Surge upon surge they come.
People with COVID-19 in desperate need of care.
Doctors, nurses, and other Los Angeles County healthcare providers struggle to provide it.
A day off or a decent night’s sleep are hard to come by.
Since before Thanksgiving, Dr. Mauricio Heilbron has had precious few days off. He says that’s not all that unusual for hospital staff these days.
Heilbron is a board-certified surgeon who specializes in general, trauma, and vascular surgery. He’s currently vice chief of staff at St. Mary Medical Center in Long Beach, California.
We spoke with Heilbron about what’s happening in Los Angeles County hospitals and his thoughts on the pandemic in general.
This interview has been condensed and edited for clarity.
Healthline: What’s happening in L.A. County hospitals right now?
Heilbron: What’s happening here is what happened on the East Coast in the spring.
L.A. County hospitals are filled to capacity. Hospitals are using every single nook and cranny for patients. Recovery rooms have been converted into intensive care units and GI labs into regular patient care units. ER nurses help with cleaning, and technicians help move patients.
Everybody’s seen that episode of “ER” or “Grey’s Anatomy” that shows, for that one episode, how out of control it can be in a hospital. It’s like that. On every floor, every place you look in the hospital, 24 hours a day. It’s not fun.
I imagine what it felt like being in the trenches of World War One or the jungles of Vietnam. At some point, you get through just being scared and move into a dogged, weary determination to just get through the day.
That’s where we are now. Just get through the day.
I’m seeing people die every day. It’s part of the horrific nature of COVID that it just decimates everything in some people. Some get so septic that all their organs fail. There are people who need their legs cut off because of gangrene.
Nobody sees that.
What they see is the person who gets the sniffles, recovers, and shows up at gyms and restaurants saying, “See, you’ll be fine.”
Healthline: What advice do you have for L.A. County residents who are sick with COVID and think they need hospital care?
Heilbron: First, just because you’re sick, it doesn’t mean you have COVID-19. But symptoms are all over the map, so you could have it. The important thing is to get a diagnosis, so you must get tested.
If you test positive, the advice I give is to call your regular primary care doctor, clinic, or other healthcare organization first. They may be able to guide you through whether additional medical help is needed, which will help conserve resources.
If you know you have COVID-19, and you’re very sick and afraid and don’t have anyone to call, call 911 as you would have in the pre-COVID era. If you’re sick enough to go to the ER, then go to the ER.
If you don’t have a primary care doctor, there are places to get help. Figure that out ahead of time — do the homework before you’re sick.
And don’t just keep important medical information on your phone. In a worst-case scenario, if you’re unconscious or so sick you can’t give information, many times nobody can unlock your phone. Get it on paper or on a business card that you can slide into your phone case.
Healthline: What about people who need other types of emergency care?
Heilbron: Many people are ignoring things like abdominal pain over COVID fears. They blow it off or decide to wait it out. Don’t. Contact your primary care physician. They can ask certain questions and safely say whether it’s something to watch or that you should head to the ER. That’s super important.
Let’s say you’re in a car accident and end up at our hospital. We test everyone once they get here. We have a large number of patients who are here for something else and end up testing positive for COVID-19.
We have separate areas for non-COVID patients, patients who are sick from COVID, and patients who test positive but are here for other things.
It’s all about allocating resources to protect patients from the spread of COVID and give everyone appropriate care. The logistics are complicated, but it’s totally doable.
Healthline: What can the rest of the country learn from what’s going on in L.A. County?
Heilbron: The problem is that L.A. County didn’t listen to the rest of the country. This happened in New York, and we ignored that.
So many people have been angry with the governor of California for “draconian” measures set up in the spring. Then those restrictions were lifted, and look what happened. It’ll take a couple of years to accurately analyze the data, but history might show that those measures controlled the problem here.
We in the medical community were really afraid of a Thanksgiving bump. It was infinitely worse because there was no lull before Thanksgiving, actually ramping up in September, October, and November.
Thanksgiving came, and people got together with no masks. The effects of this behavior take 14 to 21 days to become really obvious. When it did, hospitals were overwhelmed.
The Christmas wave came on top of a wave, so we had a bad first week of the year. Now, we’re in the New Year’s bump.
There are no big holidays coming up now, so numbers will start to go down. What we’re afraid of is a false sense of security that makes people relax again. That’s been the pattern.
If we had a giant earthquake or hurricane that caused this kind of death and destruction, people would work together to get over it. People don’t understand that infectious disease has no political or economic agenda. It’s just nature.
Anybody who knows anything about science and public health knows what kills most people around the world tends to start with infection. We are victims of an infectious disease. We can fight it but are choosing not to.
It’s been politicized. A year ago, people looked to doctors for advice. Now, in the COVID era, they look at us as part of the problem. “It’s a hoax. Doctors are just saying it’s COVID to make more money.”
It’s demoralizing. Soul-crushing. It’s not right.
But there are people who thank me and mean it. That puts an extra kick in my step for a few hours.
Healthline: With infection rates so high, what are the most important things people need to know to avoid getting infected and keep their loved ones safe?
Heilbron: It’s a broken record, but wear a mask in public. Social distance in public. Avoid crowds.
We’re getting more information that this is truly a respiratory virus. So, the most important thing is: Quit breathing on people and quit letting people breathe on you.
A “bubble” can work with a group of people that you can confirm have limited contact with others. That could help keep the numbers down.
Healthline: For those who are eager to get the vaccine, how can they keep tabs on when and where to get one?
Heilbron: It’s a huge problem. There’s a lack of consistent messaging or organizing on the federal or state level. What’s hindering getting vaccines into arms is the lack of a cohesive plan.
The early days of vaccine availability worked well. Why? Because the people allowed to get the vaccine were healthcare workers and nursing home residents. The vaccines were given almost exclusively at hospitals and healthcare organizations equipped to store, administer, and keep records for the vaccine.
It’s different in every state, every city. Where can it be stored? Will you have a second dose available in 2 to 3 weeks? How will you track it? Hospitals can do that, but how will it happen everywhere else?
Every person everywhere has to do their own homework. Primary care physicians might know. Places like CVS and other pharmacy chains could handle it like they do flu shots. That may be where we end up eventually.
Healthline: What advice do you have for people who are hesitant about getting vaccinated?
Heilbron: The vaccine, without question, prevents people from getting really sick. There are two takeaways:
- The vaccine is exceedingly safe.
- When we look at people who got the vaccine versus those who got the placebo, far fewer got sick. Those who did had minimal symptoms while the placebo group had more severe illness.
That’s what the numbers are telling us. It’s not arguable. Applying common sense, vaccination can keep people out of the hospital. It doesn’t obviate the need to change behavior, but we can start figuring out how to get back to normal. We can’t do it without the vaccine.
Vaccines aren’t all the same. They serve different purposes. The mRNA vaccines help your body get prepared for COVID so that when it sees the virus, it’s not new. It’s just a way of kick-starting your own immune system.
The vaccine will get us closer to any hope of herd immunity. I would urge anybody who is against the vaccine to just try to look at it through different eyes. It’s that important.