The struggle against COVID-19 turned into a grim battle against exhaustion in the health care industry, as exemplified by Pacifica Hospital of the Valley.At one point, 87 percent of the staff at the Sun Valley hospital was on sick leave, said Chief Executive Precious Mayes.During the last weeks of December, the hospital received aid from the National Guard. It has medical teams that can help out in a pinch.The overwhelmed hospital had to close its emergency room to new patients several times because it had no place to put them. But now, it has recovered enough to take patients from other overburdened hospitals.“That’s where we’re currently at right now,” Mayes told the Business Journal.Even though the pace has slowed in recent weeks, there’s still a great deal of work.“You’re tired, but you don’t stop … too many patients depend on you, and my staff depends on us, and the city of L.A. and the state depends on us.”Her story, of course, is similar to others as COVID patients overwhelmed hospitals throughout the Los Angeles area, particularly in late December.“There’s no rule book as a leader and a CEO in COVID, so we’ve had to rely on each other,” she said, “our peers, resources and anything and everything to make the best decision we could possibly make through this harrowing experience.”Worst stretchMayes says that December was “by far” the worst month for her hospital. Due to privacy regulations, she couldn’t disclose if the 87 percent of regular staff on sick leave was because of COVID.From mid-December to mid-January, Mayes recalled standing on the ICU floor and hearing “Code Blue” every 15 to 20 minutes – far more than usual. In a hospital setting, Code Blue is an urgent life-threatening medical emergency.“To have to go through that multiple times each hour, it just didn’t seem to stop,” Mayes said. “That is emotionally impacting, psychologically impacting to all staff and to anybody.”From Halloween through November, COVID patient admission went from 120 patients to 282, Mayes said, with a total of 718 cases through the facility during the holiday months.
Mission Community Hospital, another standalone campus in Panorama City, experienced what would normally be a year’s worth of hospital deaths in January alone. The holiday surge was three times as high as what the small hospital experienced in June, said Chief Executive James Theiring.“We had patients at one point in tents, in the parking lot, overnight, cold,” Theiring recalled. “The heaters, they’re doing the best they can, but it was like something out of a ‘M.A.S.H.’ episode. It’s something you’d never imagine you’d see in the San Fernando Valley.”Desperate for patient rooms, he reopened a nearby tower that had gone unused for patient care since the 1994 Northridge Earthquake. It houses 50 patients, but he said keeping them there is not a sustainable option. So, Mission Community is looking to replace its outdoor emergency room tent with a sturdier modular field hospital, with the help of FEMA and the Army Corps of Engineers.
Space was at a premium in Pacifica of the Valley, too.“We had to close (the emergency room) pretty much every day … due to the surge of COVID patients coming in, ambulances coming in, and not having the ability to put them anywhere,” Mayes said. “They were in the halls, they were everywhere.” Three National Guard strike teams were brought in at the end of December to give the Pacifica crew some reprieve.“Staffing in L.A. was at a crisis level. Every hospital was having the same sort of situation,” added Mayes.Morale issuesPacifica allowed patient visits when possible, but only one family member was allowed to be at the bedside during a patient’s final hours. At other times, when such a visit was not possible, that role often fell to nurses and doctors, taking a further emotional toll.As an added burden on staff morale, there’s a certain loneliness in the COVID ward, Theiring said. “You may have someone next to you, but the mask is on, the face shield and the gown, the gloves. If you’re wearing a (powered air purifying respirator), it’s almost like wearing a space helmet. It’s grueling from a day-to-day basis.”Camaraderie is lost when staff can’t do something that seemed so simple before — sit down and have lunch with friends while on a break, the Mission Community chief executive said.“It becomes very numbing,” added Mayes. “There were those moments, and I don’t mind saying it, where I had to sit and have tears. You go through so much, and you see your staff go through so much. … You cannot help but be human.”Lately, vaccines have provided hope to hospital staff, Mayes said. She sees the next six to nine months bringing improvement at Pacifica, with more than 425 staff and residents vaccinated and now family members of staff eligible to receive the vaccine at the hospital.Lessons learnedA year ago, Mayes recalled being very sick, the sickest she’s ever been, with the “classic symptoms of COVID.” While she was out, the pandemic was starting to unfold in China.“I was watching this all unveil on TV and there was something that hit — oh my goodness, this is going to hit us in the U.S. I was talking with my executive team members, because I had been so sick for a couple weeks that we really needed to make sure we had our plans in place,” explained Mayes.Pacifica secured extra personal protective equipment at the end of February and was one of the first hospitals in the Valley to turn away visitors and temperature check employees.Expecting a surge in April or March, Pacifica answered Gov. Gavin Newsom’s call to action. Its delivery and pediatric units were chosen as surge wards for ICU beds.“We also went through spending a tremendous amount of dollars, and not being able to receive a large stimulus. We received our first stimulus back in April of 2020, and then we didn’t receive any stimulus funding until right around September, October,” Mayes explained.“By that time, we had already spent $7 million.”Pacifica has lost $6 to $8 million in revenue during the pandemic because of canceled elective surgeries. By summer, visits were down 80 percent compared to the previous summer. An emergency room tent was erected outside, although at that point, people were avoiding hospital visits for fear of contracting COVID.
Nurses were hired at three times the regular cost in summer becuase of staffing shortages.“That was a very devastating impact for us financially,” said Mayes.“Lost business is very, very hard to calculate,” said Theiring, who suspects COVID cost his hospital $25 to 40 million. Bottom line, he said, “we have about a $12 million difference year over year, to the negative.”Looking ahead, Mayes said, “I will never say the worst is over until we are able to get everybody vaccinated and until we can get through the challenges of these strains which are changing.
“We will continue to prepare for whatever may happen. I feel like we were at our low, and I don’t know how much lower we could have gotten, with that much of our workforce out.”The pandemic has exposed the “cracks” in our health care system, across every facet of the industry, according to Mayes.“Our health care structure is like the earthquake fault line,” she said. “We have to do a much better job and we need to make sure we’re stabilizing this, because this won’t be the last pandemic.”
Hospitals in Distress
