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He Went to 3 Hospitals. When He Finally Got a Bed, It Was Too Late. He Went to 3 Hospitals. When He Finally Got a Bed, It Was Too Late.
(31 minutes later)
After feeling unwell with what seemed like symptoms of the coronavirus, Luis Arellano first tried going to a nearby hospital in Brooklyn, where he was told to come back if his condition worsened.After feeling unwell with what seemed like symptoms of the coronavirus, Luis Arellano first tried going to a nearby hospital in Brooklyn, where he was told to come back if his condition worsened.
Days later, as his health deteriorated, his family took him to a New Jersey hospital. He waited eight hours, and after being told they’d have to wait another seven to nine hours, the family left, they said.Days later, as his health deteriorated, his family took him to a New Jersey hospital. He waited eight hours, and after being told they’d have to wait another seven to nine hours, the family left, they said.
By the time Mr. Arellano, 65, was finally determined to be sick enough to be immediately admitted into a hospital, his body had already been ravaged by Covid-19, the disease caused by the coronavirus.By the time Mr. Arellano, 65, was finally determined to be sick enough to be immediately admitted into a hospital, his body had already been ravaged by Covid-19, the disease caused by the coronavirus.
He died of cardiopulmonary arrest on April 5 after five days in the hospital. Two days before that, his virus test had come back positive.He died of cardiopulmonary arrest on April 5 after five days in the hospital. Two days before that, his virus test had come back positive.
“If they would have admitted him, they would have found that he was gravely ill,” said Bolivar Arellano, his brother.“If they would have admitted him, they would have found that he was gravely ill,” said Bolivar Arellano, his brother.
Mr. Arellano’s prolonged attempts to receive care illustrate the quandary nurses and doctors in New York and New Jersey, the two hardest-hit states in the coronavirus pandemic, have faced as they have tried to ration limited resources.Mr. Arellano’s prolonged attempts to receive care illustrate the quandary nurses and doctors in New York and New Jersey, the two hardest-hit states in the coronavirus pandemic, have faced as they have tried to ration limited resources.
In many cases, health care workers have had to determine in a matter of minutes who was sick enough to receive urgent care in a hospital and who could recover at home. For some patients, the decision was the difference between life and death.In many cases, health care workers have had to determine in a matter of minutes who was sick enough to receive urgent care in a hospital and who could recover at home. For some patients, the decision was the difference between life and death.
The complicated and still mysterious nature of the virus has made those initial determinations difficult. The condition of a patient whose symptoms might not appear severe at first can deteriorate rapidly.The complicated and still mysterious nature of the virus has made those initial determinations difficult. The condition of a patient whose symptoms might not appear severe at first can deteriorate rapidly.
Mr. Arellano began complaining of a fever in late March. By March 26, he was diagnosed with pneumonia at a Brooklyn urgent care clinic, the family said. Two days later, he had difficulty breathing but could not get admitted into a hospital. He was dead in a week.Mr. Arellano began complaining of a fever in late March. By March 26, he was diagnosed with pneumonia at a Brooklyn urgent care clinic, the family said. Two days later, he had difficulty breathing but could not get admitted into a hospital. He was dead in a week.
“It was a week of constantly having to fight for him to get in,” Carlos Arellano, Mr. Arellano’s only son, said of the frantic search for a hospital. “Eventually he did, but it was too late.”“It was a week of constantly having to fight for him to get in,” Carlos Arellano, Mr. Arellano’s only son, said of the frantic search for a hospital. “Eventually he did, but it was too late.”
In early April, after Mark Levine, the chair of the City Council’s health committee, said on Twitter that hospitals were “turning many people away,” including patients with “pneumonialike symptoms,” both Mayor Bill de Blasio and Dr. Mitchell Katz, the president and chief executive officer of NYC Health + Hospitals, vehemently denied that was the case.In early April, after Mark Levine, the chair of the City Council’s health committee, said on Twitter that hospitals were “turning many people away,” including patients with “pneumonialike symptoms,” both Mayor Bill de Blasio and Dr. Mitchell Katz, the president and chief executive officer of NYC Health + Hospitals, vehemently denied that was the case.
“Saying that our hospitals would turn away someone with pneumonia is irresponsible, inaccurate and unfair. Mitch, would you like to comment?” Mr. De Blasio said at news conference at the temporary hospital at the Billie Jean King Tennis Center in Queens.“Saying that our hospitals would turn away someone with pneumonia is irresponsible, inaccurate and unfair. Mitch, would you like to comment?” Mr. De Blasio said at news conference at the temporary hospital at the Billie Jean King Tennis Center in Queens.
The hospital network did tell patients who have mild symptoms to stay at home, Dr. Katz said. But, he added, “We are not turning away anybody with pneumonia who is short of breath.”The hospital network did tell patients who have mild symptoms to stay at home, Dr. Katz said. But, he added, “We are not turning away anybody with pneumonia who is short of breath.”
In the days after Mr. Arellano first began steadily coughing and complaining of a fever, he began sleeping on a mattress in the living room of an apartment in Greenpoint he shared with his sister and their 96-year-old father.In the days after Mr. Arellano first began steadily coughing and complaining of a fever, he began sleeping on a mattress in the living room of an apartment in Greenpoint he shared with his sister and their 96-year-old father.
