Healthcare workers across New York City are bracing for a surge in COVID-19 patients who need hospital care. But they are already seeing shortages of supplies and staff as their colleagues test positive for the virus, and while patients displaying flu-like symptoms continue to crowd emergency rooms.
“Everything is being rationed,” said one nurse in a Queens hospital whose floor was just converted to the first COVID-19 floor, and is now full with two dozen patients.
“We went from donning and doffing gowns, only in the patient room, to being told we can wear the same gown in two positive-Corona patients rooms,” said the nurse, who like many we spoke to asked us to withhold their names because they are not authorized to speak to the press. “Supplies are running short. N95s are running short, those are being rationed.”
The nurse said they may add more beds in the ward she works and two more floors in the hospital will be converted in the coming days. Patients who need critical or intensive care are whisked away to intensive care at different parts of the hospital, while “they had 100 people down in the emergency room needing to come up” to her floor, the nurse said.
Another nurse practitioner at a private hospital in Manhattan said about a dozen doctors and nurses had tested positive for the virus and were recovering at home.
“It was the first big day, more patients coming in with these symptoms,” the nurse said. “It escalates quickly, rapid breathing and the next thing you know they’re blue,” she said of her shift on Monday. “It’s starting.”
She also described patients who had come in for other issues suddenly developing symptoms of COVID-19, which had led the hospital to restrict its visitor policy.
“There are some nurses that are really scared, the ones with children at home,” she said. “My kids were crying this morning when I left, ‘Are you gonna catch the virus.’ I said that I don’t think so. There are ways to stay safe and I’m gonna do my best.”
Another nurse at NYU-Langone in Manhattan described similar circumstances, and said that one 16-bed ICU unit filled up with COVID-19 patients in a matter of days.
“You hear a lot about old people—oh, it’s only old people,” the nurse said. “There was a 20-year-old, no medical history coming in with a 103 fever and rash and an x-ray of his lungs that looks similar to a 60-year-old’s. This is really happening."
According to the NYU nurse, a non-medical employee who circulates throughout the hospital and comes in contact with patients and staff recently contracted COVID-19.
“This person was seeing other patients, and now they are in the ICU.”
As of Tuesday there are now 1,300 confirmed cases of the virus in New York, a rise of 432 overnight. In New York City, the number of positive cases surged to 644, an increase of 187. Two-hundred-and-sixty-four people, or 19 percent of confirmed cases are currently.
Judy Sheridan-Gonzalez is the President of the 40,000 member New York State Nurses Association and is an Emergency Room RN in Montefiore Hospital. The union’s members at different hospitals have been given different guidance on how to protect themselves, that’s shifted with access to personal protective gear, she said.
“For us in particular at risk, if we get ill, if we die, who’s going to take care of the people who get sick,” she said. The Centers for Disease Control and Prevention has been shifting its guidance on how health care workers should protect themselves as circumstances change, she said.
“Now because of the shortage the CDC said, ‘Well there’s a shortage so I think you could probably use regular masks, it’s usually not transmitted airborne, we’re not sure. Well, if you say, ‘This is the science, and now you say there’s scarcity so the science goes out the window, that’s just not acceptable to us.”
The NYU nurse said that each staffer is given a paper bag with an N95 mask and a pair of goggles to use during an entire 12-hour shift.
“What’s going on now is a stretching of the imagination,” the nurse said. “This is scary. These are ICU-trained, battle-hardened nurses who are scared as hell to get these patients because [the virus] is so new. And you can tell that hospital administration is just as worried.”
A nurse with over 10 years of experience at NYU Hospital in Brooklyn agreed.
“We don’t know right now if we’re wearing these for effect or for show,” the nurse said of the masks.
“It’s very dispiriting for us to be looking at images all the time of people in a full monkey suit and a mask to take somebody’s temperature in a car,” the nurse said of drive-through testing facilities. “And we are out here potentially surrounded by it, reusing an N95 mask in a way that has not been verified to be safe.”
The state Health Department didn’t immediately return a request for comment.
"We provide daily updates on supplies and other matters related to preparedness to the appropriate regulatory agencies, such as the State DOH," said Jim Mandler, a spokesperson for NYU-Langone.
Councilman Mark Levine, who chairs the city council’s Health Committee, is calling for the state to loosen rules that require healthcare workers who have suspected exposure to self-quarantine.
“We’re calling for healthy medical professionals to be able to return back to work even if they have a suspected exposure, at this point all of us should be presumed to have a suspected exposure, and we all should be taking the same precautions, ” Levine said. “Medical professionals need to come back to work, take their temperature, if they don’t have a fever, put on a mask and get down to business.”
Levine also said he’s been hearing from hospitals about limited supplies of “ventitalors, masks, face shields, surgical gloves, protective gowns.”
“All of them acknowledge they’re gonna run out,” he said.
Levine and others, including Governor Andrew Cuomo and New York City Mayor Bill de Blasio, have been calling for the federal government to release its stockpile of protective gear and other supplies as well as mandate manufacturers to switch production to critical supplies. President Trump reportedly told state governors on a call Monday morning to “try getting it yourselves.”
According to projections released by Governor Cuomo’s office Tuesday, the state has 53,000 hospital beds and 3,000 intensive care beds. The city and state have a finite quantity of ventilators, some estimates suggest the state has fewer than 3,000 unused ventilators, according to a 2015 New York State report, which are critical for caring for severe patients.
With a 15 to 19 percent hospitalization rate, New York hospitals may need as many as 110,000 hospital beds and anywhere from 18,600 to 37,200 intensive care beds. That number is expected to peak 45 days from now, mid-April, according to the state’s projections. Meanwhile officials are racing to build out new hospital wards. Mayor de Blasio outlined a plan to add 8,200 additional hospital beds in underused hospital facilities and at existing hospitals now that elective surgeries have been canceled.
A urologist whose surgeries have been canceled described seeing a totally empty operating room in his hospital, which he described as an eerie, “calm before the storm.”
“The other concern to me is the shortage of doctors who know the ventilator settings,” he said. “If it comes to it, I’ll go to the ICU and do whatever they ask me to do…[but] you can’t just train to be an ICU doctor within a week or two.”
Widespread school, library and business closures are an effort to “flatten the curve,” or slow the spread of the virus, to reduce the number of patients who need critical care at the same time. But one of the nurse practitioners feared the general public still didn’t understand the severity of what was coming.
“I’m not feeling as much fear for myself as I’m feeling frustration with the wider community that is not getting it,” she said. “We’ve seen the warning signs, from other countries, we’ve seen the collapse of other healthcare systems. Some people are not taking this seriously enough..[and] we’re putting ourselves on the line.”
The nurse at NYU in Brooklyn said they are wondering “how to maintain morale and our numbers through this.”
“In terms of the lack of response on the part of the federal government, it’s occurring to us that it’s a particularly bad place and time to be on the front lines.”
They added, “We need to get a sense from the public we serve that they also have our backs.”