On Saturday, Los Angeles County in southern California became the first in the United States to hit the grim record of 1 million confirmed coronavirus cases since the start of the pandemic.

The hospital systems in Los Angeles and surrounding cities are strained past their limits, with some operating at over 320 percent capacity, and the region is recording more than 250 deaths each day. Patients line corridors, hallways, gift shops, and cafeterias turned patient care, and fill parking lot tents. Los Angeles County is the starkest expression of the pandemic’s spread throughout the state of California. According to the state’s official dashboard, as of January 17, California has 2,942,475 confirmed cases of COVID-19, resulting in 33,392 deaths, the second highest toll in the US, behind New York.

The crisis facing the nation’s most populous county, with more than 10 million residents, is deepening as the presence of the UK variant, which is predicted to be some 70 percent more transmissible, has been confirmed. There is no end in sight to this upward trend as over 20 percent of tests in Los Angeles County are coming back positive, pointing to rampant community spread.

The county’s hospital morgues are so full that more than a dozen members of the California National Guard have been called in to help store corpses as funeral homes and mortuaries work through a backlog. A temporary morgue consisting of five 53-foot refrigerated trailers and a number of other containers were set up last week in a parking lot adjacent to the Los Angeles County Coroner’s building. As of Friday, over 2,700 bodies were being stored at hospitals and the coroner’s office. Just east of Los Angeles, Riverside County has also procured additional storage space to store bodies—10 refrigerated trailers, eight of which can store 50 bodies per trailer.

There are so many deaths that air quality regulations for crematoriums in the county had to be suspended to keep up with the death toll and speed up cremations of bodies. On Sunday, the South Coast Air Quality Management District issued an executive order to suspend air quality regulations that currently limit the number of cremations. The official district order states that the current death rate is “more than double that of pre-pandemic years, leading to hospitals, funeral homes and crematoriums exceeding capacity, without the ability to process the backlog.”

The skyrocketing death toll reflects the deep poverty and social inequality that exists in the wealthiest state in the US. In Los Angeles, some 16 percent of the population live below the poverty line. Dr. Elaine Batchlor, CEO of the Martin Luther King Jr. Community Hospital, described the higher rates of chronic illness among impoverished residents, telling CNN that “Diabetes is three times more prevalent here than in the rest of California. Mortality is 72 percent higher. The life expectancy is 10 years shorter here than in the rest of the state.”

California also has one of the lowest numbers of hospital beds per capita—just 1.8 beds for every 1,000 people, compared to four beds in Mississippi. The shortage of hospital beds is a reflection of the profit motive in the health care system, and of the conscious decisions to keep hospitals short-staffed, known as the LEAN model, which is embraced by all hospital systems to maintain the bare minimum of staff, a method focused on “minimizing waste”—i.e., labor costs.

The sorry state of California’s intensive care unit (ICU) capacity has been prepared through decades of cost-cutting to services such as intensive care that are more costly. According to a 2017 financial analysis by the California Health Care Foundation (CHCF), titled “Rethinking the Use of Intensive Care Beds in California’s Hospitals,” the foundation, speaking for the shareholders and CEOs of the state’s health care systems, argued that hospitals should shift ICU patients to non-ICU beds instead of increasing ICU capacity, noting that an unforgivable $55 billion is spent annually on critical care across the United States.

The report sought to undermine the 1:2 nurse-to-patient ratios in ICUs and advocated instead for 1:5 ratios in non-ICU nursing. The job losses that would result for nurses is a celebrated cost-cutting measure to boost the profits of the owners of the hospital system. It also regretfully noted that the average Medicare discharge of an ICU patient results in hospital losses of $2,431, losing a yearly aggregate of $5.8 billion, whereas $2 billion in profits are made on patients that do not spend time in an intensive care or critical care unit.

Health care workers are facing lack of bed capacity, dwindling resources, and dangerous short-staffing amid the worst wave of the pandemic so far. The response of the ruling elite and Democratic Governor Gavin Newsom has not been for an immediate lockdown to halt the spread of cases but has been to grant hospitals the ability to waive the nurse-to-patient ratios. About 115 hospitals in California have been approved for 90-day waivers repeatedly including about 31 facilities in Los Angeles County, according to an analysis of California Department of Public Health data. Most recently, Antelope Valley Hospital in Lancaster received approval shortly after Thanksgiving.

The result of these conditions has pushed hospitals and strained staff to a breaking point as they face war-like carnage on a daily basis that is only fueling the understaffing issues. A nurse from the Apple Valley hospital told Reuters that “We’ve had physicians retire, we’ve had lab staff quit, we’ve had nurses quit, we’ve had CNAs quit, monitor techs quit, people have left critical care and gone to other units because it’s too much for them.”

Numerous hospitals have reported they are rationing care and limited resources due to lack of beds and staff, and to add insult to injury, many hospitals throughout the state have declared “internal emergencies,” as they are runningoutofoxygen. First responders in Los Angeles County have been ordered not to administer oxygen unless a patient’s levels drop below 90 percent. Nurses at Riverside Community Hospital have been directed via e-mail to “preserve their oxygen supplies.”

Throughout the media, headlines for the necessity of “ethical protocols to prioritize lifesaving care” dominate, but stripped of their euphemistic language, these are arguments for withholding patients from lifesaving care. Gary Herbst, the CEO of Kaweah Delta, the largest acute care hospital in Tulare County in central California, who brings home a yearly package of $1,058,692, remarked coolly last week that it was “our responsibility as a healthcare facility to plan for these types of scenarios.”

As the death toll mounts and care continues to be rationed, the slow pace of vaccinations will do little to nothing to affect the upward trend of cases and provide relief to strained health care systems. Los Angeles County is still not through vaccinating health care workers who had exposure to patients or infectious materials. There are an estimated 450,000 health care workers who have yet to be vaccinated and only 700,000 residents out of 3 million are currently eligible to receive the vaccine. The additional facilities set up for “mass” vaccinations can only provide relief for an additional 8,000 people per day.

In Riverside County, the registration for 11,000 vaccination slots scheduled for a four-day period starting Tuesday was filled two hours after registration opened, while many were unable to access the overwhelmed county website. “As of right now, we have 14,346 doses in our hands as public health and that is just enough to get through the vaccine clinics we have planned Sunday,” Kim Saruwatari, the county public health director, said Friday at a live-streamed meeting with county officials. “And by the end of Sunday we should be pretty close to out of vaccine as a public health department.”

Despite the horrific strain on the system and the 1 million infection mark reached, the Democratic-controlled government is doubling down on its plans to reopen the economy. Los Angeles County Board of Supervisors met behind closed doors for a perfunctory 10-minute meeting on Friday and announced that they do not see a need to enforce additional restrictions. Governor Newsom continues to pursue a $2 billion plan to force cash-starved schools to reopen by mid-February, and emphasized this past week that the state’s hospitalization rates are beginning to show “the light at the end of the tunnel” since they’re now growing at a slower rate than the December influx.

A Riverside nurse blasted Newsom’s statement, telling the WSWS: “Yesterday a patient in his 40s asked me with fear in his eyes ‘Am I going to die?’ He was maxed on oxygen support and the time was near for him to be put on a ventilator. The short answer was yes, he would likely die. I tried to explain without lies so he would have hope in the end. ‘We’re going to take care of you and do everything we can. We have the best treatment available. I’m going to be right here with you and holding your hand.’ He didn’t make it. Where is his light at the end of the tunnel? He’s not the first and won’t be the last to suffer from this virus.”