With intensive care units across the region essentially full, hospitals have constructed new patient areas in their parking lots, called in refrigerated trucks to ease the burden on overflowing morgues and prepared plans to ration care. But inside the building, there’s another worrying toll from the pandemic: Health care workers are exhausted.

“Over the course of this year, we have become very adept at being flexible and overcoming challenges that seem to come almost every day,” Long Beach Memorial’s Dr. Graham Tse said in an interview with the Post. “It is—it is tiring, though. All our staff  have been working very hard … in this latest surge. People are very, very tired.”

Tse is the physician in charge of Memorial’s incident command center for the COVID-19 pandemic, meaning he provides hospital decision-makers with a physician’s perspective on handling the health crisis.

The last several weeks have been an “interesting journey,” Tse said. The surge of patients, increased deaths and overall increased demands on health care workers across the board has taken a toll on staff physically and emotionally.

In recent days, hospitalizations have dipped slightly in LA County after peaking at more than 8,000. But with about 7,500 coronavirus patients hospitalized as of Sunday, the number is still extremely high, and officials have said a new wave of patients could soon arrive because of Christmas and New Year’s gatherings.

“It is certainly unprecedented,” Tse said. “I’ve been in health care for over 30 years and there has been nothing to this degree, on this scale.”

A doctor waits to triage patients outside the emergency room at St. Mary Medical Center, Monday, Dec. 14, 2020. Photo by Brandon Richardson.

The one silver lining is watching how staff has banded together, Tse said. While the hospital has programs such as counseling for staff who feel overwhelmed or need help dealing with current events emotionally, a lot of support is occurring staff-to-staff in the form of a gift basket with coffee and snacks or other gestures of camaraderie that Tse said go a long way.

“We can’t downplay the impact on staff. It’s very intense at times, even somewhat chaotic,” he said. “There are days where our calls for codes, where someone’s having a medical emergency, are heard several times during the day or night.”

While hospitals are extremely busy, Tse said there has been a growing trend of people not seeking medical attention when needed, which results in them becoming more ill than they otherwise would have, thereby requiring more time and resources once they do call on hospitals. The better alternative is to seek medical attention early, Tse said.

To keep up with demand, requests to the county and state for additional support and supplies go out on a regular basis, Tse said, noting that the situation often changes hourly. But staff continues to step up by volunteering for extra shifts and stepping outside their comfort zone to work in departments they normally would not, he added.

Health workers are also frustrated. Tse said it’s hard to watch people flout health guidelines because he knows the dire consequences.

FILE – In this Jan. 12, 2021 file photo, provided by the LA County Dept. of Medical Examiner-Coroner Elizabeth “Liz” Napoles, right, works alongside with National Guardsmen who are helping to process the COVID-19 deaths to be placed into temporary storage at LA County Medical Examiner-Coroner Office in Los Angeles. LA County Dept. of Medical Examiner-Coroner via AP, File.

Long Beach officials Friday reported 14 new deaths for a total of 520. At the county level, total cases surpassed one million over the weekend and 108 more deaths Sunday brought the total to 13,848. California now has a total of 33,593 deaths. The United States as a whole is just shy of 400,000 COVID-19 fatalities. And worldwide coronavirus deaths surpassed two million.

“This pandemic is not over, unfortunately. Even though we’re vaccinating, we need to vaccinate many more people … to create herd immunity,” Tse said. “This is not a sprint, this is a marathon, maybe even an ultra marathon.”

For all their planning and exhaustive work, health officials remain concerned about another possible surge following Christmas and New Year’s Eve gatherings. Facilities have already prepared for “crisis care,” which is a rationing of resources and ultimately deciding which patients will live or die.

Local, county and state health officials are working in tandem to avoid enacting crisis care, doing everything in their collective power, Tse said. But, in the end, it may not be enough.

“[The possibility of] not being able to provide care to one of my patients is very scary,” Tse said. “I take comfort in knowing that if it ever reaches that point that means we have truly exhausted all possible remedies and situations and there is no other choice. But it is absolutely a scary proposition, something that I never thought I would see in my lifetime.”

Brandon Richardson is a reporter and photojournalist for the Long Beach Post and Long Beach Business Journal.