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The 1,000-Bed Comfort Was Supposed to Aid New York. It Has 20 Patients. The 1,000-Bed Comfort Was Supposed to Aid New York. It Has 20 Patients.
(2 months later)
Such were the expectations for the Navy hospital ship U.S.N.S. Comfort that when it chugged into New York Harbor this week, throngs of people, momentarily forgetting the strictures of social distancing, crammed together along Manhattan’s west side to catch a glimpse.Such were the expectations for the Navy hospital ship U.S.N.S. Comfort that when it chugged into New York Harbor this week, throngs of people, momentarily forgetting the strictures of social distancing, crammed together along Manhattan’s west side to catch a glimpse.
On Thursday, though, the huge white vessel, which officials had promised would bring succor to a city on the brink, sat mostly empty, infuriating executives at local hospitals. The ship’s 1,000 beds are largely unused, its 1,200-member crew mostly idle.On Thursday, though, the huge white vessel, which officials had promised would bring succor to a city on the brink, sat mostly empty, infuriating executives at local hospitals. The ship’s 1,000 beds are largely unused, its 1,200-member crew mostly idle.
Only 20 patients had been transferred to the ship, officials said, even as New York hospitals struggled to find space for the thousands infected with the coronavirus. Another Navy hospital ship, the U.S.N.S. Mercy, docked in Los Angeles, has had a total of 15 patients, officials said.Only 20 patients had been transferred to the ship, officials said, even as New York hospitals struggled to find space for the thousands infected with the coronavirus. Another Navy hospital ship, the U.S.N.S. Mercy, docked in Los Angeles, has had a total of 15 patients, officials said.
“If I’m blunt about it, it’s a joke,” said Michael Dowling, the head of Northwell Health, New York’s largest hospital system. “Everyone can say, ‘Thank you for putting up these wonderful places and opening up these cavernous halls.’ But we’re in a crisis here, we’re in a battlefield.”“If I’m blunt about it, it’s a joke,” said Michael Dowling, the head of Northwell Health, New York’s largest hospital system. “Everyone can say, ‘Thank you for putting up these wonderful places and opening up these cavernous halls.’ But we’re in a crisis here, we’re in a battlefield.”
The Comfort was sent to New York to relieve pressure on city hospitals by treating people with ailments other than Covid-19, the illness caused by the coronavirus.The Comfort was sent to New York to relieve pressure on city hospitals by treating people with ailments other than Covid-19, the illness caused by the coronavirus.
President Trump left a nine-day sequester in the White House last week to travel to Norfolk, Va., to personally see off the ship as it set sail for New York, saying it would play a “critical role.” The ship’s arrival on Monday was cheered as one of the few bright moments in a grim time for the city.President Trump left a nine-day sequester in the White House last week to travel to Norfolk, Va., to personally see off the ship as it set sail for New York, saying it would play a “critical role.” The ship’s arrival on Monday was cheered as one of the few bright moments in a grim time for the city.
But the reality has been different. A tangle of military protocols and bureaucratic hurdles has prevented the Comfort from accepting many patients at all.But the reality has been different. A tangle of military protocols and bureaucratic hurdles has prevented the Comfort from accepting many patients at all.
On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship.On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship.
Ambulances cannot take patients directly to the Comfort; they must first deliver patients to a city hospital for a lengthy evaluation — including a test for the virus — and then pick them up again for transport to the ship.Ambulances cannot take patients directly to the Comfort; they must first deliver patients to a city hospital for a lengthy evaluation — including a test for the virus — and then pick them up again for transport to the ship.
At a morning briefing on Thursday, officials said three patients had been moved to the Comfort. After The New York Times published an article with that number, Elizabeth Baker, a spokeswoman for the Navy, said the number had increased to 20 by late in the day. “We’re bringing them on as fast as we can bring them on,” she said.At a morning briefing on Thursday, officials said three patients had been moved to the Comfort. After The New York Times published an article with that number, Elizabeth Baker, a spokeswoman for the Navy, said the number had increased to 20 by late in the day. “We’re bringing them on as fast as we can bring them on,” she said.
The next day, on Friday, Ms. Baker said the Comfort would begin screening patients for the coronavirus on site by taking their temperature and giving them a short questionnaire, to relieve the burden on hospitals.The next day, on Friday, Ms. Baker said the Comfort would begin screening patients for the coronavirus on site by taking their temperature and giving them a short questionnaire, to relieve the burden on hospitals.
Hospital leaders said they had been exasperated by the delays.Hospital leaders said they had been exasperated by the delays.
Mr. Dowling said he has had to tear his hospitals apart, retrofitting any unused space, including lobbies and conference rooms, into hospital wards. His facilities now house 2,800 so-called Covid patients, up from 100 on March 20, he said. About 25 percent of those are in serious conditions in intensive care units.Mr. Dowling said he has had to tear his hospitals apart, retrofitting any unused space, including lobbies and conference rooms, into hospital wards. His facilities now house 2,800 so-called Covid patients, up from 100 on March 20, he said. About 25 percent of those are in serious conditions in intensive care units.
Across the city, hospitals are overrun. Patients have died in hallways before they could even be hooked up to one of the few available ventilators in New York. Doctors and nurses, who have had to use the same protective gear again and again, are getting sick. So many people are dying that the city is running low on body bags.Across the city, hospitals are overrun. Patients have died in hallways before they could even be hooked up to one of the few available ventilators in New York. Doctors and nurses, who have had to use the same protective gear again and again, are getting sick. So many people are dying that the city is running low on body bags.
