Paramedics escort COVID-19 patients at the ambulance entrance to the emergency room at Los Angeles County + USC Medical Center on Sunday. REUTERS/Bing Guan

By Dan Whitcomb and Steve Gorman | Reuters

Los Angeles health officials have told first responders to stop bringing adult patients who cannot be resuscitated to hospitals for treatment, citing a shortage of beds and medical staff, as the latest COVID-19 surge threatened to overwhelm the city’s healthcare systems.

The orders, issued late on Monday and effective immediately, marked a further escalation of measures being taken nationwide by state and local officials due to alarming increases in COVID-19 infections, hospitalizations and deaths.

“Patients in traumatic full arrest who meet current Ref 814 criteria for determination of death shall not be resuscitated and shall be determined dead on scene and not transported,” Marianne Gausche-Hill, medical director of the Los Angeles County Emergency Medical Services Agency, said in the directive.

Ref 814 refers to the county’s policy on determining and pronouncing death in a patient who has not been transported to a hospital.

California, the most populous U.S. state, has been hit particularly hard by the latest coronavirus surge that some public health officials attribute to Thanksgiving holiday gatherings in November. Los Angeles is one of two counties reporting a shortage of intensive care unit beds.

The state of some 40 million residents reported 72,911 COVID-19 cases on Monday, a single-day record since the pandemic began.

Los Angeles County EMS Director Cathy Chidester has called the situation a “hidden disaster,” not plainly visible to the public in a county where COVID-19 patients were dying last week at the rate of one very 10 minutes.

Ambulances have in some cases been forced to wait several hours to unload patients, causing delays throughout the county’s emergency response system.