Rural California hospital overwhelmed by Covid

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APPLE VALLEY, United States, Jan 13, 2021 (BSS/AFP) – As Covid-19 tears
through southern California, small hospitals in rural towns like Apple Valley
have been overwhelmed, with coronavirus patients crammed into hallways,
makeshift ICU beds and even the pediatric ward.

When AFP visited St Mary hospital in this desert town of 70,000 people
this week, palliative care supervisor Kari McGuire said her team were seeing
“astronomical numbers of patients who are dying” from the novel coronavirus.

“It’s most definitely the darkest period of my entire career. Most
definitely,” she said, fighting back tears as she recalled the loss of
patients, including staff and their families.

“I’ve personally had to watch people that I know that I care for watch
their loved ones die. It’s been very difficult.”

Populous Los Angeles, just 80 miles (130 kilometers) away, has suffered
the highest number of Covid cases and deaths in California. However when per
capita the outbreak in neighboring San Bernardino county — where Apple
Valley is located — has been even worse.

While rural regions further north have been helped by their isolation,
this mainly working-class town in the Mojave Desert, where towns stuffed with
warehouses and factories have long since replaced orchards, has seen more
than one-in-10 people infected.

In crowded hospital corridors, the constant hum of beeping monitors and
coughing patients is regularly punctured by Covid victims going into cardiac
or respiratory arrest.

The intensive care unit originally had 20 beds, but the hospital is
currently struggling to treat 54 ICU patients, improvising with plastic walls
to create isolated “pods.”

“Where do you put 60 ICU patients when you only have planned to hold 20?
And then with staffing as well?” asked Randy Loveless, interim director of
the emergency department and ICU.

“We’ve had to be very creative about how we’ve managed that. But
currently, we are managing it.”

Still, employees are working up to 18-hour shifts, and some patients have
to wait days for a room.

“The impact that this surge of COVID has had on the hospital is
tremendous… an operational strain, as well as a tremendous emotional
strain.”

– ‘Hard to swallow’ –

Mendy Hickey, executive nursing director, said her team was battling with
post-traumatic stress disorder due to the non-stop extreme pressure.

“People are extremely exhausted, people are definitely angry, it’s tension
all the time,” she said, with “spiritual care teams” called in to help her
nurses.

Many have now received vaccines, part of a massive statewide inoculation
effort that — after a slow start — has seen sites including Disneyland and
the Los Angeles Dodgers’ baseball stadium converted to soon administer doses.

California health secretary Mark Ghaly said Tuesday that flattened state
hospitalization numbers were “encouraging,” although he warned numbers could
pick up again in late January.

But it comes too late for many at St Mary, which in December saw patients
dying at rates “at least three to four times” higher than in usual months,
said Hickey.

“In the beginning of COVID, back in the spring, there were times… you
would get patients off of the ventilator, you would see patients go home.”

“Now, that is not the swing of things — majority of times now, we’re
having families coming in, we’re having difficult conversations about
patients and how they’re doing multiple codes every day.

“The patients are just so sick. So sick… every day you come in and more
and more patients are dying, it’s hard,” she said.

Adding to Hickey’s frustration is the continued skepticism about the virus
and protective measures among many Americans, including in rural California.
“You hear a lot of negative comments about ‘it’s a fake disease. This isn’t
real. It’s so hard to swallow, when you’re in the middle of it, living it
every day,” she said.

“When your nurses are breaking down and crying on the unit, because
another patient died.”

She added: “You wish you could bring them in here and see what we see. It
would definitely change people’s minds.”