As surging coronavirus cases push intensive care units across Los Angeles to the breaking point, Mayor Eric Garcetti says what's needed more than hospital space and safety equipment right now is trained health workers and more vaccine doses.
"The toughest thing right now isn't just space — though it's pinched — it's really personnel and getting enough people to be there for the shifts to save lives," Garcetti tells All Things Considered. "That's increasingly where we are feeling the crunch."
A startling 7,613 patients are currently hospitalized with COVID-19 in Los Angeles County, including at least 1,580 of whom are in ICUs as of 4 p.m. ET on Thursday, according to the state Department of Public Health website.
As much as the health system expected a surge in cases, Garcetti says there is only so much staffing available to brace for the influx of patients.
"The plans were there to have surge capacity and that's what we're seeing enacted," he says.
Now, the number of ICU beds available is "very close" to operating at that new surge capacity, says Garcetti.
"There's a point in which there's just not enough people for the shifts," he says. "No matter how much you surge up, there's a point in which [case] numbers can go beyond what capacity is."
The staffing crisis is further strained by front-line workers' daily exposure to the coronavirus. During the second week of December alone, 2,191 health care workers tested positive for the virus — a 25% jump in cases compared to the previous week.
The city's vaccine distribution efforts give the mayor some sense of hope. He says some 85,000 to 90,000 Angelenos have already received their first dose — largely health care workers, nursing facility residents and firefighters.
But he says Los Angeles has the capacity to inoculate its population at a faster pace — thanks to the infrastructure it set up for testing, Garcetti says — and is pressing the state and federal governments to accelerate its distribution of the Moderna and Pfizer-BioNTech vaccines.
"We've got the storage, we've got the firefighters, we've got the volunteers, we're bringing together the medics and clinicians," Garcetti says. "We can go as fast as you give us those vaccines."
Like most of the state, Los Angeles is under a stay-at-home order. But the virus continues to spread rapidly in the city despite the strict restrictions. Garcetti says that's because LA is the state's most densely populated metro area.
Health officials have linked Thanksgiving gatherings to a spike in positive cases. For New Year's Eve, Garcetti says he's leaning on the city's police officers and building safety inspectors to enforce business closures and bans on large gatherings. And he says he is supportive if county health officials decide to implement further restrictions.
For now, though, Garcetti says slowing the spread is "less about what's open and closed and more about our own individual behaviors."
Jonaki Mehta and Jan Johnson produced and edited the audio interview..
AILSA CHANG, HOST:
And I'm Ailsa Chang in Los Angeles, a city where on this New Year's Eve, people are facing a nightmarish COVID reality. Hospitals are at their breaking point. ICUs are at or near capacity, and patients are getting treated in parking lots, outdoor tents, even hospital gift shops. And now a variant of the virus has arrived in Southern California. To talk about the surge, we are joined now by LA Mayor Eric Garcetti.
ERIC GARCETTI: Thank you. Good to be with you, Ailsa.
CHANG: So let's start with the immediate problem at hand. What is being done to increase hospital and ICU capacity right now?
GARCETTI: The toughest thing right now isn't just space, though it's pinched. It's really personnel and getting enough people to be able to be there for the shifts to save lives. And that's increasingly where we are feeling the crunch of this moment. And so we're pouring everything we can in. And, you know, shout out to all of those personnel that are putting in the shift after shift after shift with very little sleep - and many of them who are exposing themselves, obviously, to great danger in this moment.
CHANG: But if I may, I mean, why have we even been seeing zero or close to zero percent capacity in some ICUs in LA? - because a surge around the holidays had been expected. Could the city and the hospitals have planned better?
GARCETTI: Well, they planned really well for it. I think one thing that gets reported is zero capacity. That's - zero capacity is built out, let's say, in October. But the plans were there to be able to have surge capacity, and that's something that we're seeing enacted. Some hospitals can do that better than others. And we're getting to the point where we need to make sure they're coordinating well with each other, which is happening. But there's a point in which there's just not enough people for the shifts. And it's just - no matter how much you surge up, there is a point in which numbers can go beyond what capacity is, and we're very close to that.
CHANG: Well, why do you think California is seeing such startling numbers when the state, including Los Angeles, had some of the toughest restrictions, like lockdowns?
