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Still Not Convinced There’s A COVID-19 Crisis? LA Doctors Are Told To Have End Of Life Talk With Fragile Patients

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Even as the COVID-19 pandemic rages out of control, there are still those who downplay or even deny the seriousness of the situation. Here’s the latest bit of evidence that we really, truly, are in a crisis: L.A. County is asking doctors not to send patients to the ER “unless absolutely medically necessary.”

On top of that, the “health alert” from the Department of Public Health is advising providers to make sure their seriously ill and frail patients have filled out advance care directives. That request comes as Department of Health Services Director Dr. Christina Ghaly says hospitals should be prepared to enter a new phase, in which those less likely to survive won’t get the same level of care as they normally would because there won’t be enough staff to save everyone.

That type of battlefield medicine-type triage is just weeks away, said Brad Spellberg, chief medical officer of L.A. County-USC Medical Center.

(You can find a sample advance care directive here and a supplemental Physician Orders for Life Sustaining Treatment here.)

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Hospitals are already adding beds, moving ICU patients to other areas, and trying to retrain staff to backfill for highly trained ER doctors and ICU nurses.

But they’re losing the fight.

"There are very limited hospital and ICU beds available and emergency departments are strained to capacity," reads the health alert from Dr. Sharon Balter, head of Public Health’s Division of Communicable Disease Control and Prevention.

The memo notes that, over the past two weeks, the number of people hospitalized with COVID-19 has jumped by 90%.

As of Wednesday, a staggering 6,155 Angelenos were hospitalized in L.A. County with the virus, and 20% of them were in ICUs spread across the county's acute-care hospitals.

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"We are forecasting that in this current surge — between Nov. 1 and Jan. 31 — 8,700 people in Los Angeles County will die from COVID. That is nearly three times the number of people that died in the 9/11 terrorist attacks," Ghaly said in a press call yesterday.

"The worst is yet to come," she warned.

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