COVID-19: Group greenlights Moderna vaccine for use in California as hospitals struggle

Los Angeles: A working group of scientists and experts Sunday endorsed the COVID-19 vaccine developed by Moderna and the National Institutes of Health, clearing the way for it to be distributed throughout California and much of the West.

The group, initially formed by California and later joined by Nevada, Oregon and Washington, reviewed the vaccine separately from the U.S. Food and Drug Administration, which on Friday issued emergency use authorization. The group made its recommendation to the governors of the four states Sunday morning, officials said in a news release.

Shipments of the vaccine are expected to arrive in California early this week, officials said.

“While California is in some of the darkest days of our COVID-19 surge, with too many families grieving lost loved ones, there is light as more vaccines are approved for distribution,” Gov. Gavin Newsom said in a statement.

California has already received shipments of the vaccine developed by Pfizer and BioNTech, which were earmarked for workers at acute-care hospitals and residents of long-term care facilities.

The vaccine isn’t expected to be available to members of the general public until spring or summer.

Experts say that’s not soon enough to avert catastrophe at the region’s hospitals, which have been struggling as they fill up with COVID-19 patients. There were 16,843 COVID-19 patients in California hospitals Saturday, with 3,614 of them in intensive care, according to data released by the state Sunday. That was a huge increase from two months before, when there were 2,291 such patients, 657 of them in intensive care.

The availability of intensive care unit beds in Southern California and the San Joaquin Valley remained at zero Sunday, according to the state.

Largest share

Los Angeles County hospitals were treating the largest share of patients: 5,709, with 1,175 of them in intensive care.

Patient volume is expected only to increase, as new cases of the coronavirus are growing more quickly than at any other point during the pandemic and often take two to three weeks to result in hospitalization.

L.A. County public health officials announced Sunday that the county had surpassed 600,000 total cases of the virus, a troubling development given that it was only eight days after the county had reached 500,000 cases.

By comparison, L.A. County surpassed 200,000 reported cases of the virus Aug. 6. It was 80 days later that the county recorded its 300,000th case Oct. 25.

As the transmission rate began to climb, L.A. County reported its 400,000th case 36 days later, on Nov. 30. Just 11 days later, the county topped 500,000 cases.

UCLA infectious disease epidemiologist Dr. Tim Brewer said the exponential increase means that L.A. County is on a dangerous path.

“I have yet to see any clear signals that things are slowing down, and I’m very concerned about the next two months,” he said.

He worries that any precautions people are taking now will loosen in late December as people long to be around people for Christmas and New Year’s, adding another surge to the current one.

Already, UCLA Health is scheduling multiple infectious disease doctors to be on call at any given time, due to the unprecedented numbers of COVID-19 patients needing hospitalization, he said. The biggest issue is that hospitals may quickly run out of providers who can administer ICU-level care and will be forced to draft doctors from other specialties.

“I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff. It’s the physicians, the nurses, the respiratory therapists, all of the trained people to do that highly specific work that you can’t just pull out of a hat.”

New cases, hospitalizations and deaths are all surging more ferociously than they were in the summer, which was previously the high-water mark for the pandemic in Southern California.

The increases mirror a trend seen nationwide, which poses an added challenge when it comes to calling in staffing assistance, said Dr. Brad Spellberg, chief medical officer at Los Angeles County-USC Medical Center.

“During the first phase of the ramp-up of cases in the L.A. County area, the virus was not simultaneously out of control everywhere and so people could be summoned from other counties or out of state,” Spellberg said. “When the entire United States is in crisis, where are you going to find people?”

Healthcare professionals are bracing for the likelihood that things will get worse before they get better.

No end in sight

A doctor at an L.A. County public hospital said that the number of COVID-19 patients is “increasing exponentially without an end in sight.”

Many parts of the hospital are being converted to COVID-19 wards, and ICU teams are being staffed up with workers from other departments that are temporarily halting their services. The doctor said it seems as though they will be stretched so thin that by early January they will have to begin rationing care.

“We’re going to be New York with bodies piling up. Wouldn’t be surprised if L.A. rings in the new year as the COVID capital of the world,” said the physician, who requested anonymity because the person was not authorized to speak to the media.

“I don’t know how many ways to explain to people to isolate and stay home short of bringing a camera to the ICU and ED [Emergency Department] to show them the mess of what we’re experiencing.”

In a welcome bright spot, hundreds of healthcare workers at L.A. County hospitals have received a vaccine dose so far, and that number was expected to hit roughly 6,000 by Christmas, officials said earlier this week.

L.A. County will reserve the initial allotment of the Moderna vaccine for staff and residents at skilled nursing facilities, frontline EMTs and paramedics, and those who administer vaccines, public health officials said.