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What’s driving a COVID-19 surge in California

California has become an epicenter for COVID infections. The state has been averaging about 40,000 new cases a day over the last week and recently passed its 2 millionth case. Amna Nawaz speaks with Dr. Christina Ghaly, director of the Los Angeles County Department of Health Services, talks about the strain on city hospitals and how officials are trying to curb the virus’ spread.

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  • Amna Nawaz:

    As we have been reporting this week, California is an epicenter of COVID infections in the U.S. right now.

    The state has been averaging about 40,000 new cases a day over the last week and passed its two millionth case since the pandemic began. About 20,000 people are hospitalized with COVID, and ICUs are near capacity in some areas, with roughly 4,000 patients around the state.

    Los Angeles County, which includes not just Los Angeles, but many other cities, like Pasadena, Inglewood and Santa Clarita, is struggling mightily. Hospitals have had to divert ambulances in some cases and redirect them to other facilities.

    Dr. Christina Ghaly is the county's health services director. And she joins me now.

    Dr. Ghaly, welcome to the "NewsHour" and thanks for making the time.

    Your hospitals are clearly strained. You have used the word overwhelmed. What does that look like inside? What kind of steps and decisions are hospitals having to make now that they weren't making before?

  • Christina Ghaly:


    Hospitals are under so much pressure right now, and it's the staff within them who have been working hard over the past nine months that are feeling all of that stress at this time.

    The ICUs and medical surgical units and emergency departments are full. As you mentioned, ambulances are often being diverted, a large number of cases to other hospitals that are close by. But that's longer drive times.

    And even when they get to a hospital, they're often having to wait several hours to off-load patients because the emergency departments can't take them. And this affects patients with COVID and non-COVID alike because of how many COVID patients are in the hospitals. A third of all patients in the hospitals right now in Los Angeles County have COVID.

    It really doesn't leave that much room for patients with other conditions or injuries.

  • Amna Nawaz:

    Dr. Ghaly,do you know what's behind these numbers? What is driving the surge you're seeing right now?

  • Christina Ghaly:

    There are so many factors behind this.

    Certainly, I think some people have called out the weather. And I think that's a part of it, both just the type of air and having it — the virus transmitted a little bit more easily, people being pushed inside with the slightly colder weather. Even though it's still California, people are still moving inside a little bit more.

    But more than anything, I just think it's the amount of intermingling that is happening within our communities. And we see images of this every day on the news. Los Angeles International Airport is crowded with large numbers of people traveling. You see images of crowded shopping mall parking lots, a number of people out holiday shopping.

    You hear about holiday parties and get-togethers. And all of this is what is raising concern for the weeks ahead. And, certainly, similar — similar things to this is what happened over Thanksgiving is what caused us to be in the situation that we're in today.

  • Amna Nawaz:

    Dr. Ghaly, can you tell us a little bit about the patients that you're seeing? Obviously, when they come to the hospital, they need that critical care.

    But is there a patient profile? Are they usually a certain age, from certain communities? What are you seeing?

  • Christina Ghaly:

    Well, one of the underlying stories of this pandemic is how much it's hurt vulnerable populations, low-income populations and communities of color.

    They have been the hardest hit throughout this entire pandemic. Latinx communities are getting infected and dying at rates that are three times that of white communities and Asian communities. And Black, African American individuals are dying at twice the rate as their white counterparts.

    There are so many reasons behind this, a lot of the structural and institutional racism and reasons behind these higher exposure rates and higher death rates. But we, as a society and a community, really need to come together to help all of the people out there in the community.

    I will say, though, as much as it affects vulnerable populations, it is affecting everybody. And we see people of all ages within the hospitals. Certainly, many more of them are a little bit on the older side. But there's countless stories of people who are 30 years old, 35, 40 years old, with no underlying medical conditions, no reason to believe that they might have a serious course with COVID, and they're coming into the hospital.

    They can't breathe. They're not doing well on any of the interventions that can be done to try to keep people breathing without mechanical ventilation. And then we get to the point where they have to be ventilated in the hospital.

    And these are scary situations. To be in the intensive care unit with a tube down your throat breathing for you with six or seven or eight lines coming out of your body, these are scary, scary situations for the individuals and their families, and it can affect anybody.

  • Amna Nawaz:

    We have heard from communities experiencing surges throughout the pandemic that it's not necessarily bed capacity that worries them.

    It's staffing, that you can have overflow rooms and turn beds as needed, but, as staff gets sick and a staff get overwhelmed, you start to run short. Are you worried about having the staffing that you need to meet this surge?

  • Christina Ghaly:

    Yes, this is a big worry.

    And it's two things. It's what you mentioned, the fact that healthcare workers are people, just like anyone else. And they get infected with COVID in their communities, just like anybody else. And when we have our highly trained health care workers that are out with COVID or out on quarantine orders, that leaves less staff to care for the patients within the hospitals.

    And then, also, that's combined with just the fact that there's a large number of patients coming in. And there's only so many of those highly trained staff to be able to care for patients, particularly the patients that need that ICU level of care.

    It's still about a quarter of the patients, plus or minus, that get admitted to the hospital need that critical level of care.

    And one thing I want to say is just, you know, I have heard stories over and over again about how health care workers are our heroes. And I know a lot of people believe that.

    But, at the same time, it does feel a little bit over the past month or so that those words ring a little bit hollow, that, when we see those images of people intermingling, we see people not following the public health interventions, that it starts to feel discouraging for the health care workers, when they're putting their lives on the line out there working in so many ways within our hospitals to care for people in the midst of their pain and suffering.

    I would just ask that everyone come together and really show that healthcare workers are heroes by following the public health interventions that can keep people safe.

  • Amna Nawaz:

    Dr. Christina Ghaly, health services director from Los Angeles County, thank you so much for being with us.

    And we wish you good luck and safety in the weeks ahead.

  • Christina Ghaly:

    Thank you very much. Happy holidays.

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