Happy New Year, L.A.–Could Your COVID Obituary Be Next?

More than 100,000 new COVID-19 cases in seven days. Over 600 COVID deaths in that same period. ICU capacity at zero. And the malls are still open.

L.A. County, the country’s most populous, is in the grips of a lethal denial that has made it the national epicenter of the COVID pandemic. With emergency rooms and ICUs overflowing, care will soon be rationed – not just for COVID patients but for anyone requiring life-saving medical attention. Can anything wake us up from our collective rush toward the abyss?

It won’t be the L.A. County Public Health Department. While the agency has issued increasingly dire public statements about the county’s skyrocketing COVID numbers, its record in managing the crisis has been mixed at best. As Capital & Main has reported, the department presided over a disastrous response to the rapid spread of COVID-19 in nursing homes in the early months of the pandemic. The agency’s rollout of contact tracing and workplace inspections was also slow and ineffective, with communities of color bearing much of the brunt.

Now, with the virus rampaging across the region even as Angelenos, post Christmas, continue to flock to retail outlets, county public health director Barbara Ferrer told the L.A. Times that her agency is “going to take a hard look at the shopping malls.” How much more do Ferrer and her bosses at the Board of Supervisors need to see before they stop looking and shut down obvious vectors of COVID infection, including teeming indoor stores that are blowing off the health department’s 20 percent occupancy limits?

Earlier this month, a coalition of unions called on L.A. County officials to close all non-essential businesses for the entire month of January. The demand for a shutdown, along with financial assistance to affected workers and businesses, has been met with resistance or indifference by the Board of Supervisors, while other political leaders, including L.A. Mayor Eric Garcetti and the L.A City Council, have been silent. At the same time, the county slaps violators of its COVID rules, including large retailers, with a maximum $500 fine – a virtual admission that it is not serious about using its authority to stem the disaster unfolding across the county.

The rationale for allowing so many businesses to operate is economic. But how much long-term economic damage is the refusal to shut down non-essential commerce inflicting on families who are losing breadwinners to COVID, or on kids who are losing a year of schooling to the virus? What will be the medical costs borne by those with lasting health impairment — costs that will be shared by taxpayers?

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Meanwhile, hospitals in Los Angeles and around the state were unprepared for a surge that was widely predicted as early as this spring by health care experts. As my colleague Mark Kreidler reported, “Even as infection rates calmed during the summer, researchers and epidemiologists were warning that late fall weather would drive more people indoors and, along with things like holiday gatherings and the normal cold and flu season, spike infection rates into the stratosphere. How could hospitals still run low on ICU capacity so quickly?”

Here’s how: California ranks 48^th in the country in hospital beds per people, and 39^th in ICU beds. In a county of 10 million people, there are only 2,500 ICU beds. The real issue, of course, is not literally the beds, but staffing, equipment and supplies. The common denominator with all of these is money – and in a profit-driven health care system, increasing costs to prepare for a possible crisis is not rewarded.

The widespread refusal to sacrifice convenience and pleasure for the common good is baffling and dispiriting

Nancy Foster, vice president of the American Hospital Association, admitted as much to The New York Times. “In an era when you’re focused on reducing the cost of health care, having excess capacity…is just antithetical to your efforts to be as lean as possible, to be as cost-efficient as possible,” Foster said.

Foster might have added that, in a pandemic, the lack of excess capacity is also antithetical to the stated purpose of medicine – to save lives and reduce suffering.

Aggravating the failures of our political, public health and corporate leaders is the crippling disregard by so many people for the most basic COVID-era precautions. Yes, the spread of the virus is tied in part to essential workers who, through no fault of their own, contract the disease and transmit it to co-workers and family members. But the reckless participation in everything from indoor socializing to recreational travel to in-person holiday shopping is far too commonplace. Who among us doesn’t have a family member or friend who has skirted the fundamental rules of containing COVID? Who hasn’t witnessed neighbors brazenly throwing parties or winced at strangers, unmasked and unashamed, gathering in close quarters?

The widespread refusal to sacrifice convenience and pleasure for the common good is both baffling and dispiriting. It also underscores why local leaders must set and enforce strict regulations immediately. If this entails political risk, so be it. If it requires deficit spending to keep shuttered businesses and their workers afloat, let’s remember that we have gone into the red for far less noble reasons.

The pleas by beleaguered nurses and doctors speak volumes about what this moment demands from all of us. Los Angeles must embrace its better angels or fully cede control to the angel of death.