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]