“This is a tragedy,” said Dr. Nida Qadir, co-director of the Ronald Reagan UCLA Medical Center Medical Intensive Care Unit, on the MLK statistics. Her hospital had “much lower death rates,” she said, although the hospital hadn’t publicly released the number. A new study on patients in 168 hospitals found that about half of Covid patients died using ventilators and survival varied widely under hospitals.
Dr. Theodore J. Iwashyna, an intensive care physician at the University of Michigan, said the differences in hospital outcomes reflected a “system choice.” He and others have studied patients with complex lung diseases and found that those treated in smaller hospitals with fewer resources and less experience in treatment tend to have poorer survival rates. “Big hospitals should have taken these patients in and pulled them out of the MLK,” he said.
During the surge in Los Angeles, hospital mortality also rose as less mildly ill patients were hospitalized, said Dr. Roger J. Lewis, Professor of Emergency Medicine at Harbor-UCLA Medical Center helping with analyzing Covid data for the county. This is likely to be even more the case in small hospitals like MLK in areas with high chronic disease rates, he said.
The medical team invited Mr Flores’ wife to the hospital, which was normally closed to visitors during the pandemic. She found her husband scared and trembling. He wasn’t getting enough oxygen, a doctor said, and without a ventilator he could die in two days. Mr. Flores told her he wanted to go home and then changed his mind. He said he was exhausted and had chest pain. He would try the ventilator because he wanted to live longer for his family.
Even so, its oxygen levels remained low. Doctors gave him steroids and drugs to stop blood clots. They turned him on his stomach and even paralyzed him for some time so the ventilator could work more effectively. But nothing seemed to make a difference. Mr Flores had “cut and dried covid lung failure,” said Dr. Prasso.
Some Covid patients have a final option: treatment with a machine that allows the lungs to rest and hopefully repair. The procedure, the extracorporeal membrane oxygenation or ECMO, is typically only offered to patients in larger hospitals who meet strict criteria.
According to Dr. Christopher Ortiz, an intensive care specialist from, Mr Flores might once have been a candidate for it UCLA, a high level hospital, But Dr. Prasso said he stopped thinking about treatment. At the start of the pandemic, he had pushed for some MLC patients to be taken to hospitals that offer ECMO, but eventually gave up.
“We have never been successful,” he said. “Nobody wants their insurance.”