洛杉矶-加利福尼亚州的卫生保健系统在该国最大规模的冠状病毒爆发的压力下屈曲，如果人们忽视假日社会疏离，可能会在数周内破裂，卫生官员警告说，由于需要床位和专门护理的人数猛增至以前无法想象的水平。
该州最大的医院系统（Kaiser Permanente，Dignity Health和Sutter Health，覆盖了1500万加利福尼亚人）的最高管理人员周二表示，越来越精疲力竭的员工（许多人因正常工作而被迫上班）现在正在照顾COVID-19患者在走廊和会议室。
洛杉矶马丁·路德·金社区医院的首席执行官伊莱恩·巴特卡尔博士分别表示，那里的病人涌入了礼品店和急诊室外的五个帐篷。
“我们没有空间容纳任何人。我们已经把病人关了好几天了，因为我们不能让他们转移，也不能为他们铺床，”帝国角El Centro地区医疗中心急诊室医师Alexis Lenz博士说。状态。该设施在其停车场内搭建了一个可容纳50个床位的帐篷，并将三个手术室转变为病毒防护室。
加利福尼亚即将结案的200万例COVID-19确诊病例。该州周二报告了近32,700例新确诊病例。另有653名患者入院，这是一日住院人数最多的一次跳升，总数接近18,000。
州数据模型预测，如果继续保持目前的水平，住院治疗可能在一个月内达到100,000。
缺少床位比没有床位还要令人担心。总部位于圣地亚哥的医疗保健人员服务公司Aya Healthcare表示，由于对旅行护士的需求在过去一个月内猛增了44％，加利福尼亚州，德克萨斯州，佛罗里达州，纽约州和明尼苏达州的需求增加了，因此可供旅行的护士队伍正在枯竭。。
加州大学旧金山分校公共政策教授珍妮特·科夫曼博士说：“我们现在处在全国各地激增的局面，因此没有人有很多空余。”
加利福尼亚州正在向澳大利亚和台湾等地伸出援手，以满足3,000名临时医务人员的需求，尤其是接受过重症护理培训的护士。
在全国各地，人们将感恩节期间缺乏社交距离和戴口罩的罪魁祸首归咎于疫情，官员们担心，如果人们聚集在圣诞节和新年那天，疫情还会进一步恶化。
加利福尼亚农业中央谷地的弗雷斯诺县处于绝境。弗雷斯诺社区医疗中心首席医疗官托马斯·乌泰特（Thomas Utecht）博士讲述了医护人员每天如何看待悲惨的家庭，绝望的病人和在隔离病房中死去的人们，以及亲人在远处注视。
那里的医生和卫生官员恳求人们避免聚集在直系亲属之外。
弗雷斯诺县姑息治疗专家帕特里克·麦克米伦（Patrick Macmillan）博士说：“如果人们不在家，我们将要看到的东西简直是难以想象。” “我认为这将破坏医疗体系。”
从田纳西州到美国，密西西比州和西维吉尼亚州均出现了最严重的新人均COVID-19感染激增，密西西比州和西维吉尼亚州也出现了类似的警告，周二的一天中，密西西比州和西维吉尼亚州的病毒死亡人数超过了此前的最高水平。
COVID-19的影响不仅限于感染者。缺少床铺或护士意味着到其他急诊室的排队也很长，例如心脏病发作或外伤的患者，必须等待急诊室护士负责病人的护理人员可能无法立即弗雷斯诺市区社区医疗中心的急诊医生安妮·冯·赖因哈特（Anneli von Reinhart）博士说，应接再打911电话。
在此过程中，向医护人员分发了数千剂COVID-19疫苗确实在隧道尽头标志着光明，但“感觉隧道似乎正在变窄，”临时的Rais Vohra博士说。弗雷斯诺县卫生官员。
他说：“试图让人们尽可能安全地通过这条隧道只是一场与时间的竞赛。” “这就是现在在前线工作的感觉。”
California health system buckling under COVID-19 pandemic
LOS ANGELES -- California's health care system is buckling under the strain of the nation's largest coronavirus outbreak and may fracture in weeks if people ignore holiday social distancing, health officials warned as the number of people needing beds and specialized care soared to previously unimagined levels.
Top executives from the state’s largest hospital systems —Kaiser Permanente, Dignity Health and Sutter Health, which together cover 15 million Californians — said Tuesday that increasingly exhausted staff, many pressed into service outside their normal duties, are now attending to COVID-19 patients stacked up in hallways and conference rooms.
The CEO of the Martin Luther King, Jr. Community Hospital in Los Angeles, Dr. Elaine Batchlor, separately said patients there have spilled over into the gift shop and five tents outside the emergency department.
“We don’t have space for anybody. We’ve been holding patients for days because we can’t get them transferred, can’t get beds for them,” said Dr. Alexis Lenz, an emergency room physician at El Centro Regional Medical Center in Imperial County, in the southeast corner of the state. The facility has erected a 50-bed tent in its parking lot and was converting three operating rooms to virus care.
California is closing in on 2 million confirmed cases of COVID-19. The state on Tuesday reported nearly 32,700 newly confirmed cases. Another 653 patients were admitted to hospitals — one of the biggest one-day hospitalization jumps — for a total approaching 18,000.
State data models have predicted the hospitalizations could top 100,000 in a month if current rates continue.
Even more worrying than lack of beds is a lack of personnel. The pool of available travel nurses is drying up as demand for them jumped 44% over the last month, with California, Texas, Florida, New York and Minnesota requesting the most extra staff, according to San Diego-based health care staffing firm Aya Healthcare.
“We’re now in a situation where we have surges all across the country, so nobody has many nurses to spare,” said Dr. Janet Coffman, a professor of public policy at the University of California in San Francisco.
California is reaching out to places like Australia and Taiwan to fill the need for 3,000 temporary medical workers, particularly nurses trained in critical care.
Around the country, outbreaks are being blamed on lack of social distancing and mask-wearing during Thanksgiving and officials fear an even worse surge if people gather for Christmas and New Year’s.
Fresno County in California's agricultural Central Valley is in desperate condition. Dr. Thomas Utecht, chief medical officer for Community Medical Centers Fresno, related how medical staff daily see sobbing families, desperate patients and people dying in isolation wards with their loved ones watching remotely.
Doctors and health officials there are begging people to avoid gathering outside of their immediate families.
“If people don’t stay home ... we’re going to see something that’s, it’s hard for me to even imagine,” said Dr. Patrick Macmillan, palliative specialist in Fresno County. “I think it will break the health care system.”
Similar warnings echoed around the country, from Tennessee, which is seeing the nation’s worst new COVID-19 infection surge per capita, to Mississippi and West Virginia, which surpassed their previous highs for virus deaths reported in a single day on Tuesday.
COVID-19's impact isn't just on the infected. Lack of beds or nurses means that there are long lines to emergency rooms for other patients as well, such as those with heart attacks or trauma, and paramedics who must wait for an ER nurse to take charge of a patient may not be able to immediately answer another 911 call, said Dr. Anneli von Reinhart, an emergency physician at Community Regional Medical Center in downtown Fresno.
In the midst of the surge, the distribution of thousands of doses of COVID-19 vaccine to health care workers does mark light at the end of the tunnel but “it also feels like the tunnel is narrowing," said Dr. Rais Vohra, interim health officer for Fresno County.
“It’s just a race against time to try to get people through this tunnel as safely as possible,” he said. “That’s exactly what it feels like to be working on the front lines right now.”
