioned that more COVID-19 infections could soon force hospitals to the tipping point.

And that’s what the decision-making team is preparing to handle. Here's Shriner again:

“If we get to a point where we have a very big shortage of, let's say, oxygen tubing or oxygen tanks or ventilators, they examine patients from a clinical basis in terms of whether or not that person would benefit from that intervention. They don't know the patient's ethnicity, they don't know anything about their insurance status or anything. The only thing they know is their clinical status and their age.”

L.A. County is in the midst of a historic medical crisis, with a hospital system that Shriner says is on the brink of collapse. Like many hospitals, Huntington has already set up a surge tent in its parking lot. In some cases, patients are being forced to wait hours in ambulances before they can be admitted. Some hospitals are so short on space that they are using conference rooms and gift shops to treat patients.

"No healthcare worker ever wants to have to be put in the position to make this decision," Shriner said. "Our job is to save lives and provide the very best care for everybody we can, but sometimes there's just a limit to how many resources we have."

According to the latest statistics, L.A. County has 7,415 people hospitalized with coronavirus, the most at any one time since the start of the pandemic. One in every five of those patients are in intensive care units.

The 11 counties making up the state-designated Southern California region have been maxed out for days on ICU capacity, with a bed availability of 0% for COVID patients. Beds are available for non-Covid patients requiring ICU care.

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More Than 10,000 People Have Died From COVID-19 In LA County

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File: A funeral in progress at Evergreen Cemetery in Boyle Heights. Services at most cemeteries are discouraged or limit the number of guests that can attend. (Chava Sanchez/LAist)

The death toll from COVID-19 in Los Angeles County has passed a grim new milestone.

Health officials on Wednesday reported a staggering 274 additional deaths, tipping the county total past 10,000. The new deaths include a backlog from a communications outage on Christmas Day.

But county Public Health Director Barbara Ferrer warned that the rate of holiday travel — and the fact that many people are still getting together for the holidays — means many more deaths are likely in the new year:

"We all need to be prepared for another surge that will start with even higher case numbers in January. Increasing cases always translates to more and more people being rushed to already overcrowded hospitals, and tragically, also results in more people continuing to die."

About 150 people now die from COVID-19 in L.A. County every day — that's almost equal to the number of people who die per day from all other causes combined.

OVERALL LOOK AT LOS ANGELES COUNTY'S NUMBERS:

  • 10,392 new cases
  • 756,116 total cases
  • 274 new deaths
  • 10,056 total deaths
  • 7,415 hospitalizations

Here's a look at longer-term trends in the county. To see more, visit our California COVID-19 Tracker and choose Los Angeles or any other county that interests you. These numbers are current as of Tuesday, Dec. 29:

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Deputy DA’s Union Sues Gascón Over Sentencing Changes

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George Gascón, then candidate for Los Angeles County District Attorney, speaks to attendees at the local Democratic Party's drive-in watch party near the L.A. Zoo on Tuesday, Nov. 3, 2020. Chava Sanchez/LAist

The Association of Deputy District Attorneys for Los Angeles County — the union that represents roughly 800 deputy DAs — filed a lawsuit Wednesday claiming L.A. County District Attorney George Gascón’s sweeping changes to the local criminal justice system violate California law.

Gascón’s new directives, which order deputy DAs to dismiss some sentencing enhancements, have seen significant pushback in recent days. During his first weeks in office, Gascón directed deputy DAs to no longer seek extended sentencing in some circumstances, including a defendant’s involvement with a gang, the use of a gun or having a criminal history.

“Data shows these harsh tactics compromise our community’s long-term health and safety, create more hardened criminals and victims, and therefore are not in the interests of justice,” Gascón said in a statement in response to the legal action, adding, “After a summer of unrest, Los Angeles County voters embraced this new, modern approach.”

But according to the assistant DA’s union, the new directives “ignore or violate” current California law, which it said in a press release “imposes a mandatory duty on prosecutors to plead and prove strike priors.”

