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Nurses Die, Doctors Fall Sick and Panic Rises on Virus Front Lines Nurses Die, Doctors Fall Sick and Panic Rises on Virus Front Lines
(32 minutes later)
A supervisor urged surgeons at Columbia University Irving Medical Center in Manhattan to volunteer for the front lines because half the intensive-care staff had already been sickened by coronavirus.A supervisor urged surgeons at Columbia University Irving Medical Center in Manhattan to volunteer for the front lines because half the intensive-care staff had already been sickened by coronavirus.
“ICU is EXPLODING,” she wrote in an email.“ICU is EXPLODING,” she wrote in an email.
A doctor at Weill Cornell Medical Center in Manhattan described the unnerving experience of walking daily past an intubated, critically ill colleague in her 30s, wondering who would be next.A doctor at Weill Cornell Medical Center in Manhattan described the unnerving experience of walking daily past an intubated, critically ill colleague in her 30s, wondering who would be next.
Another doctor at a major New York City hospital described it as “a petri dish,” where more than 200 workers had fallen sick.Another doctor at a major New York City hospital described it as “a petri dish,” where more than 200 workers had fallen sick.
Two nurses in city hospitals have died.Two nurses in city hospitals have died.
The coronavirus pandemic, which has infected more than 30,000 people in New York City, is beginning to take a toll on those who are most needed to combat it: the doctors, nurses and other workers at hospitals and clinics. In emergency rooms and intensive care units, typically dispassionate medical professionals are feeling panicked as increasing numbers of colleagues get sick.The coronavirus pandemic, which has infected more than 30,000 people in New York City, is beginning to take a toll on those who are most needed to combat it: the doctors, nurses and other workers at hospitals and clinics. In emergency rooms and intensive care units, typically dispassionate medical professionals are feeling panicked as increasing numbers of colleagues get sick.
“I feel like we’re all just being sent to slaughter,” said Thomas Riley, a nurse at Jacobi Medical Center in the Bronx, who has contracted the virus, along with his husband.“I feel like we’re all just being sent to slaughter,” said Thomas Riley, a nurse at Jacobi Medical Center in the Bronx, who has contracted the virus, along with his husband.
Medical workers are still showing up day after day to face overflowing emergency rooms, earning them praise as heroes. Thousands of volunteers have signed up to join their colleagues.Medical workers are still showing up day after day to face overflowing emergency rooms, earning them praise as heroes. Thousands of volunteers have signed up to join their colleagues.
But doctors and nurses said they can look overseas for a dark glimpse of the risk they are facing, especially when protective gear has been in short supply.But doctors and nurses said they can look overseas for a dark glimpse of the risk they are facing, especially when protective gear has been in short supply.
In China, more than 3,000 doctors were infected, nearly half of them in Wuhan, where the pandemic began, according to Chinese government statistics. Li Wenliang, the Chinese doctor who first tried to raise the alarm about Covid-19, eventually died of it.In China, more than 3,000 doctors were infected, nearly half of them in Wuhan, where the pandemic began, according to Chinese government statistics. Li Wenliang, the Chinese doctor who first tried to raise the alarm about Covid-19, eventually died of it.
In Italy, the number of infected heath care workers is now twice the Chinese total, and the National Federation of Orders of Surgeons and Dentists has compiled a list of 50 who have died. Nearly 14 percent of Spain’s confirmed coronavirus cases are medical professionals.In Italy, the number of infected heath care workers is now twice the Chinese total, and the National Federation of Orders of Surgeons and Dentists has compiled a list of 50 who have died. Nearly 14 percent of Spain’s confirmed coronavirus cases are medical professionals.
New York City’s health care system is sprawling and disjointed, making precise infection rates among medical workers difficult to calculate. A spokesman for the Health and Hospitals Corporation, which runs New York City’s public hospitals, said the agency would not share data about sick medical workers “at this time.”New York City’s health care system is sprawling and disjointed, making precise infection rates among medical workers difficult to calculate. A spokesman for the Health and Hospitals Corporation, which runs New York City’s public hospitals, said the agency would not share data about sick medical workers “at this time.”
