A brutal letter by virus-ravaged Los Angeles county health authorities detecting paramedics to not transport dying patients or waste oxygen reveals the extent of the Covid crisis gripping the US.
California has moved into a “dangerous” new phase of the pandemic as besieged hospitals run short of oxygen and the state’s top health officials described it as being “in the deep dark part of the tunnel”.
The LA County Emergency Medical Service (EMS) has directed ambulance crews not to transport patients with little chance of survival to hospitals, and to conserve the use of oxygen which is in short supply.
Issued on January 4 the letter is marked “Effective immediately due to the severe impact of the Covid-19 pandemic on EMS and 911 receiving hospitals”.
The letter outlines that “adult patients in blunt traumatic and non-traumatic out-of-hospital cardiac arrest shall not be transported if return of spontaneous circulation is not achieved in the field”.
“Patients in traumatic full arrest who meet current … criteria for determination of death shall not be resuscitated and shall be determined dead on scene and not transported.”
Los Angeles’ mayor Eric Garcetti said on Sunday that the city’s residents are being infected at a rate of one every six seconds.
A further letter issued by LA’s EMS on the same day contains a directive not to administer oxygen to critical patients because of the shortage of it in the current circumstances.
“Given the acute need to conserve oxygen, effective immediately, EMS should only administer supplemental oxygen to patients with oxygen saturation below 90 per cent,” it reads.
“For patients with hypoxia (O2 levels below 90pc) the minimum amount of oxygen necessary to maintain the oxygen saturation at or just above 90pc shall be administered.
California became the first US state where Covid-19 cases surged past two million last month, and numbers are now just under 2.5m, with more than 27,000 deaths.
It has the fastest growing case numbers of any US state in a country which has 20.9 million total cases, with 354,000 deaths at the rate of 3000 Americans dying each day.
The US has just under a quarter of the world’s 85.6m cases, of which 1.85m people globally have died.
America has by far surpassed every other country in the world in total confirmed cases of coronavirus, as well as per capita of population.
California’s per capita rate of Covid-19 cases is second only to Arizona and the state’s governor Gavin Newsom described the situation as a “surge on top of a surge”.
He said hospitalisations had increased seven-fold in the past two months, and that Covid-19 “is more deadly today than any time in this pandemic’s history”.
Californian chief health official Dr Mark Ghaly said his state’s hope of getting out of the “tunnel” into the “light ahead” was via mass immunisation with Covid-19 vaccines, calmatters.org reported.
State health officials are accelerating the distribution of vaccines by Pfizer and Moderna to health care workers and nursing home residents, and will allow dentists to administer them.
However virus projections estimate a further 6286 Californians will die from the disease over the next three weeks.
The state is sourcing more oxygen containers and has dispatched army engineers to hospitals to facilitate the supply to patients.
Six cases of the highly contagious mutant UK coronavirus strain B117 have been reported in southern California.
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