The family was tight-knit.The family was tight-knit.
Born in Alausí, a small town in Ecuador with a population of about 44,000 residents in the Chimborazo province, Mr. Arellano, one of eight children, had been a psychologist in his native country, but had been unable to pass the necessary exams to continue his career in the United States after moving to New York in 1981.Born in Alausí, a small town in Ecuador with a population of about 44,000 residents in the Chimborazo province, Mr. Arellano, one of eight children, had been a psychologist in his native country, but had been unable to pass the necessary exams to continue his career in the United States after moving to New York in 1981.
Instead, he took jobs cleaning college dorms and offices.Instead, he took jobs cleaning college dorms and offices.
Recently, Mr. Arellano had been working as a home attendant, taking care of older people.Recently, Mr. Arellano had been working as a home attendant, taking care of older people.
It had been after one of these work days that he began to feel ill.It had been after one of these work days that he began to feel ill.
Mr. Arellano, like his sister, was a diabetic, but did not have previous respiratory issues. Still, the family took precautions, isolating Mr. Arellano in the living room while he rested at home. But his condition grew worse.Mr. Arellano, like his sister, was a diabetic, but did not have previous respiratory issues. Still, the family took precautions, isolating Mr. Arellano in the living room while he rested at home. But his condition grew worse.
Two days after his visit to urgent care, Mr. Arellano began gasping for air at the apartment. His sister called an ambulance, which took him to Woodhull Medical Center, a public hospital in Brooklyn, on the morning of March 28.Two days after his visit to urgent care, Mr. Arellano began gasping for air at the apartment. His sister called an ambulance, which took him to Woodhull Medical Center, a public hospital in Brooklyn, on the morning of March 28.
That date had been a particularly harrowing moment in New York, the sixth consecutive day in the city in which more than 1,000 people had been hospitalized.That date had been a particularly harrowing moment in New York, the sixth consecutive day in the city in which more than 1,000 people had been hospitalized.
The total number of hospitalizations on March 28 would reach 1,261, according to city data. Mr. Arellano had arrived via ambulance to Woodhull in the midst of a crisis.The total number of hospitalizations on March 28 would reach 1,261, according to city data. Mr. Arellano had arrived via ambulance to Woodhull in the midst of a crisis.
Family members said they had told the paramedics that Mr. Arellano was diagnosed with pneumonia, that he suffered from diabetes and that he was also awaiting for Covid-19 test results from the urgent care clinic. But, they said, the hospital sent him home.Family members said they had told the paramedics that Mr. Arellano was diagnosed with pneumonia, that he suffered from diabetes and that he was also awaiting for Covid-19 test results from the urgent care clinic. But, they said, the hospital sent him home.
At that point, it appeared hospitals were budgeting beds and ventilators as they braced for the anticipated peak.At that point, it appeared hospitals were budgeting beds and ventilators as they braced for the anticipated peak.
“I was shocked,” his son, Carlos, 23, said. “I didn’t think that they would send him home. I’m not sure what the reasoning was.”“I was shocked,” his son, Carlos, 23, said. “I didn’t think that they would send him home. I’m not sure what the reasoning was.”
“Our condolences go out to the family of the deceased,” said Stephanie Guzman, the deputy press secretary of NYC Health + Hospitals, the public hospital network that oversees Woodhull. Citing privacy laws, she declined to comment further.“Our condolences go out to the family of the deceased,” said Stephanie Guzman, the deputy press secretary of NYC Health + Hospitals, the public hospital network that oversees Woodhull. Citing privacy laws, she declined to comment further.
With Mr. Arellano’s condition not improving, his son worried his father might infect the rest of the Greenpoint household. Going to New Jersey, which had fewer cases than New York and where the son lived, seemed like his father’s best chance at survival.With Mr. Arellano’s condition not improving, his son worried his father might infect the rest of the Greenpoint household. Going to New Jersey, which had fewer cases than New York and where the son lived, seemed like his father’s best chance at survival.
Two days after his visit to Woodhull, on March 30, Mr. Arellano took 20 minutes to walk down the three flights of stairs at his apartment building to meet his son and his son’s mother, who would drive him to New Jersey.Two days after his visit to Woodhull, on March 30, Mr. Arellano took 20 minutes to walk down the three flights of stairs at his apartment building to meet his son and his son’s mother, who would drive him to New Jersey.
Updated June 22, 2020 Updated June 24, 2020
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.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 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.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.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.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.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.
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.
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.)
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.
Mr. Arellano sat in the car’s back seat, breathed heavily and barely spoke during the ride, his son said. They arrived midday at Overlook Medical Center in Summit, N.J., where the family was told to go outside to an improvised emergency room waiting area. They waited for eight hours, they said.Mr. Arellano sat in the car’s back seat, breathed heavily and barely spoke during the ride, his son said. They arrived midday at Overlook Medical Center in Summit, N.J., where the family was told to go outside to an improvised emergency room waiting area. They waited for eight hours, they said.