William P. Jaquis, president of the American College of Emergency Physicians, said the situation across the country was too fluid to begin tracking such data, but he said he expected the danger to intensify.William P. Jaquis, president of the American College of Emergency Physicians, said the situation across the country was too fluid to begin tracking such data, but he said he expected the danger to intensify.
“Doctors are getting sick everywhere,” he said.“Doctors are getting sick everywhere,” he said.
Last week, two nurses in New York, including Kious Kelly, a 48-year-old assistant nurse manager at Mount Sinai West, died from the disease; they are believed to be the first known victims among the city’s medical workers. Health care workers across the city said they feared many more would follow.Last week, two nurses in New York, including Kious Kelly, a 48-year-old assistant nurse manager at Mount Sinai West, died from the disease; they are believed to be the first known victims among the city’s medical workers. Health care workers across the city said they feared many more would follow.
Mr. Riley, the nurse at Jacobi, said when he looked at the emergency room recently, he realized he and his colleagues would never avoid being infected. Patients struggling to breathe with lungs that sounded like sandpaper had crowded the hospital. Masks and protective gowns were in short supply.Mr. Riley, the nurse at Jacobi, said when he looked at the emergency room recently, he realized he and his colleagues would never avoid being infected. Patients struggling to breathe with lungs that sounded like sandpaper had crowded the hospital. Masks and protective gowns were in short supply.
“I’m swimming in this,” he said he thought. “I’m pretty sure I’m getting this.”“I’m swimming in this,” he said he thought. “I’m pretty sure I’m getting this.”
His symptoms began with a cough, then a fever, then nausea and diarrhea. Days later, his husband became ill. Mr. Riley said both he and his husband appear to be getting better, but are still experiencing symptoms.His symptoms began with a cough, then a fever, then nausea and diarrhea. Days later, his husband became ill. Mr. Riley said both he and his husband appear to be getting better, but are still experiencing symptoms.
Like generals steadying their troops before battle, hospital supervisors in New York have had to rally, cajole and sometimes threaten workers.Like generals steadying their troops before battle, hospital supervisors in New York have had to rally, cajole and sometimes threaten workers.
“Our health care systems are at war with a pandemic virus,” Craig R. Smith, the surgeon-in-chief at NewYork-Presbyterian Hospital, wrote in an email to staff on March 16, the day after New York City shut down its school system to contain the virus. “You are expected to keep fighting with whatever weapons you’re capable of working.”“Our health care systems are at war with a pandemic virus,” Craig R. Smith, the surgeon-in-chief at NewYork-Presbyterian Hospital, wrote in an email to staff on March 16, the day after New York City shut down its school system to contain the virus. “You are expected to keep fighting with whatever weapons you’re capable of working.”
“Sick is relative,” he wrote, adding that workers would not even be tested for the virus unless they were “unequivocally exposed and symptomatic to the point of needing admission to the hospital.”“Sick is relative,” he wrote, adding that workers would not even be tested for the virus unless they were “unequivocally exposed and symptomatic to the point of needing admission to the hospital.”
“That means you come to work,” he wrote. “Period.”“That means you come to work,” he wrote. “Period.”
Arriving to work each day, doctors and nurses are met with confusion and chaos.Arriving to work each day, doctors and nurses are met with confusion and chaos.
At a branch of the Montefiore hospital system in the Bronx, nurses wear their winter coats in an unheated tent set up to triage patients with symptoms, while at Elmhurst Hospital Center in Queens, patients are sometimes dying before they can be moved into beds.At a branch of the Montefiore hospital system in the Bronx, nurses wear their winter coats in an unheated tent set up to triage patients with symptoms, while at Elmhurst Hospital Center in Queens, patients are sometimes dying before they can be moved into beds.
The inviolable rules that once gave a sense of rhythm and harmony to even the busiest emergency rooms have in some cases been cast aside. Few things have caused more anxiety than shifting protocols meant to preserve a dwindling supply of protective gear.The inviolable rules that once gave a sense of rhythm and harmony to even the busiest emergency rooms have in some cases been cast aside. Few things have caused more anxiety than shifting protocols meant to preserve a dwindling supply of protective gear.
