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Brian Lehrer: Brian Lehrer on WNYC. 

Right now, the worst place in the country in the COVID pandemic is Los Angeles as the nation's second largest city, New York, the largest. New York has reason to watch very carefully and learn from what's happening there, which is now so extreme that LA County Supervisor Hilda Solis said yesterday that hospitals are declaring internal disasters and having to open church gyms as hospital units.

It's now so extreme that here are some of the headlines from the LA Times from just the last couple of days. LA County hospitals are losing the battle against COVID-19 surge as problems multiply. Extreme precautions urged for LA County residents because COVID is everywhere. Short on equipment, ambulances, and oxygen, LA County hospitals faced darkest month.

Those headlines from the LA Times and all those articles were written by the reporter who joins us now, Rong-Gong Lin II, who specializes in covering statewide earthquake safety issues and the COVID-19 pandemic. Rong, thanks very much for doing this with us as a service for New York area listeners. I know it's really early out there.

Rong-Gong Lin II: Sure thing.

Brian: Let's just go down some of your headlines first and I'll ask you to give us more detail. Short on equipment, ambulances, and oxygen, LA County hospitals face darkest month. There's a shortage of oxygen?

Rong: Yes, it's a pretty horrific situation here. Compared to New York in the early days where there was an effort to try to get everyone on ventilators, hospitals have figured out, it's really best to try to avoid getting people on ventilators. Instead, they're trying to put tubes into the nose so that you can get this high flow of oxygen.

The problem is that there's so much demand for oxygen that it's like 10 times the amount that you would normally give a patient. The pipes in the hospitals, especially the older ones, are starting to freeze and that's reducing the capacity to give oxygen to people. That's caused situations where the internal distribution systems and a number of hospitals, their pipes are freezing, and so they've had to go on what's called "internal disaster," which means they are no longer accepting any ambulance patients at all.

This is posing quite a bit of a crisis here. They even called the Army Corps of Engineer to survey a number of hospitals that are seeing their oxygen systems become very problematic. Unfortunately, it's going to be a really difficult thing to really resolve because you can't take a blowtorch and heat up the ice that's been forming on a bunch of these oxygen pipes. You don't want to blow up the hospital, right?

It's going to take some time to deal with that. What they really want to do is send people home with oxygen. The problem is that there's a number of canisters-- there are shortages of canisters with which to send people home with. There's even a shortage of drivers to fill up-- to bring these oxygen tanks home.

Brian: Are they literally rationing oxygen and oxygen canisters resulting in decisions over who lives and who dies?

Rong: Well, we're getting to that point. In fact, hospitals have been told to create a contingency plan just for that. It's a thing called when a hospital has to declare they're in crisis standards of care. What this means is there will come a point and we're getting to that point where hospitals need to decide, "Okay, we have a limited number of specialized staff or a limited number of equipment. How do we decide who gets this limited source of treatment?"

It does mean that the mindset has to change to the point where instead of treating every patient individually and thinking, "I'm going to do the best I can for every patient," it's deciding, "Okay, I have a limited number of resources. I'm going to devote my resources to people who have the best chance of survival and for the people who are unlikely to make it through ICU care to just have them ease their pain. We're about to report that at least one hospital is now in this situation where they're having to make these necessary decisions about how to allocate limited resources to critically-ill patients.

Brian: Wow, that is really horrifying and tragic. We never reached that point even in New York when we were the epicenter in the spring. Are there new lockdowns being ordered at a new rate? The original reason for the lockdowns was to stop the spread enough that the hospitals are not overwhelmed.

Rong: Yes. We've had a regional stay-at-home order in place since December 6th for about a month. The thing is, is that the stay-at-home orders only work if people follow it. We've all seen nationally despite the stay-at-home orders and pleas by officials to stay home for the holidays, people really aren't following that.

One of the things that the state just did just last night was order that all but the most essential surgeries be canceled across wide swaths of Southern California. What it attempts to do is try to free up as much surgery space and ICU space available for this tsunami of patients coming in. The problem though is that the people who were on tap to get these essential surgeries are going to suffer.

For example, one of my colleagues spoke with someone whose kidneys are at 3% function. He undergoes dialysis at home every night for nine hours at a time. He had his transplant surgery that was scheduled for mid-January cancelled because the hospital called him up and said, "You know what? There's no more ICU space. We have to put off your transplant surgery." It's a pretty dire situation-

Brian: - to reach that point. We have two minutes left in the show. The governor of Florida, the anti-lockdown and anti-mask mandate, Republican Ron DeSantis has pointed to California to say, "Look, they have locked down much harder than Florida has, but COVID in California is worse than here," in the ways that you've been describing in the most extreme cases. Therefore, lockdowns are not the key to COVID spread prevention. Have California officials responded to that?

Rong: Yes, it's a little bit of an odd argument to make considering that Florida has had a higher cumulative death rate than California. The last time I looked at the numbers, if California had the same death rate as Florida, you'd have 15,000 more deaths. It doesn't make sense to say Florida has a better situation when Florida has had a worse summer peak in terms of deaths than California did. We're just in that terrible phase right now.

In fact, California has probably saved a lot of lives because of earlier action in implementing a stay-at-home order. The problem is in part of the success because a lot of people until the late fall didn't have that experience of knowing people who had died from COVID. There was a sense of confidence that we had really gone through this. That led to a sense of overoptimism that led a lot of people to basically ignore pleas for people to stay home as the fall got underway.

Brian: In just a few seconds, is there anything that our listeners hearing this and horrified by this and sympathetic to people in LA can do? I know healthcare workers came from all over the country when New York was the epicenter in the spring. What can listeners do if anything?

Rong Officials are pleading for help from around the country. Even the Bay Area is sending medical professionals to Southern California for help. The problem is that everyone in the country is getting hit hard right now. Some of the things that officials say is, "Please stay home as much as possible." If New York is better off, California will be better off if we can keep the disease as much under control until everyone can get vaccinated.

Brian: Rong-Gong Lin II covering the COVID-19 pandemic for the LA Times. I hope you and everybody there is okay. Thank you for joining us.

Rong: Thanks.

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