Union president Michele Hanisee said an elected DA does have broad discretion in determining which charges to pursue on a case-by-case basis. “But — here’s a big but — that discretion does not authorize him or her to violate the law with a blanket policy refusing to enforce particular law, ever,” she said.

Hanisee added that Gascón’s directives put prosecutors in an “impossible situation” by forcing them to choose between upholding current law or defying their supervisors’ orders and risking “getting disciplined or even fired.”

The union also petitioned the court for a temporary restraining order, which would have halted the implementation of Gascón’s orders, but ultimately withdrew its request after a judge said he would deny it.

L.A.’s office of Countywide Communications said it does not comment on pending legal matters, but issued a statement saying: “However, the Los Angeles County Board of Supervisors has made it clear that justice reform continues to be one of its six major priorities with the goal of reducing the number of inmates with mental health and/or substance use disorders."

In his response, Gascón said despite the legal challenge, he believes “a collaborative path exists to achieve these goals based on what research shows, what voters want, and what L.A. County deserves.”

Black Lives Matter Los Angeles released a statement on Wednesday in support of Gascón's position on sentencing enhancements.

This post has been updated with additional details from the county.

Newsom: Schools Can Restart In-Person Classes As Early As February Under New Plan

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File: Gov. Gavin Newsom speaks in a press conference. (Gov. Newsom's Office via Facebook)

California's governor has introduced a $2 billion plan to support and guide schools that wish to reopen for in-person instruction as early as February.

Some 1,700 elementary schools already have waivers for in-person instruction, according to Gov. Gavin Newsom, who made the announcement Wednesday morning. But in purple-tier counties like Los Angeles, where COVID-19 cases continue to surge, much of that instruction has been limited to younger students.

California's Safe Schools for All Plan lays out a series of guidelines and support aimed at reopening schools starting in the spring, after the current regional stay-at-home order is lifted.

In-person learning would be gradually reintroduced, focusing first on the youngest and highest-need students, including those in transitional kindergarten through 2nd grade and those in special education.

In-person attendance would not necessarily be required, however. Distance learning will still be an option, Newsom said.

In order for local schools to open, counties must have a seven-day average of at most 28 cases per 100,000 residents. And schools will be allowed to open only if they submit a safety plan to both local and state officials.

The new plan covers several key areas, including funding, safety and mitigation, oversight, and accountability.

1. FUNDING: The $2 billion in additional funding works out to $450 per pupil, Newsom said. The money will be weighted for districts serving students from low-income families, English learners and foster youth. Working with federal partners, Newsom also noted that he hopes to get the cost of testing covered through Medi-Cal, the state's version of Medicaid.
2. SAFETY AND MITIGATION: Testing will be required for staff and students — weekly, in areas with high rates of transmission. All staff and students will be required to wear masks, and the state plans to distribute millions of surgical masks to schools at no cost. Schools will be asked to participate in contact tracing by reporting cases with local health departments, and they will be supported by the state's contact tracing workforce. School staff will be prioritized for vaccinations through spring 2021.
3. OVERSIGHT: The plan lead will be UC San Francisco pediatrician Dr. Naomi Bardach, who the state refers to as an expert on COVID-19 transmission in schools. As schools roll out their safety plans, her team is expected to provide support, including school visits, training, and technical assistance.
4. TRANSPARENCY AND ACCOUNTABILITY: The state will provide a public dashboard detailing each school's reopening status, funding levels, and any reported COVID-19 cases. Staff and parents will be able to report any concerns to the state via a web hotline.

Debra Duardo, L.A. County's superintendent of schools, said she was grateful for the state's guidance. In a statement, she also called on the state to prioritize vaccinations for K-12 and early education teachers and staff, and she appealed to residents to help the county reduce transmission:

"Right now, LA County is facing a horrific surge of COVID cases. The absolute best thing we all can do to reopen our schools is to strictly follow public health guidelines. Please help by avoiding gatherings, staying at home as much as possible, wearing your masks and maintaining a 6-foot distance from others when you do need to leave home."

