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As COVID-19 cases surge across Oklahoma, hospital leaders throughout the state remain in talks with ethicists and lawyers over how to handle the allocation of critical resources for patients on the brink of death. Those conversations heated up in April, when the Oklahoma Department of Health — with input from doctors, chief medical officers and other healthcare experts — published its Hospital Crisis Standards of Care, a set of guidelines for delivering healthcare if resources run scarce during the pandemic. “It is the most sobering conversation I’ve ever been a part of,” said Patti Davis, president of the Oklahoma Hospital Association. (Dulaney, 1/14)

California hospitals are preparing the ethical protocol to guide who may get lifesaving care as providers struggle to meet the growing demand sparked by the latest COVID-19 surge. While hospitals have yet to implement crisis-level care rationing, the steady increase of 40,000 new COVID-19 cases a day continues to threaten hospital capacity. Space and staff are stretched, particularly in Southern California, as the state endures a surge 4 to 5 times the size of the spike in summer. (Kacik, 1/14)

The situation here is dire. Every minute, 10 people test positive for Covid-19. Every eight minutes, someone dies. Ambulances circle for hours, unable to find ERs that can accept patients. Hospitals are running out of oxygen. ICU capacity is at zero. Patients lie in hallways and tents. Emergency room nurses have more patients than they can handle — sometimes six at a time. (McFarling, 1/15)

Los Angeles County scientists now estimate that 1 in 3 residents have contracted COVID-19 since the beginning of the pandemic, the Los Angeles Times reported on Thursday. That would mean at least 3 million of the county's 10 million residents have been infected — more than triple the number confirmed through testing, according to the Times. (Polus, 1/14)

As horrific as the U.S. Covid-19 outbreak looks right now, it is almost certainly about to get worse. They’ve raced through South Africa, the United Kingdom, and, increasingly, elsewhere, and now, new, more infectious variants of the coronavirus have also gained toeholds in the United States. If they take off here — which, with their transmission advantages, they will, unless Americans rapidly put a brake on their spread — it will detonate something of a bomb in the already deep, deep hole the country must dig out of to end the crisis. (Joseph, 1/14)