GARCETTI: Right. And, you know, that's what the frustrating thing about this virus that makes you feel, sometimes, so powerless is you can do everything right. We were the first city to close down the places of gathering, first city to have masks mandated and the first city to have widespread testing with or without symptoms. But, you know, this has come down to something which we see in the colder months; a very dense city that - the CDC has a vulnerability index. Los Angeles was always at the top of that list, so we have been very lucky, saved thousands and thousands of lives. But we've known this has been coming based on that index. So we are working, you know, as hard as we can to make sure that we fill the holes, especially in vulnerable communities.
CHANG: Well, I want to talk about enforcement of some of the restrictions that you have asked people to heed. You've been pleading for people to stay home on this New Year's Eve. But then we saw a well-known restaurant in Beverly Hills slip a note into takeout bags, inviting reservations for an indoor party. An evangelical Christian singer even planned multiple mass worship gatherings here, including on Skid Row, one of the most vulnerable populations in LA. What specifically are you doing to stop people from defying your guidance?
GARCETTI: We've had strong enforcement throughout this year, and we're going to continue to. And we know if 95% of people are doing the right thing, this is still a dangerous virus. If only 80% are doing the right thing, it could be disastrous. And so we've put our - not just police officers but also our inspectors, building and safety folks who have had really remarkable records in places like construction sites, with certain industries that have continued going without big outbreaks, precisely because we try to, at first, you know, encourage and educate and then if necessary, we do enforce. And we won't stop doing that, especially now.
CHANG: I want to turn now to this new COVID variant. It's here in Southern California. This mutant strain is apparently more contagious. Some scientists are recommending even tougher restrictions. Should we be expecting to see tougher restrictions here in Los Angeles?
GARCETTI: Well, I've been 100% supportive of our public health officials whenever they recommend closure. Right now that's not been the recommendation. This is less about what's open and closed and more about our own individual behaviors. It's about the mixing of households. It's Christmas, saying, hey, I'll just get together with my parents. It's New Year's; maybe that one close friend can come over. We'll just go indoors for a little bit with a window open. These are the things that are spreading this disease rapidly. And so I am absolutely supportive if that's the recommendation of our county public health department to go further with closures. I certainly would beg the federal government to go much further than this package we just saw to make sure that people can safely stay home and don't feel that they need to get that work shift because they're covered not with $600 but with $2,000 and a monthly payment until this ends. And we need to have the financial support to make sure those closures can work and people can still survive.
CHANG: I want to turn to vaccines now. How is Los Angeles doing with vaccine rollouts? Do you have any concerns at the moment?
GARCETTI: We are running at full speed. About 85- to 90,000 Angelenos have already received their first dose, but we need to go faster. We need the federal help. We need the state help to surge up even more. We have the capacity because Los Angeles built up probably the strongest testing program in the country. And so we're taking that knowledge and that infrastructure. And we're saying, we can turn that around if you give us the vaccines. We've got the storage. We've got the firefighters. We've got the volunteers. We're bringing together the medics and clinicians. We can go as fast as you give us those vaccines. So...
CHANG: But what specifically do you need from the federal government to help with...
CHANG: ...Vaccine distribution?
GARCETTI: More vaccines - we can handle the distribution on our own. We just need to get as much supply as quickly as possible, and we'll take care of the rest.
CHANG: Finally, Mayor, is there anything - on this last day of this incredibly difficult year, is there anything that you would like to tell the people of LA?
GARCETTI: Thank you for your heroism this year. We've held so much pain and so much loss and so much suffering and so much stress. Don't let the rays of light fool you that the clouds are not still overhead. The vaccine is now here, but it will still be some months. And the difference between life and death is what we do right now. Make it your New Year's resolution to stay home tonight, and make it your New Year's resolution to save lives in January and February. And we will come back, and we will come back strong. Never bet against Los Angeles. This is the City of Angels. And you certainly have acted that way so far. Let's finish strong.
CHANG: Los Angeles Mayor Eric Garcetti, thank you very much and all the best for the New Year.
GARCETTI: Thank you; sending you strength and love and to all your listeners too. Transcript provided by NPR, Copyright NPR.