March 27, 2020

'It's apocalyptic': What it's like inside NYC hospitals as COVID-19 surges

Daily Briefing

    As New York becomes the epicenter of the new coronavirus epidemic, hospitals in densely populated New York City are increasing capacity as a wave of COVID-19 patients overwhelms hospital EDs and ICUs.

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    NYC hospitals fill up with sick, worried COVID-19 patients

    Medical workers in New York City said they first started seeing signs of the virus in patients in the beginning of March, when there was an influx of patients coming in with mild flu-like symptoms, the New York Times reports. But in recent weeks, more cases of COVID-19 have been diagnosed, and EDs throughout New York City have started to fill up with sick and worried patients.

    As of Friday morning, New York City had 22,747 active cases and had seen 365 deaths. Overall, the United States has seen nearly 86,012 cases of COVID-19.

    Elmhurst Hospital Center in Queens has become one of the hardest-hit facilities in New York City, the Times reports. At some points the hospital has had more than 200 patients in the ED, and within one 24-hour period, 13 people died of the virus, according to the city's public hospital system.

    Ashley Bray, a general medicine resident at Elmhurst said, "It's apocalyptic."

    Brooklyn Hospital Center has seen more than 800 potential COVID-19 cases over the last few weeks, and more than 40% of its inpatients and two thirds of critical care patients either tested positive for or are suspected to have the disease, the Times reports.

    And the patients hospitals are seeing are only getting sicker, according to medical staff. Now that patients are advised to stay home until their symptoms worsen, a lot of patients are coming in with life-threatening symptoms, according to Jolion McGreevy, medical director of Mount Sinai Hospital's ED.   

    Providers prepare for equipment, supply shortages

    As a wave of critically ill patients continues to descend upon the EDs, hospitals and state and local government are worried about capacity and the dwindling supply of ventilators. According to the Federal Emergency Management Agency, all of the more than 1,800 intensive care beds in New York City are expected to be full by Friday.

    Hospitals across the state are canceling elective surgeries, working with state and federal officials to expand treatment areas, and deploying medical staff into new roles to accommodate new patients with the disease, the Times reports.

    Elmhurst, which has 545 beds, has started transferring non-COVID-19 patients to other hospitals so it can transform other areas of the hospital into ICUs for patients with the virus, according to Mitchell Katz, the head of the New York City Health and Hospitals Corporation, which runs New York City's public hospitals. The city's public hospital system in a statement said it is working to send "supplies and personnel" so the facility can "keep pace with the crisis."

    Brooklyn Hospital Center, which can treat up to 464 patients at a time, typically has enough medical staff and beds to treat 250 to 300 people, but the state requested it increase that capacity by 50%, the Times reports.

    Other hospitals, such as the Jacobi Medical Center in the Bronx, are bringing in other medical staff like OB-GYNs and radiologists to work in the ED to help boost staffing, the Times reports.

    Meanwhile, health care workers are becoming increasingly anxious, especially as protective gear runs low.

    "You're on 100% of the time—no matter what," McGreevy said. "It's been a month of full force, and that's certainly very stressful."

    Eric Cioe-Pena, director of global health at Northwell Health, said getting sick is "definitely on the mind of every health care worker in America," especially as the hospitals become overrun with COVID-19 patients.

    One of the medical professionals' biggest concerns is that they will eventually have to decide which patients get access to life-saving equipment like ventilators and which will not, according to Joseph Habboushe, an ED physician at NYU Langone Medical Center.

    "It's one of those things you learn about. It's hard to imagine you actually would face that," he said. "And now we're all realizing there's a really high chance we'll be facing that, and that breaks my heart."

    For now, medical staff are pushing through to treat all patients. "Of course they have anxiety, of course they have fear, they're human," said Sylvie de Souza, chair of the ED at Brooklyn Medical Center. "None of us knows where this is taking us. We don't even know if we might get sick. But none of them so far has defaulted on their duty, their calling" (Sisak, et al., Associated Press, 3/25; Rothfeld, et al., New York Times, 3/25; Fink, New York Times, 3/26; Johns Hopkins tracker, accessed 3/27).

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