Palliative care is the medical specialty that helps improve the quality of life for patients with serious illnesses — everything from the curable, such as trauma or certain cancers, to those that bring people to the end of their days. It aims to support the whole patient and the whole family with nurses, social workers, chaplains and doctors.It is difficult to find a circumstance that has hit Kilani’s team as hard as the pandemic. Before the coronavirus swept through Los Angeles County, infecting more than 636,000 and killing nearly 9,000 people, Holy Cross’ palliative care team averaged about 20 cases at any given time. In early December that caseload hit 60. In one recent four-day period, 12 of the team’s patients died.During the second week in December, the hospital’s COVID unit reached capacity, and there was no longer room for families to visit loved ones as they died of the virus. On Monday, a member of the palliative care team tested positive.Holy Cross has cared for more than 1,350 people with COVID-19 since March. The current surge has forced the hospital to turn basement lab space into patient rooms. COVID-19 patients now take up the hospital’s entire recently expanded south tower. Half of all palliative care patients have the virus.Kilani was a medical student in the 1990s, during the last health crisis that rocked the nation, when HIV/AIDs spread pain and panic. The similarities between that disaster and this one are glaring: The stigma. The victim blaming. The inequity.Both diseases, she said, lay bare the wide chasm between the haves and have-nots, between who gets good care and who has little access to treatment. In both crises, paBecause hospital visits are largely banned the palliative care team often steps in, a kind of “substitute for family. Which is why she does not wear gloves as she makes her rounds in the COVID unit. Touch, she said, is healing. Her hands are raw from constant scrubbing and sanitizer, her nails, dry and split.

Chaplain Kevin Deegan, left, prays over patient Bob Harris as Bob family is participating via an iPad on Thursday, Dec. 3, 2020 in Mission Hills, CA. Bob has been on a ventilator for over 30 days. He is in a rotoprone bed that will rotate him to a prone position. During the coronavirus pandemic the palliative care team here is working closely with covid patients and their families at Providence Holy Cross Hospital, in Mission Hills, CA. The families are not allowed inside to visit generally. The palliative care team includes chaplains, physician, nurse, and a social worker to helps as surrogates for the families and patients. They work closely with the hospital ethicist.

During the global pandemic Dr. Babak Eshaghian, MD, left, Nurse Practitioner Lia Christian, middle, and Scott Hoagland, RCT, right, and the medical team intubates a covid positive patient inside the hot zone in the covid unit at Providence Holy Cross Medical Center - Mission Hills on Thursday, Dec. 9, 2020 in Mission Hills, CA. This entire floor has been transformed into the covid unit. As California hospitals rapidly approach capacity because of the unprecedented spike in coronavirus cases, there are growing concerns about shortages of workers as the healthcare system strains to handle the growing demand.

During the global pandemic a nurse adjusts a covid patients IV medication inside the hot zone in the covid unit at Providence Holy Cross Medical Center - Mission Hills on Thursday, Dec. 9, 2020 in Mission Hills, CA. This entire floor has been transformed into the covid unit. As California hospitals rapidly approach capacity because of the unprecedented spike in coronavirus cases, there are growing concerns about shortages of workers as the healthcare system strains to handle the growing demand.

Hospital Chaplain Sister Mary Jo Piccione, Sp visits a cover possitive patient at Providence St. Mary Medical Center in Apple Valley, CA on Tuesday, Dec. 22, 2020 in Apple Valley, CA. Sister Mary Jo is part of the Sisters of Providence order. She has been a nun for more than 50 years and she she has worked as an RN. She is now a Chaplain. She works with patients and their families.

Registered Nurse Deb Falk has worked at JRMC for over 30 years. Today she holds Teresa Cole, a 57-year-old COVID-19 positive patients at Jamestown Regional Medical Center, on Sunday, Nov. 22, 2020 in Jamestown, ND. Cole’s daughter is a nurse who cares for COVID-19 patients in Rugby, 140 miles northeast. Falk asked Cole whether she had been in touch with her daughter. “She doesn’t know how sick I am,” said Cole, coughing and starting to cry. “I won’t tell her. She’s got too much to worry about.”

MISSION HILLS, CA - DECEMBER 29: Chaplain Kevin Deegan, left, gives Juan Legaspi-Lozano, 90, a small sip of water after checking with the nurse first at Providence Holy Cross Medical Center on Tuesday, Dec. 29, 2020 in Mission Hills, CA. Juan is a patient inside the covid unit (Francine Orr / Los Angeles Times)

Registered Nurse Kat Yi holds an iPad up to Eduardo Rojas so that his wife Angelica Rojas inside the ICU at Providence St. Jude Medical Center Christmas Day on Friday, Dec. 25, 2020 in Fullerton, CA. Eduardo Rojas is a covid patient. His fever is rising at the moment. Due to the coronavirus people can not generally visit their family members. The medical staff are caring for them and the staff are working the link between families and patients.

