In Los Angeles, a severely ill patient has to wait for a new lung after his transplant, scheduled for last Friday, was canceled.
In San Diego, brain surgery to ease the chronic pain of a 7-year-old girl was called off last week.
In Arcadia, as many as 60 patients will likely have their surgeries canceled this week. In Folsom, at least 11 operations already were scrapped last week. And at one hospital in Anaheim, a patient waited on a gurney for back surgery for three hours before he was sent home because of lack of staff.
Throughout California, as COVID-19 infections deplete their staff of nurses, anesthesiologists and other essential workers, hospitals are canceling or postponing so-called 鈥渆lective鈥� surgeries to repair injured knees and aching back, remove kidney or bladder stones, and repair cataracts or hernias, among other procedures.
Alarmed by a growing shortage of specialized health care workers, the California Department of Public Health is evaluating whether to issue an order to hospitals statewide to suspend elective surgeries in cases in which patients wouldn鈥檛 be immediately harmed.
For now, the decision is voluntary for hospitals. But the state health department鈥檚 chief deputy director, Susan Fanelli, on Thursday told a meeting of county health officers, 鈥淲e know (a directive on elective surgeries) has to be on the table.鈥� Officials with the public
health department did not respond to CalMatters鈥� requests for more information.
鈥淓lective鈥� means a surgery is not an emergency and can be scheduled in advance; it does not mean it鈥檚 optional. Waiting in some cases can be life-threatening.
Hospitals are carefully weighing which surgeries can be delayed, executives say. A cataract surgery or knee replacement might be canceled, for example, but not heart surgery or a breast cancer biopsy.
In response to the shortages, the state health department on Saturday to hospitals and skilled nursing facilities. Workers who are infected with COVID-19 but have no symptoms may immediately return to work without isolation or additional testing. Exposed health care workers may also work. The new guidelines remain in effect until Feb. 1.
Health workers immediately attacked the new policy.
SEIU-United Healthcare Workers member Gabe Montoya, an emergency room technician in Downey, called the policy dangerous and disappointing.鈥�
鈥淣o patient wants to be cared for by someone who has COVID-19 or was just exposed to it,鈥� he said.
Many surgeries already scrapped
On Friday, a scheduled lung transplant at a University of Southern California hospital had to be delayed for lack of specialized staff, according to Michael Simonton, a USC intensive care unit nurse. Further details were unavailable.
Also on Friday, at a Kaiser Permanente hospital in Anaheim, Joe Sanders, a 74-year-old retiree from La Habra, waited on a gurney for three hours after being prepped for surgery to treat serious lower back pain. He dozed until his surgeon appeared at his bedside.
鈥淚 have some bad news for you,鈥� the surgeon told Sanders. There wasn鈥檛 enough staff for the operating room so the long-awaited procedure, scheduled two months earlier, would have to be postponed several days, Sanders told CalMatters.
鈥淚 was disappointed, my wife and I were looking forward to this. I鈥檓 in pain all the time,鈥� Sanders said. 鈥淏ut I knew the pandemic was raging and we hadn鈥檛 reached the zenith of this thing. I knew it was going to be touch and go.鈥�
At Methodist Hospital in Arcadia, east of Los Angeles, nearly a tenth of nurses were out sick or isolating last week. Only 17 of its 40 licensed intensive care beds could be staffed 鈥� and all of them were full, Clifford Daniels, senior vice president and chief strategy officer, told CalMatters on Friday.
Starting this week, the 348-bed hospital will cancel elective procedures such as gallbladder surgeries, joint replacements and colonoscopies, but not cancer treatments, Daniels said.
鈥淲e鈥檙e using every resource we can possibly find, including traveler and registry nurses at extraordinary costs,鈥� he said.
In the Sacramento region, at least 11 elective procedures at Mercy Hospital of Folsom had to be postponed last week because of staffing shortages, said Dr. Brian Evans, CEO of the Folsom facility and Mercy General Hospital in Sacramento. Evans could not provide details about the types of procedures that will be canceled.
