Running low on oxygen, emergency workers in Los Angeles County are told to administer the minimum necessary.


California’s daily coronavirus case tallies remain around four times what they were during the state’s summer surge, and officials predict that the aftereffects of a December surge linked to holiday gatherings will worsen as the winter drags on.

After new infections — driven by Thanksgiving travel and gatherings, then Christmas festivities — resulted in a surge unlike any the state had yet seen, the trajectory of its new cases has leveled off somewhat in the early days of 2021.

But there are more than twice as many Covid-19 patients in California hospitals now as there were a month ago, and many intensive care units in the state have been overflowing. At least six people in the state have also been found to be infected with the new, more transmissible variant of the virus first identified in Britain.

The state is also facing an oxygen shortage for patients, and it has deployed the U.S. Army Corps of Engineers and the California Emergency Medical Services Authority to help deliver and refill oxygen tanks.

In a sign of how dire that shortage is, Marianne Gausche-Hill, the medical director for Los Angeles County’s E.M.S. agency, issued guidelines to emergency workers on Sunday for administering the “minimum amount of oxygen necessary” to keep patients’ oxygen saturation level at or just above 90 percent. (A level in the low 90s or below is a concern for people with Covid-19.)

In the pandemic’s brutal logic, more cases inevitably translates to more suffering and deaths. As of Monday night, 4,258 people with Covid-19 had died in the preceding two weeks, compared with 3,043 in the two weeks before that.

“This is a deadly disease, this is a deadly pandemic,” Gov. Gavin Newsom told reporters on Monday. “It remains more deadly today than at any point in the history of the pandemic.”

There has been some progress. California’s daily average of 38,086 cases per day over the past week represents a decrease of 11 percent from the average two weeks earlier, for example. And although Covid-19 hospitalizations have increased by 18 percent over the past two weeks, to 20,618, Governor Newsom said that represents a slight flattening of the curve.

But the state’s last major Covid-19 surge, over the summer, only produced around 10,000 infections on its worst days. And in Los Angeles County, the latest crisis has stretched the health care system so thin that incoming patients at one hospital were recently being instructed to wait in an outdoor tent.



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