Los Angeles Health Crisis Could Be Repeated Across the U.S. in the Next Few Months

It’s the worst nightmare for public health officials and it appears to be coming true. Los Angeles County is experiencing a health emergency as hospitals are literally filling up with COVID patients. Ambulances circle the city waiting for a spot to open up in emergency rooms. The ICUs are at zero capacity. They are running out of oxygen. The emergency rooms are treating six patients at a time. There are people in hallways waiting for a bed.

The COVID crisis is hitting hospitals across the U.S. although none appear to be in as bad a shape as LA — for now. But the dramatic rise in positive tests and increasing numbers of people showing serious symptoms across the country point to a similar crisis erupting in other big cities as well.

What the hell happened?

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“With the first wave, LA was the poster child on how to do things right,” said Leo Beletsky, a professor of law and health sciences at Northeastern University who is based in Los Angeles. “Then we blew the lead.”

The city’s early success may be one reason things are so bad right now. “What happened in New York is that people got very scared and they behaved,” said Karin Michels, who chairs the department of epidemiology at the UCLA Fielding School of Public Health. “We did so well, people started to relax, and they stopped following the rules.”

Los Angeles may be particularly hard hit because even though it’s spread out geographically, most of the city is overcrowded. With housing costs astronomically high, people — especially the poor — are forced to squeeze into smaller and smaller spaces leading to more and longer exposure to the coronavirus.

Epidemiologists are quick to point out that every city has similar risks and, therefore, could see their own “megawaves” of infection. But with vaccination now underway, and masking more commonplace, other cities may be able to avoid the fate of Los Angeles, which saw cases surge at the worst possible time, during the peak of holiday travel and gatherings.

Los Angeles residents, more than others, are ignoring the dictates from Governor Newsom and continuing to party on.

Despite the lockdown here, mobility and cellphone data show Angelenos are out and about at higher rates than people in many other cities. ”Even when we call it a lockdown, we are not doing it the same way New York was,” Bibbins-Domingo said. Part of this may be that many people have to keep working outside the home, and often commute long distances to do so.

But many, whether suffering pandemic fatigue or to make a statement, are clearly flouting the restrictions. People are still gathering, holding large parties, and many are not wearing masks. Both Orange County and LA have been the site of multiple MAGA anti-mask rallies. And it’s not just those on the right who are flouting the rules. “A lot of people who refuse to mask or practice social distancing are not just the quote, unquote Trumpers,” Beletsky said. Many, he noted, are residents of wealthy enclaves like Pacific Palisades and Malibu, which have some of the state’s lowest child vaccination rates.

Forcing people to wear masks and stay inside and away from crowds doesn’t work when your credibility is below zero. But it’s not a paranoid fantasy that Los Angeles is in deep trouble and now, it’s too late to salvage the situation.