Ambulance workers in Los Angeles County, California, have been told not to transport hospital patients that have extremely low chances of survival.
The directive comes as officials say the region could soon hit over 1,000 Covid-related deaths per day, and hospitals are overrun with patients.
Emergency workers have also been told to ration oxygen, which is in short supply due to the pandemic.
Hospital beds in LA are running low and officials fear a post-holiday spike.
New York City issued a similar directive to ambulance workers in April 2020 at the height of the city’s Covid outbreak, instructing them not to bring in patients who were unable to be resuscitated at the scene.
The LA County Department of Public Health reported 9,142 new Covid cases on Monday, and an additional 77 deaths. The county, which is the worst hit in the US, has recorded 818,000 coronavirus cases and more than 10,700 deaths since the start of the pandemic.
Hospitals in California, which are already at maximum capacity, have begun seeing patients in gift shops, parking lots and outdoor tents. Ambulances are being forced to queue outside of hospitals for hours as they wait for Emergency Room workers to take their patients.
Dr Marianne Gausche-Hill, the medical director of LA County’s Emergency Services Agency who issued the latest directives, told CBS News that ambulance workers will continue to work to save lives of patients at the scene.
“We are not abandoning resuscitation,” Dr Gausche-Hill said. “We are absolutely doing best practice resuscitation and that is do it in the field, do it right away.”
“What we’re asking is that – which is slightly different than before – is that we are emphasising the fact that transporting these patients arrested leads to very poor outcomes,” she added. “We knew that already and we just don’t want to impact our hospitals.”
Treating heart attack and stroke patients at the scene can increase chances of survival, she said.
It comes as the US broke its record for the number of Covid patients in hospital.
On Monday, 2,800 Americans were admitted to the hospital for Covid, the highest daily total yet. This brings the total number in hospital to 128,210, according to the Covid Tracking Project. Over 23,000 patients were listed as in intensive care.
In California, the number of patients in hospital for coronavirus has doubled in the past month. The mayor of LA said on Sunday that a new infection occurs there every six seconds.
It also comes as criticism mounts of the slower-than-expected US vaccine rollout. On Monday, the Centers for Disease Control and Prevention (CDC) said that of the 15.4m vaccine doses that have been distributed so far, only around 4.5m people have been given their first jab.