When the pandemic first hit New York, medical workers changed gowns and masks each time they visited an infected patient. Then, they were told to keep their protective gear on until the end of their shift. As supplies became even more scarce, one doctor working on an intensive care unit said he was asked to turn in his mask and face shield at the end of his shift to be sterilized for future use. Others are being told to store their masks in a paper bag between shifts.When the pandemic first hit New York, medical workers changed gowns and masks each time they visited an infected patient. Then, they were told to keep their protective gear on until the end of their shift. As supplies became even more scarce, one doctor working on an intensive care unit said he was asked to turn in his mask and face shield at the end of his shift to be sterilized for future use. Others are being told to store their masks in a paper bag between shifts.
“It puts us in danger, it puts our patients in danger. I can’t believe in the United States that’s what’s happening,” said Kelley Cabrera, an emergency room nurse at Jacobi Medical Center.“It puts us in danger, it puts our patients in danger. I can’t believe in the United States that’s what’s happening,” said Kelley Cabrera, an emergency room nurse at Jacobi Medical Center.
An emergency room doctor at Long Island Jewish Medical Center put it more bluntly: “It’s literally, wash your hands a lot, cross your fingers, pray.”An emergency room doctor at Long Island Jewish Medical Center put it more bluntly: “It’s literally, wash your hands a lot, cross your fingers, pray.”
Doctors and nurses fear they could be transmitting the virus to their patients, compounding the crisis by transforming hospitals into incubators for the virus. That has happened in Italy, in part because infected doctors struggle through their shifts, according to an article published by physicians at a hospital in Bergamo, a city in one of the hardest-hit regions.Doctors and nurses fear they could be transmitting the virus to their patients, compounding the crisis by transforming hospitals into incubators for the virus. That has happened in Italy, in part because infected doctors struggle through their shifts, according to an article published by physicians at a hospital in Bergamo, a city in one of the hardest-hit regions.
Frontline hospital workers in New York are now required to take their temperature every 12 hours, though many doctors and nurses fear they could contract the disease and spread it to patients before they become symptomatic.Frontline hospital workers in New York are now required to take their temperature every 12 hours, though many doctors and nurses fear they could contract the disease and spread it to patients before they become symptomatic.
Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
They also say it is a challenge to know when to come back to work after being sick. All medical workers who show symptoms, even if they are not tested, must quarantine for at least seven days and must be asymptomatic for three days before coming back to work.They also say it is a challenge to know when to come back to work after being sick. All medical workers who show symptoms, even if they are not tested, must quarantine for at least seven days and must be asymptomatic for three days before coming back to work.
But some employers have been more demanding than others, workers said.But some employers have been more demanding than others, workers said.
Lillian Udell, a nurse at Lincoln Medical Center, another public hospital in the Bronx, said she was still weak and experiencing symptoms when she was pressured to return to work. She powered through a long shift that was so chaotic she could not remember how many patients she attended. By the time she returned home, the chills and the cough had returned.Lillian Udell, a nurse at Lincoln Medical Center, another public hospital in the Bronx, said she was still weak and experiencing symptoms when she was pressured to return to work. She powered through a long shift that was so chaotic she could not remember how many patients she attended. By the time she returned home, the chills and the cough had returned.
“I knew it was still in me,” she said. “I knew I wasn’t myself.”“I knew it was still in me,” she said. “I knew I wasn’t myself.”
Christopher Miller, a spokesman for the Health and Hospitals Corporation, said the agency could not comment on Ms. Udell’s claim, but said its hospitals had “never asked health care workers who are sick and have symptoms of Covid-19 to continue to work or to come back to work.”Christopher Miller, a spokesman for the Health and Hospitals Corporation, said the agency could not comment on Ms. Udell’s claim, but said its hospitals had “never asked health care workers who are sick and have symptoms of Covid-19 to continue to work or to come back to work.”
There is also the fear of bringing the disease home to spouses and children. Some medical workers said they were sleeping in different rooms from their partners and even wearing surgical masks at home. Others have chosen to isolate themselves from their families completely, sending spouses and children to live outside the city, or moving into hotels.There is also the fear of bringing the disease home to spouses and children. Some medical workers said they were sleeping in different rooms from their partners and even wearing surgical masks at home. Others have chosen to isolate themselves from their families completely, sending spouses and children to live outside the city, or moving into hotels.
