On a recent Friday afternoon, the critical care charge nurse at a South Los Angeles hospital tries to send another nurse off to grab lunch. Maria Arechiga is interrupted by the beeping of an alarm, the vitals of a patient declining, organs failing.
She dons a surgical gown and unzips a plastic tarp that hangs from the doorway of a hospital room — a makeshift isolation room on this floor temporarily transformed into a larger intensive care unit to make space for the patients that just keep coming. She slips inside.
Dr. Stefan Richter follows her in, both telling the other nurse to get lunch now, because later may never come.
There are two patients in the room. Within an hour, both patients’ organs are failing. Arechiga yells for someone to call a Code Blue, a medical emergency.
“May I have your attention please. Code Blue, Code Blue,” booms from the PA system.
Reinforcements arrive. In the urgency, there is practiced calm. A team helps each nurse, doctor and respiratory therapist put on protective gear before they go in to try to resuscitate the patients.
They lose one patient, get the pulse back on another. And then another Code Blue is called. They begin again. Every single person in the critical care unit on this floor is COVID-19 positive.
A deadly, predictable disaster
The intensive care unit at Martin Luther King Jr. Community Hospital is at the epicenter of the coronavirus surge that is ripping through Los Angeles County, the country’s most populous.
One in three people in the county have been infected with COVID-19.
But at this hospital in Willowbrook, an unincorporated part of South L.A. neighboring Compton and Watts, the pandemic is preying on the inequities that disproportionately hurt Latino and Black communities. The neighborhoods are densely populated and multiple generations of families live together, making it hard to isolate.
It’s a place where most people are on public health insurance and where chronic illnesses are much more prevalent because there is a systemic lack of access to quality health care. Add COVID-19 to that mix and it’s a deadly but predictable disaster.
“This is a community that is largely low-income, people of color,” says Dr. Elaine Batchlor, the CEO of MLK hospital. “This is where the essential workers live. These are the people that are stocking the grocery stores, driving our buses, cleaning up after the rest of us. And they are continuing to be exposed to COVID on the job.”
She speaks in her office where she has been managing the crisis.
“Our small hospital now has more COVID patients than hospitals that are three to four times larger in L.A. County,” Batchlor says. “We have added beds to the hospital. We’ve doubled up single rooms. We’ve added five tents outside of the emergency department. The staff converted an entire medical floor into a critical care unit. So we’ve been doing everything we can to create enough capacity to care for all of the patients that have been coming in to see us.”
“We are in a crisis situation”
On Christmas Eve, Elaine Batchlor sent an urgent letter to California Gov. Gavin Newsom.
“I’m writing with a critical update on how the COVID-19 coronavirus is impacting our black and brown community in South Los Angeles,” Batchlor wrote.
The data she cites in her letter is sobering. Sixty-six percent of patients in the hospital are COVID-19 patients, triple if not quadruple what other hospitals in the county are seeing. She describes a recent day when 70 patients were in the emergency department with just 29 beds. She writes about the meditation room below her office now filled with gurneys, a gift shop turned hospital room.
“We are in a crisis situation, with devastation wrought on caregivers and community alike,” she wrote.
She pleaded not just for short-term solutions but also for fundamental change to the health care system that brought the community to this point.
She ends the letter: “It is time to address the separate and unequal health system that has been heartbreakingly exposed by COVID-19.”
The state sent temporary help. Three National Guard Medical Strike Teams, some 90 nurses and respiratory therapists. This week, COVID-19 hospitalizations are finally going down — but the number remains high.