At the same time, there is not a high volume of noncoronavirus patients. Because most New Yorkers have isolated themselves in their homes, there are fewer injuries from car accidents, gun shots and construction accidents that would require an emergency room visit.Ultimately, Mr. Dowling and others said, if the Comfort refuses to take Covid patients, there are few patients to send. And given the pernicious spread of the disease in New York City, where nearly 50,000 were infected as of Thursday, dividing patients into those who have it and those who do not is pointless, he said. At the same time, there is not a high volume of noncoronavirus patients. Because most New Yorkers have isolated themselves in their homes, there are fewer injuries from car accidents, gun shots and construction accidents that would require an emergency room visit.
Ultimately, Mr. Dowling and others said, if the Comfort refuses to take Covid patients, there are few patients to send. And given the pernicious spread of the disease in New York City, where nearly 50,000 were infected as of Thursday, dividing patients into those who have it and those who do not is pointless, he said.
The solution, he and others said, was to open the Comfort to patients with Covid-19.The solution, he and others said, was to open the Comfort to patients with Covid-19.
“It’s pretty ridiculous,” he said. “If you’re not going to help us with the people we need help with, what’s the purpose?”“It’s pretty ridiculous,” he said. “If you’re not going to help us with the people we need help with, what’s the purpose?”
Asked about Mr. Dowling’s criticisms, the Defense Department referred to Mr. Trump’s statements about the Comfort at his daily briefing. The president said only that the ship was not accepting patients with the coronavirus.Asked about Mr. Dowling’s criticisms, the Defense Department referred to Mr. Trump’s statements about the Comfort at his daily briefing. The president said only that the ship was not accepting patients with the coronavirus.
Late Thursday, Governor Andrew M. Cuomo of New York reached an agreement with Mr. Trump to bring Covid patients to the Javits Convention Center in Manhattan, another alternative site operated by the military, with 2,500 hospital beds.Late Thursday, Governor Andrew M. Cuomo of New York reached an agreement with Mr. Trump to bring Covid patients to the Javits Convention Center in Manhattan, another alternative site operated by the military, with 2,500 hospital beds.
Updated June 2, 2020
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.
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.
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.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
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.
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.
“I asked President Trump this morning to consider the request and the urgency of the matter, and the President has just informed me that he granted New York’s request,” Mr. Cuomo said in a statement.“I asked President Trump this morning to consider the request and the urgency of the matter, and the President has just informed me that he granted New York’s request,” Mr. Cuomo said in a statement.
There was no word about doing the same with the U.S.N.S. Comfort.There was no word about doing the same with the U.S.N.S. Comfort.
Capt. Patrick Amersbach, the commanding officer of the medical personnel aboard the Comfort, said at a news conference that, for now, his orders were to accept only patients who had tested negative for the virus. If ordered to accept coronavirus patients, he said, the ship could be reconfigured to make that happen.Capt. Patrick Amersbach, the commanding officer of the medical personnel aboard the Comfort, said at a news conference that, for now, his orders were to accept only patients who had tested negative for the virus. If ordered to accept coronavirus patients, he said, the ship could be reconfigured to make that happen.
“If our mission shifts, we do what we can to meet that mission,” he said.“If our mission shifts, we do what we can to meet that mission,” he said.
From the outset, readying the hospital ship for use in a pandemic proved a challenge. The Comfort was built to operate in battlefield conditions, and its physicians accustomed to treating young, otherwise healthy soldiers suffering from injuries related to gunshots and bomb blasts. Most people who are hospitalized with Covid-19 are older and infected with a novel pathogen that even the world’s top medical researchers do not fully understand.From the outset, readying the hospital ship for use in a pandemic proved a challenge. The Comfort was built to operate in battlefield conditions, and its physicians accustomed to treating young, otherwise healthy soldiers suffering from injuries related to gunshots and bomb blasts. Most people who are hospitalized with Covid-19 are older and infected with a novel pathogen that even the world’s top medical researchers do not fully understand.
Any outbreak on board could quickly spread and disable the ship’s operations. As a precaution, the ship’s crew isolated for two weeks before embarking on their mission to New York. They must remain onboard for the duration of their mission in New York.Any outbreak on board could quickly spread and disable the ship’s operations. As a precaution, the ship’s crew isolated for two weeks before embarking on their mission to New York. They must remain onboard for the duration of their mission in New York.
The ship has struggled to fulfill civilian missions in the past. After Hurricane Maria pummeled Puerto Rico in 2017, the Comfort was sent to relieve overextended hospitals, but ended up treating only a handful of patients each day.The ship has struggled to fulfill civilian missions in the past. After Hurricane Maria pummeled Puerto Rico in 2017, the Comfort was sent to relieve overextended hospitals, but ended up treating only a handful of patients each day.
A military physician who had previously served on the Navy’s hospital ships said in an interview that conditions on board were suitable for soldiers, but, with its narrow bunked cots instead of modern hospital beds, it was not ideal for treating civilians.A military physician who had previously served on the Navy’s hospital ships said in an interview that conditions on board were suitable for soldiers, but, with its narrow bunked cots instead of modern hospital beds, it was not ideal for treating civilians.
Though military physicians are accustomed to battlefield situations, they are well-trained, and should be able to handle strains of the pandemic if ordered to treat patients with the coronavirus, he said.Though military physicians are accustomed to battlefield situations, they are well-trained, and should be able to handle strains of the pandemic if ordered to treat patients with the coronavirus, he said.
“As military doctors,” he said, “they would absolutely do their best.”“As military doctors,” he said, “they would absolutely do their best.”
Michael D. Shear contributed reporting.Michael D. Shear contributed reporting.