‘Tipping Point’ at New York Area Hospitals as Virus Spreads
‘Tipping Point’ at New York Area Hospitals as Virus Cases Mount
(Bloomberg) --
A doctor recovering from Covid-19 who took a test on Thursday says he will return to work treating patients on Monday. Staff at one hospital system got a foreboding email: patients with severe respiratory symptoms doubled in the past week.
After harried preparations, hospitals in the New York area are being pummeled with patients, including a surprising number of young people. Healthcare workers, including those who recently became sick with the virus, are pushing to respond in every way possible.
At the same time, supplies of protective gear are running dangerously low at many facilities. Tensions are flaring among staff who feel they are poorly equipped and unprotected.
“This is the tipping point,” said Anne Goldman, vice president for non-education members at the United Federation of Teachers, which represents some health care workers. “We’re pretty much saturated with critically ill.”
Help Coming?
Politicians and health officials say some relief is on the way: Governor Andrew Cuomo announced on Saturday field hospitals, thousands of ventilators and a flood of protective gear. He said New York needed another 50,000 hospital beds.
But in the wait, the workers and the hospitals are up against the disease’s spear-tip -- and it’s jolting.
Just a few days ago, many intensive care units resembled ghost towns, as patients were cleared out to make way for an influx of new patients.
In New Jersey, Holy Name Hospital had admitted 66 confirmed or suspected Covid-19 patients through Sunday, including a 100-year-old person in critical condition. The 321-bed facility in Teaneck is creating dozens of special new rooms.
“We’re making it work,” said Adam Jarrett, Holy Name’s chief medical officer. But he said, they worry “that at some point we’re going to get overwhelmed.”
Seventeen staff members have tested positive. One of those is “critically ill” in intensive care, Jarrett said Sunday. Holy Name’s chief executive officer, Michael Maron, learned Friday that he tested positive.
“He’s working from home as a lot of our staff are,” Jarrett said.
A primary task at many hospitals has been to clear beds for new patients.
At Northwell Health, New York state’s largest health care provider, inpatient capacity ranges from 63% to about 90% after the chain discharged patients and canceled elective surgeries, said Terence Lynam, a spokesman. The 5,500-bed system will be able to add about 1,000 beds, he added.
At a Mount Sinai hospital on Manhattan’s Upper East Side, patients who don’t have respiratory symptoms appear to be staying away, according to Jolion McGreevy, medical director of the hospital’s emergency department. The total number of patients has dropped from an average of about 350 a day before the pandemic to about 200 now, he said.
The Sick Young
Goldman, who is also a nurse, says that Elmhurst Hospital and NYU’s Brooklyn campus are seeing their intensive care units filled with a share of patients under 40 years old they had not anticipated.
“It’s not who we were expecting,” she says.
Over half of all Covid-19 patients in New York are between 18 and 49, the state says.
The swell is pushing out patients with other serious conditions, Goldman says. Cancer patients are having chemo treatments postponed, and wait times for treatment of even severe injuries, such as broken limbs, are spiking.
Health-care workers are increasingly worried about things they can’t control: stores of masks, gloves and gowns.
At one hospital system, an email was sent to some department heads telling them that their employees will “only receive one mask to be used indefinitely.”
John F. Bonamo, chief medical and quality officer for RWJBarnabas Health, the largest system in New Jersey, said his organization had purchased 500,000 masks from a vendor that’s not part of its typical supply chain -- for nine times the normal price.
“One patient consumes a huge drain on supplies,” Bonamo said.
Caregivers Tested
In upstate New York, a doctor stood outside the emergency room door of one hospital on Friday, where his staff refused to start their shift unless they got a fresh set of N95 respirator masks, according to one administrator.
When a box arrived, staff cheered, before ripping open the box and stuffing extra masks into the hems of their scrub suits.
Not all hospitals are having the same problem.
McGreevy, of Mount Sinai, said they have become more “flexible” after years of preparation from outbreaks like Ebola.
Mount Sinai would share protective supplies among its eight hospitals as needed, McGreevy said.
Cuomo has said that the peak of the pandemic could come in late April. But doctors are quickly realizing their systems are already stressed.
Some doctors and nurses have already been infected with Covid-19, and most won’t have much recovery time.
On Wednesday, some healthcare workers received an email with new state guidance: they could return to work after 72 hours with no fever, while wearing a mask until two weeks had passed since the first symptoms.
The changing rules reflect a growing reality: staffing is already strained and getting tighter as workers fall ill. One doctor described getting a test and seeing two coworkers in the waiting room.
Hope for Peak
And the nature of the virus means that many staff, either immune-compromised themselves, or those with family who are, are wary of working in emergency medical wards or other high-risk environments.
“On one hand, you took the Hippocratic oath,” one doctor said. “But none of us signed up for a global pandemic that’s a minor cough in some and deadly in others.
For now, workers are bracing for the long haul.
“Every single night I go to bed and say I hope it’s peaked,” Holy Name’s Jarrett said. “If it peaks in the next three to four weeks, health care in New York City and New Jersey is going to be a real problem.”
©2020 Bloomberg L.P.