'One Hospital’s Last Resort to Protect Doctors: Yankee Rain Ponchos' diff viewer (5/6)

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One Hospital’s Last Resort to Protect Doctors: Yankee Rain Ponchos	One Hospital’s Last Resort to Protect Doctors: Yankee Rain Ponchos
2020-06-09 23:50:40 UTC	2020-06-13 05:40:50 UTC (3 days later)
When a doctor at one of New York City’s top hospitals arrived for work on Tuesday night, she found the following items in the bag of protective equipment that she received: a mask, an eye shield — and, in place of the usual medical gown, a plastic white-and-navy New York Yankees poncho, the kind available for purchase on rainy game days.	When a doctor at one of New York City’s top hospitals arrived for work on Tuesday night, she found the following items in the bag of protective equipment that she received: a mask, an eye shield — and, in place of the usual medical gown, a plastic white-and-navy New York Yankees poncho, the kind available for purchase on rainy game days.
Outraged, the doctor, an obstetrician-gynecologist resident at the hospital, part of Montefiore Medical Center in the Bronx, took a picture of the poncho and posted it on Twitter. “I’m a physician at a hospital in NYC and THIS IS THE ‘PPE’ I WAS JUST HANDED for my shift,” she wrote, using the acronym for “personal protective equipment.”	Outraged, the doctor, an obstetrician-gynecologist resident at the hospital, part of Montefiore Medical Center in the Bronx, took a picture of the poncho and posted it on Twitter. “I’m a physician at a hospital in NYC and THIS IS THE ‘PPE’ I WAS JUST HANDED for my shift,” she wrote, using the acronym for “personal protective equipment.”
The post was retweeted tens of thousands of times, emerging as a viral illustration of the equipment shortages that have plagued hospitals during the coronavirus pandemic.	The post was retweeted tens of thousands of times, emerging as a viral illustration of the equipment shortages that have plagued hospitals during the coronavirus pandemic.
From Seattle to Miami, but especially in New York City, the epicenter of the coronavirus crisis in the United States, workers have said they do not have enough gear to protect themselves from the virus as they treat patients. Doctors and nurses have had to reuse equipment or use trash bags and scarves for protection.	From Seattle to Miami, but especially in New York City, the epicenter of the coronavirus crisis in the United States, workers have said they do not have enough gear to protect themselves from the virus as they treat patients. Doctors and nurses have had to reuse equipment or use trash bags and scarves for protection.
In a statement, Montefiore Medical Center said the ponchos were not intended as protective gear but instead were a gift to weary staffers.	In a statement, Montefiore Medical Center said the ponchos were not intended as protective gear but instead were a gift to weary staffers.
“We received a very generous donation of 2,500 ponchos from our Bronx neighbors and friends The New York Yankees,” said the statement, issued on Wednesday evening. “We distributed them, first come first served, to the first 2,500 of our staff who walked in the door last night and this morning. This was a gift intended for their personal use.”	“We received a very generous donation of 2,500 ponchos from our Bronx neighbors and friends The New York Yankees,” said the statement, issued on Wednesday evening. “We distributed them, first come first served, to the first 2,500 of our staff who walked in the door last night and this morning. This was a gift intended for their personal use.”
The obstetrician-gynecologist resident who first tweeted about the ponchos under the Twitter handle @racheljulie declined to comment, saying Montefiore had not authorized her to speak to the media.	The obstetrician-gynecologist resident who first tweeted about the ponchos under the Twitter handle @racheljulie declined to comment, saying Montefiore had not authorized her to speak to the media.
The Yankees also declined to comment. But a team executive, speaking on condition of anonymity, said someone at the hospital contacted the team recently, asking specifically for ponchos. The club donated thousands, the executive said.	The Yankees also declined to comment. But a team executive, speaking on condition of anonymity, said someone at the hospital contacted the team recently, asking specifically for ponchos. The club donated thousands, the executive said.
And four other hospital employees, who spoke on the condition of anonymity for fear of retribution, said they had received bags containing ponchos and were told to use the items in the bags as protective equipment. All said they refused to wear the ponchos and instead reused old gowns or dipped into the hospital’s dwindling emergency supplies.	And four other hospital employees, who spoke on the condition of anonymity for fear of retribution, said they had received bags containing ponchos and were told to use the items in the bags as protective equipment. All said they refused to wear the ponchos and instead reused old gowns or dipped into the hospital’s dwindling emergency supplies.