In a joint statement shortly after Newsom's announcement, the superintendents of L.A. Unified and a number of other large districts said they would review the plan carefully and provide feedback to the state ahead of the legislature's return on Jan. 11.

READ MORE ON THE PLAN HERE:

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New COVID-19 Variant From UK Found In Southern California

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People wait in line at a coronavirus testing and vaccination site at Lincoln Park on Dec. 30, 2020 in Los Angeles. (Frazer Harrison/Getty Images)

A new and potentially more contagious variant of the coronavirus from the United Kingdom has now been confirmed here in Southern California.

California Governor Gavin Newsom made the announcement during a live-streamed conversation Wednesday with Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Details are unclear about the case, which had just been reported to Newsom's administration. Dr. Fauci said he wasn't surprised to see the variant appear in California, after it was first detected in Colorado just yesterday.

"I think you're gonna start seeing it, because if you have that much of a prominence of this in the UK with all the travel — not only directly to the United States, but through other countries intermittently," Fauci told Newsom. "I don't think that the Californians should feel that this is something odd, this is something that's expected."

Earlier this week, Los Angeles County Public Health Director Barbara Ferrer said officials screened a very small sample size of tests for the variant, but did not find it at the time. However, she noted there was a "high probability" that the strain was already here, but it does not appear to be dominant.

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UC Campuses Weigh Options For Fall 2021 Semester

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UCLA is part of the 10-campus UC system. (Robyn Beck/AFP via Getty Images)

Earlier this month the California State University system announced it would return to in-person instruction in the fall of 2021, but so far there’s no word from the University of California on its plans for next year.

Nevertheless, administrators at some of the university's 10 campuses are taking steps to prepare for students’ return to in-person learning.

“We'd like to be able to make a decision as soon as possible,” said UC Irvine Executive Vice Chancellor Hal Stern.

Administrators and faculty on his campus have held meetings in the past few months, he said, to discuss various options that could include continued distance learning.

“[There] is still concern that we won't be in a position to have large lectures in person, so they might, for example, stay remote,” Stern said. But smaller classes with fewer than 30 students could convene in person, he said.

Other ideas: hold some classes outdoors, and lengthen the time between classes to keep students from crowding together as they make their way around the campus.

UC Riverside Chancellor Kim Wilcox suggested some in-person classes could make accommodations for students who prefer remote learning for health reasons.

“If you're in a class, for instance, with 25 students, and most of them want to come back to … a face-to-face experience and the professor would like to as well, but you live at home with a grandmother who's medically compromised, or you have health issues yourself, you deserve a safe option, you shouldn't have to come back to campus,” Wilcox said.

Both the UC and CSU systems give a great deal of autonomy to campus leaders to decide how learning takes place.

Stern said the next step for his campus is to get input from the academic departments on their preferences for conducting classes. Fall class schedules need to be final by May, when students can begin registration for classes.

UC President Michael Drake is likely to announce UC’s systemwide plans early in the new year. His office was not available for comment.

CSU’s announced return to in-person for the fall did not include any details about what class offerings would look like or what kind of limits there would be on students living on campus. CSU and UC campuses have opened a fraction of their dorms to students during the pandemic and several campuses have seen COVID-19 outbreaks as students have broken rules that limit gatherings.

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Morning Brief: 2020's Best Of Arts

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Artist Pony Wave paints a scene depicting two people kissing while wearing face masks on Venice Beach on March 21, 2020. Mario Tama/Getty Images

This week, we’ll be looking back at our coverage of 2020, one of the strangest, most difficult years through which many of us have ever lived. Reporting on it was hard, and at times painful. But amid the tragedy of the coronavirus, there were some bright spots. Today, we’ll take a look at our coverage of L.A.’s arts and entertainment scene.

