Los Angeles’s Perspective of COVID 19 Effect and Impact on Cardiac Surgery
Tiffany Worthington, DMSc, PA-C and Ali Khoynezhad, MD, PhD
Department of Cardiovascular Surgery
MemorialCare Heart and Vascular Institute
Running Title: COVID-19 in Los Angeles
Corresponding author:
Ali Khoynezhad, MD, PhD
Department of Cardiovascular Surgery
MemorialCare Heart and Vascular Institute
2801 Atlantic Ave
Long Beach, CA 90806
akhoynezhad@memorialcare.org
Phone: 562-933-7174
Fax: 562-933-7178
Author contributions:
A.K. and T.W. both contributed to data collection, drafting the article, critical revision of the article. A.K. performed final approval of the version to be published.
This manuscript did not involve research of human subjects, therefore is exempt from Institutional Review Board (IRB) or Ethics Committee Approval.
Los Angeles’s Perspective of COVID 19 Effect and Impact on Cardiac Surgery
Los Angeles County is home to over 10 million residents. As comparison only nine states in the US have more population than Los Angeles county. It serves as home to professional sporting teams, the entertainment industry, theme parks, and a variety of outdoor recreation activities. LA County is a popular destination for approximately 48.3 million tourists annually.
On December 31, 2019, an initial report of pneumonia of unknown cause was reported to the World Health Organization (WHO) office detected in Wuhan in the Hubei province of China. By January 30, WHO declared a “public health emergency of international concern” as COVID-19 cases had been reported in five WHO regions in the course of one month.[1] That same day, LA Times headlines read “For Americans, flu remains a bigger threat than coronavirus”.[2] As a community, LA was still recovering from the news of Kobe Bryant and his daughter dying in a helicopter crash along with several other passengers, headlines of novel coronavirus spread were buried within the newspapers, with limited appearance on the front page.
As concerns worldwide continued to grow surrounding the COVID-19 pandemic, WHO issued a notice of impending shortage of personal protective equipment (PPE) on March 3, 2020. [3] The following day, LA county officials issued a declaration of local public health emergency. By 5 days later, the first community spread case was reported in LA. On March 11th, the first death from COVID-19 was reported in Los Angeles County. [4] March 18thGovernor Newsom wrote to President Trump requesting federal funding and additional support with concern that more than half of the population of California would be infected with the virus over the following 2-month period. As awareness of the impact of the pandemic in the greater LA area continued, a “safer at home” emergency order was issued on March 19th. This order entailed the closure of all non-essential businesses, no gathering of more than 10 people, and all persons to remain home unless visiting an essential business or participating in outdoor activities at least 6 feet apart from others. The order to wear face masks whenever out of the home and interacting with people was issued as an official guidance on April 1 and became a requirement on April 10th. On April 23rd, COVID became the leading cause of death in LA county, surpassing coronary artery disease, emphysema, influenza, and COPD. [4]
As the number of COVID cases continued to grow, certain trends were emerging, including a significant impact on residential care facilities and in lower-income areas. In response to a growing shortage of staffing in nursing homes, the medical director for LA county EMS made a temporary allowance for EMTs and paramedics to staff the nursing homes. As of mid-June, there were 321 nursing homes in LA county with a least one resident who has tested positive for COVID. [5] The number of deaths related to COVID have been three times higher in areas of poverty than in higher income areas within LA county. Ninety-four percent of deaths in the LA area related to COVID were patients with underlying health conditions. Of those who died, 42% occurred among Latino residents, 28% White, 17% Asian, 11% African American, and less than 1% Native Hawaiian/Pacific Islander residents. [6]