Michelle Harris, 25, has come to pay her respects to her father Bob Harris at Providence Holy Cross Hospital on Monday, Dec. 7, 2020 in Mission Hills, CA. Bob is a covid patient and he has been on a ventilator for over 30 days. Bob’s daughter Michelle stays with him briefly as the Palliative team and her mother and brother stand outside the room.

Chaplain Anne Dauchy, left, places her hand on Dr. Marwa Kilani’s, MD, right, shoulder to comfort her. Kilani begins to cry after talking with a patients family while she stands inside the COVID ICU. Three people passed way this morning on this one wing of of the unit from complication of covid at Providence Holy Cross Medical Center on Thursday, Dec. 31, 2020 in Mission Hills, CA. “Simply in true 2020 fashion, the last day of the year sums up what this year has been like - truly awful. Today’s experiences left me feeling defeated and conflicted about what it means to honor and respect those who are suffering, particularly at the end of life. I worry for those out there who journey alone through this unreal time.,” says Palliative care physician Dr. Marwa Kilani, MD.

Arroyo Grande Hotshots are silhouetted as they watch the backfire they set to burn off 100 aches of brush to protect homes near the fire line at Carter Street and Bears Den Ranch Road in Yucaipa on Sunday, September 6, 2020.

An air tanker makes a retardant drop behind homes near the San Bernardino National Forest fighting the El Dorado Fire as it burns more than 1,500 acres in Oak Glen and Yucaipa on Saturday, September 5, 2020.

A basketball player stops shooting hoops at Yucaipa Community Park to watch as a DC-10 tanker flies over head to make a retardant drop on the El Dorado Fire as it burns close to homes in triple digit heat, wind gusts and low visibility in Yucaipa on Sunday, September 6, 2020.

Residents run from the flames of the El Dorado Fire as it tops the hill behind a home on Kevari Court in triple digit heat with high wind gusts and low visibility in Yucaipa on Sunday, September 6, 2020.

Family members comfort one another as the El Dorado Fire moves closer to their home at Ivy Avenue and Jefferson Street as triple digit heat, high wind gusts and low visibility limited air attack in Yucaipa on Sunday, September 6, 2020.

An Arroyo Grande Hotshots firefighter starts a back fire to burn off 100 aches of brush to protect homes near the fire line at Carter Street and Bears Den Ranch Road in Yucaipa on Sunday, September 6, 2020.

A water dropping helicopter heads back to refill for another drop on the El Dorado Fire as the sun sets in the heavy smoke in Yucaipa on Sunday, September 6, 2020.

Family members watch as the body of U.S. Forest Service Big Bear Hotshot Charles Morton, killed fighting the El Dorado fire is walked into the San Bernardino County Coroner’s Office by San Bernardino Sheriff’s Honor Guards in San Bernardino on Friday, September 18, 2020.

Firefighters react after U.S. Forest Service Big Bear Hotshot Charles Morton was killed fighting the El Dorado fire before the firefighters body arrives at the San Bernardino County Coroner’s Office in San Bernardino on Friday, September 18, 2020.

U.S. Forest Service Big Bear Hotshot Charles Morton was killed in the line of duty on Sept. 17 fighting the El Dorado Fire. Firefighters salute as Morton’s fiancee, Monica Tapia carries his urn during his memorial service at The Rock Church in San Bernardino on Friday, Sept. 25, 2020.

As the coronavirus spread across the globe, Los Angeles County fell under a stay-at-home order. The bustling metropolis came to a standstill, taking months to crawl back toward a “new normal,” wear masks have become the standard.A man walks by a mural on La Brea Ave by artist Thierry Guetta, aka Mr. Brainwash, has the bold message of “Stay Home, Life is Beautiful,” made during the coronavirus pandemic, photographed Saturday, April 18, 2020, in Los Angeles, CA. Guetta is known for “Life is Beautiful” being used in his pop-art, including in a 2019 campaign for the city of Beverly Hills.

The Fairfax Cinema in Los Angeles, CA, is closed and left the message, “Stay Safe Los Angeles,” on its marquee, during the coronavirus pandemic, photographed Sunday, April 19, 2020.

The scene down Boyd Street, off South Los Angeles Street, in downtown Los Angeles, CA, March 23, 2020, as the city is under a new mandate from California Gov. Gavin Newsom, to stay home, with only essential businesses allowed to stay open, as a preventative measure of the COVID-19 spread.

With California’s COVID-19 positive cases rising, stay-at-home orders are kept in place, with playgrounds included in the lock-down. A sign of our civid-times, swings are secured and taped off in Manhattan Beach, CA, during the coronavirus pandemic, Friday, April 24, 2020.

Just one mile from the sand of Hermosa Beach, sisters Britta, left and Haley Cameron, 23, joined by their dog Kiki, are adhering to the California stay-at-home self quarantine order during the coronavirus pandemic, utilizing a patch of astroturf next to their home driveway in Redondo Beach, CA, on a warm day, Thursday, April 23, 2020.