“If it was a gift, it was a terrible gift,” one added.	“If it was a gift, it was a terrible gift,” one added.
The episode has inflamed a major health system that has been besieged by the coronavirus. As of Thursday, more than 375 Montefiore employees, out of a total work force of about 17,000, had tested positive for the virus, according to an internal email obtained by The New York Times.	The episode has inflamed a major health system that has been besieged by the coronavirus. As of Thursday, more than 375 Montefiore employees, out of a total work force of about 17,000, had tested positive for the virus, according to an internal email obtained by The New York Times.
A respected neurosurgeon at the hospital died of complications related to the virus this week.	A respected neurosurgeon at the hospital died of complications related to the virus this week.
The Bronx has been among the hardest-hit parts of New York City, with more than 8,600 cases — 584 cases for every 100,000 residents, a higher rate than any borough other than Queens, according to city data. The Bronx had the highest percentage of cases resulting in hospitalizations.	The Bronx has been among the hardest-hit parts of New York City, with more than 8,600 cases — 584 cases for every 100,000 residents, a higher rate than any borough other than Queens, according to city data. The Bronx had the highest percentage of cases resulting in hospitalizations.
Overall, New York had more than 45,000 confirmed coronavirus cases and 1,374 deaths as of Wednesday night, making it by far the most affected city in the United States.	Overall, New York had more than 45,000 confirmed coronavirus cases and 1,374 deaths as of Wednesday night, making it by far the most affected city in the United States.
At Montefiore, a network of 11 hospitals and the Albert Einstein College of Medicine, many employees have been complaining about shortages in protective equipment for weeks.	At Montefiore, a network of 11 hospitals and the Albert Einstein College of Medicine, many employees have been complaining about shortages in protective equipment for weeks.
Early in the pandemic, tensions over protective equipment came to a head when a fistfight broke out among workers and visitors at one of the Montefiore hospitals over access to masks, several Montefiore staffers said. After that incident, administrators locked up masks and other gear across the system and began rationing them.	Early in the pandemic, tensions over protective equipment came to a head when a fistfight broke out among workers and visitors at one of the Montefiore hospitals over access to masks, several Montefiore staffers said. After that incident, administrators locked up masks and other gear across the system and began rationing them.
At first, Montefiore barred workers from using full protective gear except around patients who had tested positive for the virus or had a pending test, according to the staffers. Later, it said workers should wear heavy-duty N95 masks only when performing major procedures.	At first, Montefiore barred workers from using full protective gear except around patients who had tested positive for the virus or had a pending test, according to the staffers. Later, it said workers should wear heavy-duty N95 masks only when performing major procedures.
On March 25, the system started ordering doctors and nurses to wear the same N95 masks for up to three days at a time, according to an email obtained by The Times. That plan called for masks to be distributed on Mondays and Thursdays and reused in between.	On March 25, the system started ordering doctors and nurses to wear the same N95 masks for up to three days at a time, according to an email obtained by The Times. That plan called for masks to be distributed on Mondays and Thursdays and reused in between.
~~Updated June 5, 2020~~	Updated June 12, 2020
	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.
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.	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.
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.	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.	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.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
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.
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.	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.
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 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.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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.	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.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Then this week came the new distribution process, the paper bags and the ponchos.	Then this week came the new distribution process, the paper bags and the ponchos.
On Tuesday and Wednesday, all employees entering the Montefiore main campus in the Bronx had to submit to a temperature check when they entered the front door and then were given the bag of protective equipment.	On Tuesday and Wednesday, all employees entering the Montefiore main campus in the Bronx had to submit to a temperature check when they entered the front door and then were given the bag of protective equipment.
An online editorial in the Journal of American Medicine last month listed rain ponchos and “bedbug sheet material” as potential replacements for gowns in a crisis. But some experts have said ponchos would be a poor substitute, in part because they are thinner and flimsier than conventional protective gowns.	An online editorial in the Journal of American Medicine last month listed rain ponchos and “bedbug sheet material” as potential replacements for gowns in a crisis. But some experts have said ponchos would be a poor substitute, in part because they are thinner and flimsier than conventional protective gowns.
In interviews, Montefiore employees noted that the Yankees ponchos do not even cover the arms and have no openings in the back to allow for removal without contamination.	In interviews, Montefiore employees noted that the Yankees ponchos do not even cover the arms and have no openings in the back to allow for removal without contamination.
Several employees said they do not think their bosses are taking their concerns seriously.	Several employees said they do not think their bosses are taking their concerns seriously.