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'Crisis Care' A Strong Possibility At Hospitals During Surge of COVID Patients

LOS ANGELES (CBSLA) — Crisis care at some hospitals in the state will become necessary as resources have become scarce during a surge in COVID-19 cases, the California Department of Health & Human Services said Tuesday.

Many California hospitals are categorized in contingency or conventional care but some are moving to a more serious level called crisis care.

"We're trying to avoid crisis care where space would be used in usual ways and doesn't have everything that it needs," said Dr. Mark Ghaly, California Health & Human Services Agency Secretary.

He added that medical professionals in crisis care will have to make hard choices.

"I'm going to use the word here that I think is it's an important one to emphasize that in crisis care you are in situations with occasionally you have to ration...There might be situations where the staff is stretched thin and patients don't get the same level of attention," said Ghaly. "We're doing everything in our power to make sure this doesn't happen across the state."

Each individual hospital determines if crisis care status has been met based on the need for hospitalization and available resources.

If crisis care is implemented at a hospital in a county or region, other hospitals will be asked to share resources or temporarily change their operations.

It's a scenario that USC Verdugo Hill's Chief Medical Officer, Dr. Armand Dorian, said he can't believe he could be facing.

"Just the fact that we have to mention rationing of care in the United States of America is mind-boggling," he said. "We are not there at my hospital but we could be there literally within a day."

The department is asking that hospitals have prepared plans for crisis care that include equity, fairness, and transparency.

The department added any hospitals that must go into crisis care will be helped to be there for as little time as possible by state agencies.

The Southern California region has nearly no ICU capacity to treat more COVID-19 patients, and some hospitals have been reporting having trouble securing oxygen.

State officials have released guidelines on how to classify which patients to focus on saving, should the situation become more grim.

"Medical decisions primarily are grounded in the likelihood of surviving in the near term," said Kim McCoy Wade, the Director of the California Department of Aging. "That is the appropriate basis for these decisions." 

At Dr. Dorian's hospital, he said they've started reconnecting the team of doctors, ethicists, spiritual and local leaders who would make those decisions. Still, he's worried people are not going to stay home.

"The biggest fear that I have is that the public is just tired of hearing about COVID," he said. 
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