The Manhattan Beach, CA, Pier is gated and locked and a city maintenance sign repeats the message that (parking) “LOT CLOSED,” “COVID 19” and “Social Distancing,” the evening of March 25, 2020.

Astrid Mota, with Long Beach Airport maintenance, sprays and wipes disinfectant on the security line, in Long Beach, CA, March 24, 2020. Airlines are asking the U.S. government for a $50 billion bailout, in response to the collapse of their industry because of coronavirus.

Lucy Cavazos and her daughter Amber, from Huntington Park, use a lift to help celebrate the 91st birthday of Margaret Jones, in the courtyard assisted living facility, The Kensington Redondo Beach, in Redondo Beach, CA, during the coronavirus pandemic April 07, 2020. Lucy Cavazos has celebrated Jones’ birthday with her for 20 year and Amber considers her to be a grandmother. The two didn’t want to let the coronavirus pandemic break their tradition.

As Fall arrived, with it came the first major awards show and only one associated gifting suite. Sophia Abraham,11, reaches for a “brunch box” from a Beverly Hilton Hotel employee, as she finishes up event producer Debbie Durkin's “ECOLUXE Lounge, ’Drive-Thru' Endless Summer Festival,” ahead of the weekend’s 72nd Primetime Emmy Awards, in the Beverly Hilton Hotel driveway in Beverly Hills, CA, Friday, Sept. 18, 2020. A collection of sponsors provided a variety of products, from canned water, to pet products from John Paul DeJoria, to nominees, and entertainment industry types, including social media influencers.

Winter arrives and in the final days of the year, rain soaks Southern California, including the Manhattan Beach Pier, still adorned with holiday lights. The coronavirus continued infecting the world’s population for 10 months of 2020, as humanity looks toward vaccines in the new year.

An air tanker drops retardant at a wildfire burns at a hillside in Yucaipa, Calif., Saturday, Sept. 5, 2020. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

A helicopter drops water at a wildfire in Yucaipa, Calif., Saturday, Sept. 5, 2020. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

Diane Brickley comes back home to take care her goats after evacuated as a brush fire burns nearby at the Apple Fire in Cherry Valley, Calif., Saturday, Aug. 1, 2020. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

A firefighter stands next to a fire truck as flames from a brush fire flare at the Apple Fire in Cherry Valley, Calif., Saturday, Aug. 1, 2020. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

A firefighter battles the Lake Hughes fire in Angeles National Forest on Wednesday, Aug. 12, 2020, north of Santa Clarita, Calif. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

The wind whips embers from the Joshua trees burning in the Bobcat Fire in Juniper Hills, Calif., Friday, Sept. 18, 2020. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

Flames dot a hill under a smoky sky from the Bobcat Fire in Juniper Hills, Calif., Friday, Sept. 18, 2020. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

The Lake Fire burns a vehicle near Lake Hughes in the Angeles National Forest on Wednesday, Aug. 12, 2020, north of Los Angeles. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

The charred remains of the burned out home are seen in the Lake Hughes fire in Angeles National Forest on Thursday, Aug. 13, 2020, north of Santa Clarita, Calif. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

A firefighter watches a brush fire as smoke from the Apple Fire covers the city in Banning, Calif., Saturday, Aug. 1, 2020. The 2020 California wildfire season was characterized by a record-setting year of wildfires that burned across the state of California as measured during the modern era of wildfire management and record keeping. As of the end of the year, nearly 10,000 fires had burned over 4.2 million acres, more than 4% of the state's roughly 100 million acres of land, making 2020 the largest wildfire season recorded in California's modern history.

THOUSAND OAKS, CA - DECEMBER 05, 2020: Noah Rouse, 11, and his sister Alena, 4, of Moorpark, have their temperature taken by Whispering-Willow Dela Cruz to protect against the spread of the coronavirus, before meeting with Santa Claus, (Joseph Polselli) at Santa’s Village, located at the Janss Marketplace in Thousand Oaks.

MOORPARK, CA - DECEMBER 05, 2020: Wearing protective masks against the coronavirus, Kristen Vazquez of Los Angeles points out Santa Claus to her 2 year old twin daughters, Zoe Vazquez, center, and Stella, during a visit to Underwood Family Farms in Moorpark. They were waiting in line to take a socially distanced photograph with Santa.

CENTURY CITY, CA - DECEMBER 03, 2020: Aerin Kim, 4, acting a little shy, hides behind her mom, Gina, after spotting Santa Claus (Larry Buckelew), at the Westfield Century City shopping mall. Santa was on his way to a lunch break. They are all wearing masks to protect against the spread of the coronavirus.

MOORPARK, CA - DECEMBER 05, 2020: Zoie Dabit, 4, of Northridge, waves to Santa Claus (Mark Moise), while socially distancing as protection against the coronavirus at Underwood Family Farms in Moorpark.