The two hospitals, both owned by Dignity Health, had about 54 patients admitted specifically for COVID-19 on Friday, but 鈥渨e鈥檙e seeing many of our workers and health providers getting sick as well. We expect next week to be worse,鈥� Evans said.
More than twice as many California hospitals reported critical staffing shortages last week than last summer 鈥� although not as many as a year ago.
Stanford Medical Center in Palo Alto has about 5% of its total workforce out sick, spokeswoman Julie Greicius said Saturday. 鈥淲e have seen a doubling of nurses calling off per shift, reporting that they are ill,鈥� Greicius said.
California ranks fifth in the nation in the percentage of hospitals reporting severe labor shortages.
Hospitals in , and i have canceled surgeries, and Massachusetts state health officials last month directed hospitals to if they have less than 15% capacity.
A year ago, during the last surge, the hospitals for about one month to cancel certain procedures if their intensive care capacity was less than 10%.
Since then, the highly contagious omicron variant has transformed California鈥檚 COVID-19 landscape and hospitals鈥� decision-making. Omicron appears to ,
but it鈥檚 more likely to infect vaccinated people than the original novel coronavirus and the delta variant. As a result, even though about 71% of eligible Californians are vaccinated and , more people 鈥� including health care workers 鈥� are becoming infected, many with mild or no symptoms.
鈥淭his is not about beds, this is about the staff to care for the patients in those beds,鈥� said Kiyomi Burchill, group vice president of policy for the California Hospital Association.
Exacerbating the problem and other hospital staffers who have quit or retired, citing burnout and lack of protections on the job.
Fanelli told county health officers last week that the state is working on other measures to support hospitals as they cope with yet another surge. The state health department predicts as many as 53,000 hospitalizations a day in the coming weeks.
A $614 million funding proposal
In response, the state plans to send up to 1,500 health care workers to hospitals with staffing shortages and has stockpiled oxygen, saline and other supplies ahead of the surge. Officials also are working with hospitals to help them adapt spaces to triage patients and more quickly find placements for patients ready to be discharged, she said.
Gov. Gavin Newsom鈥檚 new proposed , revealed Saturday, includes $614 million to help hospitals and other health facilities augment their staff.
鈥淭he bottom line is that we are worried about the鈥evel of staff infections and the need for isolation and quarantine among the staff,鈥� California Health and Human Services Secretary Dr. Mark Ghaly told reporters last week.
Many hospital emergency rooms also are packed with patients, some of whom arrived for other reasons than COVID-19 but happened to test positive upon arrival. Those patients then have to be isolated to protect other patients and hospital staff.
And intensive care beds already are in short supply around the state.
In 27 counties, remained available as of Jan. 5, according to state data. Statewide the number of available intensive care beds since Jan. 1.
A dearth of COVID tests also means only patients who come to Methodist鈥檚 emergency room with COVID-19 symptoms will be tested, Daniels said.
Those who aren鈥檛 symptomatic who come in for other reasons won鈥檛 get a test, and people coming to the ER just for tests will be sent to Los Angeles County testing sites.
Michael Simonton, an intensive care unit nurse at the 60-bed USC Norris Comprehensive Cancer Center in Los Angeles, said he鈥檚 been working without breaks and lunches; some of his colleagues are working 18-hour shifts to care for a flood of patients.
鈥淧eople are having to stay over(time) because there鈥檚 no one else to relieve them,鈥� Simonton said.
A member of the California Nurses Association, a union that represents some 1,400 USC nurses, Simonton places some blame on hospital administrators for the staffing shortage.
鈥淭his is a crisis that鈥檚 basically been manufactured by the hospital,鈥� Simonton said. 鈥淭hey were choosing temp workers rather than investing in (permanent employees) who are committed to their workplace, and now patients are paying the price.鈥�
Reporter Kristen Hwang contributed to this story
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