“I come home, I strip naked, put clothes in a bag and put them in the washer and take a shower,” one New York City doctor at a large public hospital said.“I come home, I strip naked, put clothes in a bag and put them in the washer and take a shower,” one New York City doctor at a large public hospital said.
Because the pathogen has spread so widely, even medical workers not assigned directly to work with infected patients risk contracting the disease.Because the pathogen has spread so widely, even medical workers not assigned directly to work with infected patients risk contracting the disease.
A gynecologist who works for the Mount Sinai hospital system said she had begun seeing women in labor who were positive for the coronavirus. Because she is not considered a front-line worker, she said, restrictions on protective gear are even more stringent than on Covid-19 units. She said she was not aware of any patients who had tested positive after contact with doctors or nurses, but felt it was only a matter of time.A gynecologist who works for the Mount Sinai hospital system said she had begun seeing women in labor who were positive for the coronavirus. Because she is not considered a front-line worker, she said, restrictions on protective gear are even more stringent than on Covid-19 units. She said she was not aware of any patients who had tested positive after contact with doctors or nurses, but felt it was only a matter of time.
“We’re definitely contaminating pregnant mothers that we’re assessing and possibly discharging home,” said the doctor, who spoke on condition on anonymity because her hospital had not authorized her to speak.“We’re definitely contaminating pregnant mothers that we’re assessing and possibly discharging home,” said the doctor, who spoke on condition on anonymity because her hospital had not authorized her to speak.
Mount Sinai said in a statement that it had faced equipment shortages like other hospitals, but added the issues had been solved in part by a large shipment of masks that arrived from China over the weekend. The hospital “moved mountains” to get the shipment, the statement said.Mount Sinai said in a statement that it had faced equipment shortages like other hospitals, but added the issues had been solved in part by a large shipment of masks that arrived from China over the weekend. The hospital “moved mountains” to get the shipment, the statement said.
This week, the Health and Hospitals Corporation recommended transferring doctors and nurses at higher risk of infection — such as those who are older or with underlying medical conditions — from jobs interacting with patients to more administrative positions.This week, the Health and Hospitals Corporation recommended transferring doctors and nurses at higher risk of infection — such as those who are older or with underlying medical conditions — from jobs interacting with patients to more administrative positions.
But Kimberly Marsh, a nurse at Westchester Medical Center outside New York City, said she has no intention of leaving the fight, even though she is a 53-year-old smoker with multiple sclerosis and on a medication that warns against getting near people with infections.But Kimberly Marsh, a nurse at Westchester Medical Center outside New York City, said she has no intention of leaving the fight, even though she is a 53-year-old smoker with multiple sclerosis and on a medication that warns against getting near people with infections.
“It almost feels selfish,” she said, though she acknowledged that with two years before retirement she could not afford leave if she wanted to.“It almost feels selfish,” she said, though she acknowledged that with two years before retirement she could not afford leave if she wanted to.
Even so, she said, the fear is palpable each time she steps into the emergency room. A nurse on her unit has already contracted the virus and one doctor is so scared he affixes an N95 mask to his face with tape at the beginning of each shift. Ms. Marsh said she sweats profusely in her protective gear because she is going through menopause and suffers from hot flashes.Even so, she said, the fear is palpable each time she steps into the emergency room. A nurse on her unit has already contracted the virus and one doctor is so scared he affixes an N95 mask to his face with tape at the beginning of each shift. Ms. Marsh said she sweats profusely in her protective gear because she is going through menopause and suffers from hot flashes.
“We all think we’re screwed,” she said. “I know without any doubt that I’m going to lose colleagues. There’s just no way around it.”“We all think we’re screwed,” she said. “I know without any doubt that I’m going to lose colleagues. There’s just no way around it.”
Somini Sengupta, Brian M. Rosenthal, Joseph Goldstein, Michael Rothfeld and Jason Horowitz contributed reporting.Somini Sengupta, Brian M. Rosenthal, Joseph Goldstein, Michael Rothfeld and Jason Horowitz contributed reporting.