By 11 p.m., about 10 patients were still ahead of Mr. Arellano. A nurse had triaged him soon after the family’s arrival, but they were told by the staff that a bed would not become available for another seven to nine hours. Carlos Arellano chose to take his father home.By 11 p.m., about 10 patients were still ahead of Mr. Arellano. A nurse had triaged him soon after the family’s arrival, but they were told by the staff that a bed would not become available for another seven to nine hours. Carlos Arellano chose to take his father home.
“I was in a state of hopelessness,” he said. “I could see that he was not going to be able to wait that long.”“I was in a state of hopelessness,” he said. “I could see that he was not going to be able to wait that long.”
An unexpected surge of coronavirus patients on March 29 had hit area hospitals, said Robert Seman, a spokesman for Overlook, in a statement.An unexpected surge of coronavirus patients on March 29 had hit area hospitals, said Robert Seman, a spokesman for Overlook, in a statement.
To combat the surge, he said, Overlook began rerouting patients who arrived by ambulance to other nearby hospitals.To combat the surge, he said, Overlook began rerouting patients who arrived by ambulance to other nearby hospitals.
Admissions at Overlook were done on a case-by-case basis, Mr. Seman said. He did not specify the criteria.Admissions at Overlook were done on a case-by-case basis, Mr. Seman said. He did not specify the criteria.
“While this also resulted in extended wait times, at no point has Overlook turned away anyone who arrived to our facility, including numerous ambulances that still arrived to our emergency department that day,” Mr. Seman said. “Our care teams worked tirelessly to move patients from the emergency setting on to the appropriate level of care as quickly as possible.”“While this also resulted in extended wait times, at no point has Overlook turned away anyone who arrived to our facility, including numerous ambulances that still arrived to our emergency department that day,” Mr. Seman said. “Our care teams worked tirelessly to move patients from the emergency setting on to the appropriate level of care as quickly as possible.”
Mr. Arellano told his son that the pain felt like someone was cutting through his lungs with a knife. At night, Carlos could hear his father wheezing.Mr. Arellano told his son that the pain felt like someone was cutting through his lungs with a knife. At night, Carlos could hear his father wheezing.
On April 1, they called an ambulance. The paramedics took Mr. Arellano to Trinitas Regional Medical Center in Elizabeth, N.J. About nine hours later, Mr. Arellano texted his son to tell him he had been placed in a private room.On April 1, they called an ambulance. The paramedics took Mr. Arellano to Trinitas Regional Medical Center in Elizabeth, N.J. About nine hours later, Mr. Arellano texted his son to tell him he had been placed in a private room.
There was never a hint that the end was near. Throughout his father’s stay at Trinitas, his son called the hospital every day for updates.There was never a hint that the end was near. Throughout his father’s stay at Trinitas, his son called the hospital every day for updates.
His father had been given the malaria drug hydroxychloroquine and then put on oxygen therapy, he said. His fever was down but he was not getting better, the nurses told Carlos. On some days, Mr. Arellano watched TV. Other days, he was given a catheter because he could not stand up to walk to the restroom. Mr. Arellano sent his son two selfies that showed him wearing his oxygen mask. Sometimes he ate solids, but he was still extremely fatigued, his son recounted.His father had been given the malaria drug hydroxychloroquine and then put on oxygen therapy, he said. His fever was down but he was not getting better, the nurses told Carlos. On some days, Mr. Arellano watched TV. Other days, he was given a catheter because he could not stand up to walk to the restroom. Mr. Arellano sent his son two selfies that showed him wearing his oxygen mask. Sometimes he ate solids, but he was still extremely fatigued, his son recounted.
Since Carlos always initiated the contact with the hospital, he knew something was wrong when he got a call from a nurse on April 5. His father’s heart and lungs had suddenly stopped beating, but they had been able to resuscitate him, a nurse told him. Carlos gave them permission to intubate his father, but before that could happen, only minutes later, a nurse called to say Mr. Arellano did not make it. He was pronounced dead at 6:10 p.m.Since Carlos always initiated the contact with the hospital, he knew something was wrong when he got a call from a nurse on April 5. His father’s heart and lungs had suddenly stopped beating, but they had been able to resuscitate him, a nurse told him. Carlos gave them permission to intubate his father, but before that could happen, only minutes later, a nurse called to say Mr. Arellano did not make it. He was pronounced dead at 6:10 p.m.
Without knowing it, Carlos had sent his last WhatsApp message to his father at 5:45 p.m.Without knowing it, Carlos had sent his last WhatsApp message to his father at 5:45 p.m.
It read: “Hi pa, I hope you are recovering and we love you a lot. Keep fighting because you’re very strong. Here my mom and I are well pa.”It read: “Hi pa, I hope you are recovering and we love you a lot. Keep fighting because you’re very strong. Here my mom and I are well pa.”
Mr. Arellano did not reply.Mr. Arellano did not reply.
Several days later, Carlos and his 96-year-old grandfather both tested positive for the coronavirus.Several days later, Carlos and his 96-year-old grandfather both tested positive for the coronavirus.
Jeffery C. Mays contributed reporting. Susan Beachy contributed research.Jeffery C. Mays contributed reporting. Susan Beachy contributed research.