Coronavirus Cases Strain New York City Hospitals: ‘We’re Getting Pounded’
Swiftly rising number of patients, sooner than expected, leads to supply shortages and concern about what is to come
New York City hospitals are already straining under the onslaught of novel coronavirus cases, even as state officials say the real peak of the outbreak is nearly a month and a half away.
Doctors at the largest public hospital in New York say equipment shortages have resulted in them wearing the same masks for as long as a week. Emergency-room physicians at another hospital are having to reuse gowns. Some large hospitals already have exceeded the capacity of their intensive-care units.
At least one city hospital, faced with dwindling supply of ventilators amid the surge of coronavirus patients, had to seek more from a sister hospital.
“We’re getting pounded,” said Mangala Narasimhan, a doctor at the Long Island Jewish Medical Center, part of Northwell Health, the largest hospital system in New York. “I’ve been in ICU care for 15 years, and this is the worst I have ever seen things.”
Hospitals expect the problems to mount. Earlier this week, Gov. Andrew Cuomo said the outbreak is expected to peak in 45 days, and by then the state would need tens of thousands of more beds. On Friday, the governor ordered all nonessential workers in the state to stay at home.
In recent days, the number of confirmed cases in New York City more than doubled to 4,408 as a blitz of testing began to reveal the rapid march of the disease, officials said. New York City alone now makes up 42% of total U.S. confirmed cases. Across the entire state, there have been 7,102 total cases and 35 deaths, making up a quarter of nationwide deaths from the illness.
With the onslaught has come a surprise for many health-care workers: Far more young people than they expected are falling very ill. According to data published Friday morning by the New York City Department of Health and Mental Hygiene, 56% of confirmed cases of coronavirus in the city at the time involved patients under the age of 50.
At the Long Island Jewish Medical Center in Queens, several coronavirus patients under 40, including a few in their 20s, were on ventilators in the intensive-care unit as of Thursday. All were healthy before getting the virus, said Dr. Narasimhan.
The Wall Street Journal talked to about 20 medical workers on the front lines of the outbreak at New York area hospitals.
About 90% of Long Island Jewish Medical Center beds were full Thursday after Northwell Health hospitals in recent days sent home about 2,500 patients scheduled for release and canceled elective procedures, said Terry Lynam, a Northwell Health spokesman.
Still the hospital is adding ICU beds, Mr. Lynam said. About half of the hospital’s intensive-care patients have been diagnosed with Covid-19.
Coronavirus cases across Northwell Health’s 23 hospitals have soared in recent days to 250, from around 50, but many were already hospitalized patients who finally received test results, he said.
The swiftness in which patients turn from mildly sick to struggling to breathe and requiring a ventilator is shocking, health-care workers said. “Things have gotten really bad this past week,” one Manhattan nurse said. “We’re all on edge.”
New York officials say the state could need as many as 110,000 hospital beds and 37,000 intensive-care beds for virus-related illnesses as they peak. The state currently has 53,000 hospital beds and 3,000 intensive-care beds, many of them occupied by people with other illnesses.
A doctor at Maimonides Medical Center in Brooklyn said the hospital had no more isolation space for coronavirus patients and was moving less-sick patients to other wings.
“Beds are needed desperately,” read a memo sent to NewYork-Presbyterian Queens nurses on Thursday. “I need you to ACTIVELY participate in the Discharge planning for your patients.”
Saquib Rahim, a doctor working at the Queens hospital, said the number of potential or confirmed cases has surged in the past week, and it is all hands on deck at the hospital. One elderly patient with Covid-19 symptoms died on the floor of the hospital ward.
“We’ve never seen anything like this,” Dr. Rahim said. “We’re praying that somehow we’ll be able to stem the tide.”
A spokeswoman for the NewYork-Presbyterian system declined to comment.
Risks that hospitals will be overwhelmed are higher in places like New York and Seattle, where outbreaks emerged before sweeping closures of businesses, schools and other public places to slow the contagion, said James Lawler, executive director of the Global Center for Health Security at the University of Nebraska Medical Center. New York further delayed some action, which may have left the city more vulnerable, he added. “You never catch up if you take that approach.”
New York City closed its schools Monday after days of pressure.
At Bellevue, the city’s largest public hospital, doctors have been told by supervisors to anticipate as many as a dozen coronavirus-related intubations a day, which is at least five times the amount on a normal day, a Bellevue doctor said. If the current trend continues, “it is totally unsustainable,” the doctor said.
Another health-care worker at Bellevue said hospital engineers are looking at 88 spaces across the hospital that can be turned into ICU rooms.
Meanwhile, the hospital has seen an uptick in employees getting sick. In one department alone at Bellevue, four doctors tested positive for the virus in recent days, while several others are awaiting results, the doctor said. Doctors at various hospitals said they were worried that staff will start to spread the virus, especially without enough tests to consistently check workers.
Public hospitals such as Bellevue and Elmhurst “have what they need to take care of people,” including ventilators and protective equipment, said Mitchell Katz, president and chief executive of NYC Health + Hospitals, which operates the two hospitals.
NYC Health + Hospitals is moving supplies to hospitals in need, including routing ventilators from a Queens hospital to Elmhurst, Dr. Katz said.
In a letter to Gov. Cuomo on Thursday, the New York State Nurses Association said it was “painfully obvious” that their 42,000 members on the front lines don’t have the gear to protect themselves against the virus.
It warned that “hospitals will cease to function” if workers are exposed, according to a copy of the letter viewed by the Journal.
The Manhattan nurse, speaking through tears, raised worries about new Centers for Disease Control and Prevention guidelines that said health-care workers should use a bandanna if masks aren’t available. Weeks ago, the hospital emergency department was quiet. “All of a sudden, the switch got flipped.”
Doctors at Tisch Hospital, part of NYU Langone Health, are reusing masks and gowns, which they tape to the wall in paper bags with their names on them when they aren’t in use, one doctor said.
“These are not normal times,” said Michael Phillips, the chief epidemiologist at NYU Langone, which asks employees to follow the Centers for Disease Control and Prevention guidelines for how to reuse masks. The move will prolong dwindling supplies.
Queens-based Long Island Jewish Medical Center has gone into “surge capacity,” or overflow, as its ICU has filled up, Dr. Narasimhan said. She is seeing three times the number of patients in the ICU today than during a “high” peak flu season, with a significant number of those patients under the age of 60.
“I’ve seen more cases in the last 10 days of severe respiratory illness than we’ve seen in years,” she said. “I’m very worried.”