I normally cover arts and entertainment — stuff like escape rooms, new TV shows set in Los Angeles, and of course, Disneyland. Fun, right? But the pace of news this year has had many of us pivoting. That's meant along with reporting on how COVID-19 has affected the arts locally, I’ve also been covering the governor’s COVID-19 press conferences, the Black Lives Matter protests against police brutality, our pandemic election year, and more.

Through it all, hearing from our audience has helped to guide my coverage and helped me find the stories that need telling. Thank you for staying with us. Here are some of my favorite arts stories from the past year. It includes the serious social issues we all grappled with this year, but also a Britney Spears pop-up, theme parks, and Santa. Let’s hope there’s more of the fun in 2021, and I hope that you all stay safe during this time.


2020's Best Of Arts

UCB Faces Backlash After Receiving Coronavirus Bailout, Not Rehiring Employees At The Comedy Theater/School The Upright Citizens Brigade laid off most of its L.A. staff members after COVID-19 closures. The acclaimed comedy theater and training school received a loan from the government's Paycheck Protection Program of somewhere between $350,000 and $1 million in early April for its L.A. location — but said they didn't plan to use that funding to hire back their staff. (Read the story)

The Magic Castle Conjures Up A New Black Lives Matter Response Amid nationwide protests against police brutality and racism, Hollywood’s legendary Magic Castle came under fire for offering its parking lot as a staging area for law enforcement. Its response only drummed up more disappointment and anger. (Read the story)

Oops, They Did It: A Pop-Up Recreating Britney Spears’ Music Videos In LA’s Fairfax District Pop-up experiences range from hot garbage to magical. The Zone, a new Britney Spears-inspired and endorsed pop-up next to the Grove, isn't perfect (where’s the "(You Drive Me) Crazy — The Stop Remix" room?) but it's a good encapsulation of what it feels like to be a Britney fan. (Read the story)

Drive-Ins Spread Through Hollywood (And Beyond) As the prospects for going back to see movies indoors anytime soon grows dimmer, pop-up drive-ins are spreading. Now you can enjoy a socially distanced movie with dozens of other cars from Santa Monica to Montclair, along with more points in between. In the heart of Hollywood, you're even getting new(ish) movies. (Read the story)

How LA’s Street Artists Are Responding To Coronavirus From Ruben Rojas to Cat Donuts to Rasmus Balstrøm and more, graffiti artists took to the streets to vent frustration, feel a sense of control and bring the city together. "We don't know what tomorrow holds — we're kind of sitting here waiting — and making art and putting it up makes me feel like I'm somehow empowered over the situation,” said artist Jeremy Novy. (Read the story)

‘Our Santa Jaw Dropped.’ How SoCal Santas Are Going Virtual And Staying Safe For IRL Visits Christmas will be different this year — don't carol and spread your particles too close to me, please — and it will be no less different for Santa than for the rest of us. (Read the story)

We Traipsed Around A Star Destroyer: Your Guide To Disneyland’s ‘Star Wars: Rise Of The Resistance’ The new ride — which resides in a large portion of Galaxy's Edge (a.k.a. Star Wars Land) that up until now was relatively sparse — is one of the most ambitious attractions ever seen at Disneyland, with multiple ride systems coming together to immerse you in another world. (Read the story)

Coronavirus Shut Down Popular Escape Rooms. Now The Industry Is Going Virtual L.A.’s escape rooms are closed for now — with the tight passages and constant touching of different puzzles as you try to find your way out, they are basically ripe for spreading a virus. Here’s how they’re getting by. (Read the story)

How To Make A Sitcom Safely During Coronavirus: Have The Cast Be The Crew The life of an actor isn't always glamorous. But that may be especially true during a pandemic. The new NBC sitcom Connecting... was shot remotely at the actors' homes across Los Angeles, with cast members serving as their own crew. (Read the story)

Theme Parks Are Closed, But Here Are 17 Rides You Can Go On Right Now — Virtually We can't get you into Disneyland (though I do have a friend who drove down to take a quarantine tour of their parking lots), but we can give you your own personalized virtual theme park experience with the best theme park ride videos. (Read the story)


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