Los Angeles ambulance workers have been told to stop taking some patients who have extremely low chances of survival to hospital and to limit oxygen use as record Covid cases overwhelm medical resources.
California has become the latest centre of the US coronavirus pandemic, with about 4,000 deaths in the past two weeks, and hospitals are bracing for another surge now the holidays are over.
In Los Angeles, where packed hospitals have been turning away ambulances, medics were told on Monday not to take adult heart attack patients if they could not be resuscitated in the field.
The county's Emergency Medical Services agency also issued a directive for ambulance crews to save oxygen supplies by only administering it to patients with severely low levels.
Local agency head Marianne Gausche-Hill told CBS that medics were "not abandoning resuscitation" in the field, but that taking patients with "very poor outcomes" who cannot be resuscitated could "impact our hospitals."
California was initially praised for its handling of the pandemic in March but it is now reeling.
In the past seven days, it has recorded more than twice as many cases as any other state, placing great strain on resources.
"Many hospitals have reached a point of crisis and are having to make very tough decisions about patient care," said Christina Ghaly, LA County director of health services.
Firefighters trained as paramedics have been temporarily called up to assist hospital staff, while army engineers were drafted in to increase oxygen delivery systems at six hospitals.
"We're likely to experience the worst conditions in January that we've faced in the entire pandemic, and that's hard to imagine," LA County public health director Barbara Ferrer said on Monday.
Positive Covid-19 cases in the nation's most populous county had doubled in just over a month to 800,000, Ms Ferrer said, with more than one in five people testing positive.
"The steepness of this line is frightening and its implications for our healthcare system, our healthcare workers and all the people we care about," she added.
Vaccinations have begun for emergency healthcare workers and the most vulnerable in California, but Governor Gavin Newsom on Monday said the process has "gone too slowly."
Barely a third of the 1.3 million vaccines that were delivered have been administered so far.
South Africa World Cup squad
South Africa: Faf du Plessis (c), Hashim Amla, Quinton de Kock (w), JP Duminy, Imran Tahir, Aiden Markram, David Miller, Lungi Ngidi, Anrich Nortje, Andile Phehlukwayo, Dwaine Pretorius, Kagiso Rabada, Tabraiz Shamsi, Dale Steyn, Rassie van der Dussen.
PROFILE OF HALAN
Started: November 2017
Founders: Mounir Nakhla, Ahmed Mohsen and Mohamed Aboulnaga
Based: Cairo, Egypt
Sector: transport and logistics
Size: 150 employees
Investment: approximately $8 million
Investors include: Singapore’s Battery Road Digital Holdings, Egypt’s Algebra Ventures, Uber co-founder and former CTO Oscar Salazar
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GAC GS8 Specs
Engine: 2.0-litre 4cyl turbo
Power: 248hp at 5,200rpm
Torque: 400Nm at 1,750-4,000rpm
Transmission: 8-speed auto
Fuel consumption: 9.1L/100km
On sale: Now
Price: From Dh149,900
Groom and Two Brides
Director: Elie Semaan
Starring: Abdullah Boushehri, Laila Abdallah, Lulwa Almulla
Rating: 3/5
Timeline
2012-2015
The company offers payments/bribes to win key contracts in the Middle East
May 2017
The UK SFO officially opens investigation into Petrofac’s use of agents, corruption, and potential bribery to secure contracts
September 2021
Petrofac pleads guilty to seven counts of failing to prevent bribery under the UK Bribery Act
October 2021
Court fines Petrofac £77 million for bribery. Former executive receives a two-year suspended sentence
December 2024
Petrofac enters into comprehensive restructuring to strengthen the financial position of the group
May 2025
The High Court of England and Wales approves the company’s restructuring plan
July 2025
The Court of Appeal issues a judgment challenging parts of the restructuring plan
August 2025
Petrofac issues a business update to execute the restructuring and confirms it will appeal the Court of Appeal decision
October 2025
Petrofac loses a major TenneT offshore wind contract worth €13 billion. Holding company files for administration in the UK. Petrofac delisted from the London Stock Exchange
November 2025
180 Petrofac employees laid off in the UAE
EU Russia
The EU imports 90 per cent of the natural gas used to generate electricity, heat homes and supply industry, with Russia supplying almost 40 per cent of EU gas and a quarter of its oil.
Skewed figures
In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458.
The story in numbers
18
This is how many recognised sects Lebanon is home to, along with about four million citizens
450,000
More than this many Palestinian refugees are registered with UNRWA in Lebanon, with about 45 per cent of them living in the country’s 12 refugee camps
1.5 million
There are just under 1 million Syrian refugees registered with the UN, although the government puts the figure upwards of 1.5m
73
The percentage of stateless people in Lebanon, who are not of Palestinian origin, born to a Lebanese mother, according to a 2012-2013 study by human rights organisation Frontiers Ruwad Association
18,000
The number of marriages recorded between Lebanese women and foreigners between the years 1995 and 2008, according to a 2009 study backed by the UN Development Programme
77,400
The number of people believed to be affected by the current nationality law, according to the 2009 UN study
4,926
This is how many Lebanese-Palestinian households there were in Lebanon in 2016, according to a census by the Lebanese-Palestinian dialogue committee