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In Los Angeles County, ‘the virus is virtually everywhere’

The United Kingdom is in the midst of a lockdown, as the U.S. faces a surge in hospitalizations from COVID-19. The coronavirus has been particularly bad in Los Angeles County, California, where the daily death toll is nearing 400 and hospitals are running short on supplies. Dr. Christina Ghaly, director of the Los Angeles County Department of Health Services, joins William Brangham to discuss.

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  • Judy Woodruff:

    The United Kingdom is under national lockdown tonight, as a highly contagious mutation of COVID-19 has hospitals buckling there under the strain of new patients.

    Daniel Hewitt of Independent Television News has our report.

  • Dan Hewitt:

    On the first full day of this third lockdown, even some semblance of normality feels right now a distant hope. A few were making the most of what small freedoms remain, as the prime minister revealed a big jump in a number of people with coronavirus.

  • Prime Minister Boris Johnson:

    People understand overwhelmingly that we have no choice. When the Office of National Statistics is telling us that more than 2 percent of the population is now infected, that's over one million people in England.

  • Dan Hewitt:

    A number so alarming, the chief medical officer felt it worth repeating in more stark terms.

  • CHRIS WHITTY, Chief British Medical Officer:

    Across the country as a whole, roughly one in 50 people have got the virus.

  • Dan Hewitt:

    Getting that number down means at least another six weeks in lockdown, as the P.M. repeated that the route out remains with the vaccine.

  • Boris Johnson:

    As of this afternoon, we have now vaccinated over 1.1 million people in England and over 1.3 million across the U.K., and that includes more than 650,000 people over 80.

  • Dan Hewitt:

    But even with all of the most vulnerable vaccinated, there came this warning, that even 2021 may not be the end of restrictions on our lives.

  • Chris Whitty:

    Things will be lifted stage by stage, and we will then get over time to a point where people say, this level of risk is one that society is prepared to tolerate, and lift right down to almost no restrictions at all.

    We might have to bring a few in, in the next winter, for example. That is possible, because winter will benefit the virus.

  • Dan Hewitt:

    Next winter may feel like a lifetime away. The near empty streets of Exeter tonight speak of a city and country trying its best to get through this one.

  • William Brangham:

    Back here in the U.S., the virus' spread is especially bad in Southern California. Nearly one of every five people who is tested in Los Angeles County is positive. A record 74,000-plus new cases were recorded in the state yesterday. And the death toll for just one day is nearing 400.

    Because of this, hospitals are running short of crucial supplies, like oxygen.

    We're joined again by Dr. Christina Ghaly. She's the director of health services for Los Angeles County.

    Dr. Ghaly, very good to have you back on the "NewsHour."

    The last time we spoke to you was Christmas Day. And you said at the time that hospitals were neither capacity back then. It sounds like it's gotten a lot worse even since then. Can you just give us a sense, what's happened in the last 10 days or so?

  • Dr. Christina Ghaly:

    Sure. Thanks for having me.

    The past 10 days, we have consistently seen hospitals add, on average, of about 200 patients a day across the distribution of Los Angeles County. And hospitalizations overall in the county are at 8,000.

    That means that just over half of our hospital beds that are filled with patients are filled with patients with COVID, and three-quarters or more of the intensive care unit, the ICU beds that take care of those who are most critically ill are filled with COVID patients.

    This is stretching staff, stretching the supplies, stretching the emergency medical service system to a point that is causing both a lot of strain and pushing staff to the brink of exhaustion, but also is obviously something that is really not sustainable and doesn't lead to the conditions where we can provide outstanding patient care for each and every person who needs hospital-level care, both those with COVID and those without.

  • William Brangham:

    And I know you have been — there's an effort to discharge as many patients as you can as safely as possible.

    But, given your case numbers, I imagine the minute you empty a bed, that gets filled almost immediately.

  • Christina Ghaly:

    Yes, it does, often several times over.

    Right now, we're admitting more patients with COVID than we're able to discharge. So, about 700 patients a day come in with COVID, but only about 500 patients a day are able to be discharged. We're working to discharge patients just as quickly as hospitals can.

    But the entire health system, not just hospitals, are experiencing strain and stress, and, in particular, staffing shortages. So that affects all of the lower levels of care. It affects long-term acute, subacute facilities, skilled nursing facilities. And it's making it very hard to move patients through the continuum of care.

    What we need to do, though, is move them efficiently. We need to save those very precious acute hospital resources for the patients that need them most.

  • William Brangham:

    We know that the vaccine rollout has been sort of erratic across the country.

    And I know that, in California, I think you vaccinated about 1 percent of the population. We have also been hearing reports about staff at nursing homes and even health care facilities who themselves are reluctant to take the vaccine.

    Have you been hearing that? And, if so, what's your sense of what's driving that reluctance?

  • Christina Ghaly:

    I think there's a number of things.

    I mean, first, I think it's important to remember that this is a provisionally approved vaccine. It has been shown to be safe. It has been shown to be effective. I think there was a rigorous process to demonstrate both its safety and effectiveness, but it's still just a provisional approval.

    And that may make some people nervous. And I hope they look to the data, they look to the safety data and realize that it is safe. But many people, understandably, have some anxiety about that and don't necessarily want to be the first to get the vaccine.

    Within our health system and the four public hospitals and clinics we operate, we have seen good uptake of the vaccine, around the order of 75 percent to 80 percent, which is at the high end of I think what we're experiencing across California. But that still means that 20 percent or 25 percent of health care providers are taking another minute and deciding that, at this point, they don't want to receive it.

    We're still continuing to message with them and encourage them to get the vaccine. And we will keep that effort going. And we hope to improve the uptake rate in the future. But there's, understandably, a lot of anxiety.

  • William Brangham:

    We have also just seen that the U.K. is going under this lockdown because of the incredible surge of cases with this new variant.

    How concerned are you that that is a real driver of all the cases you're seeing in Los Angeles?

  • Christina Ghaly:

    It's certainly possible.

    There's been several cases that have been detected in Southern California. And while the public health officials haven't yet captured or identified that particular variant in the samples they have tested from Los Angeles County, they're testing only a very small fraction of the total positive case counts.

    And I think it would just be really hard to believe that that variant isn't out there. Now, how much that variant vs. the other ones are contributing to the very high case counts, we just don't know at this point. But whichever variant it is, I think the message is still the same, that the virus is virtually everywhere in Los Angeles County right now.

    One percent, if not more, of individuals are infected and infectious and potentially actively infecting others, and everyone needs to do everything they can to protect themselves and to protect others, and should always assume everyone they're interacting with might have COVID.

  • William Brangham:

    All right, Dr. Christina Ghaly, health services director for Los Angeles County, thank you very much.

    And good luck out there.

  • Christina Ghaly:

    Thanks very much.

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