The Los Angeles Times reports:

Los Angeles is careening toward catastrophe.

An explosion of COVID-19 patients has begun to flood hospitals and may soon force doctors to ration care. The number of available beds in intensive care units is rapidly dropping to zero, as healthcare providers plead with people not to come to emergency rooms unless it’s a matter of life or death.

“Ambulances are circling hospitals for hours trying to find one that has a bed open so they can bring in their critically ill COVID patient gasping for air,” a doctor at an L.A. County public hospital said last week, describing the “apocalyptic” scene. “We’re literally hanging on by a thread.”

And there are no signs of reprieve. The number of COVID-19 patients in hospitals is expected to grow through January — or beyond, if Christmas traveling and social gatherings fuel further spread of the virus.

If there is yet another wave in a few weeks, it “will result in Northern Italy-slash-New York visions of people in hallways,” L.A. Mayor Eric Garcetti said in an interview. “We’re on the verge of that.”

The dire situation has prompted confusion and dismay among Angelenos, many of whom are wondering whether their sacrifices over the past nine months have been for naught. L.A. County was an early adopter of masks, quickly instituted stay-at-home orders in March and November and, until this point, has kept its rate of coronavirus cases and COVID-19 deaths relatively low.

So what went wrong?

Interviews with 31 epidemiologists, health experts and public officials offer clues: L.A. was far more vulnerable to an extreme crisis than nearly anywhere else in the nation.

The trifecta of fatigue, winter weather and holiday travel that has led to more coronavirus transmission across the country hit here, too — and became the match that lit the tinderbox.

The popular image of L.A. — hillside mansions, urban sprawl and drivers cocooned in their cars — belies the gritty reality. L.A. County, home to more than 10 million people, suffers from high rates of poverty and homelessness, huge numbers of essential workers and some of the densest neighborhoods in the nation.

“There is no city as large and complex as L.A. The closest might be New York. And we saw what happened in New York,” said Dr. Kirsten Bibbins-Domingo, an epidemiologist at UC San Francisco.

Experts also pin L.A.’s problems on rules that can appear inconsistent or arbitrary, as well as a confusing patchwork of policies across Southern California. Additionally, the county is investigating whether a more contagious strain of the virus, circulating in the United Kingdom, could be partly to blame. [Continue reading…]