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One Rich N.Y. Hospital Got Warren Buffett’s Help. This One Got Duct Tape. One Rich N.Y. Hospital Got Warren Buffett’s Help. This One Got Duct Tape.
(7 days later)
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It has been hours since the 71-year-old man in Room 3 of the intensive care unit succumbed to Covid-19, the disease caused by the coronavirus. His body has been cleaned, packed in an orange bag and covered in a white sheet, but the overextended transport team from the morgue has yet to arrive.It has been hours since the 71-year-old man in Room 3 of the intensive care unit succumbed to Covid-19, the disease caused by the coronavirus. His body has been cleaned, packed in an orange bag and covered in a white sheet, but the overextended transport team from the morgue has yet to arrive.
The nurses on duty have too many other worries. University Hospital of Brooklyn, in the heart of the city hit hardest by a world-altering pandemic, can seem like it is falling apart. The roof leaks. The corroded pipes burst with alarming frequency. On one of the intensive care units, plastic tarps and duct tape serve as flimsy barriers separating patients. Nurses record vital signs with pen and paper, rather than computer systems.The nurses on duty have too many other worries. University Hospital of Brooklyn, in the heart of the city hit hardest by a world-altering pandemic, can seem like it is falling apart. The roof leaks. The corroded pipes burst with alarming frequency. On one of the intensive care units, plastic tarps and duct tape serve as flimsy barriers separating patients. Nurses record vital signs with pen and paper, rather than computer systems.
A patient in Room 2 is losing blood pressure and needs an ultrasound. A therapist is working to calm a woman in Room 4 who is intubated and semiconscious and who tried to rip out her breathing tube when her arm restraints were unfastened.A patient in Room 2 is losing blood pressure and needs an ultrasound. A therapist is working to calm a woman in Room 4 who is intubated and semiconscious and who tried to rip out her breathing tube when her arm restraints were unfastened.
Genevieve Watson-Grey, the head nurse on duty, says she relies on faith and prayer to fill the gap between need and reality. “Knowing there is a higher force above,” she says, gives her hope.Genevieve Watson-Grey, the head nurse on duty, says she relies on faith and prayer to fill the gap between need and reality. “Knowing there is a higher force above,” she says, gives her hope.
Every hospital in New York has struggled to cope with the pandemic, but the outbreak has laid bare the deep disparities in the city’s health care system. The virus is killing black and Latino New Yorkers at about twice the rate of white residents, and hospitals serving the sickest patients often work with the fewest resources.Every hospital in New York has struggled to cope with the pandemic, but the outbreak has laid bare the deep disparities in the city’s health care system. The virus is killing black and Latino New Yorkers at about twice the rate of white residents, and hospitals serving the sickest patients often work with the fewest resources.
Wealthy private hospitals, primarily in Manhattan, have been able to marshal reserves of cash and political clout to increase patient capacity quickly, ramp up testing and acquire protective gear. At the height of the surge, the Mount Sinai health system was able to enlist private planes from Warren E. Buffett’s company to fly in coveted N95 masks from China.Wealthy private hospitals, primarily in Manhattan, have been able to marshal reserves of cash and political clout to increase patient capacity quickly, ramp up testing and acquire protective gear. At the height of the surge, the Mount Sinai health system was able to enlist private planes from Warren E. Buffett’s company to fly in coveted N95 masks from China.
University Hospital, which is publicly funded and part of SUNY Downstate Health Sciences University, has tried to raise money for protective gear through a GoFundMe page started by a resident physician.University Hospital, which is publicly funded and part of SUNY Downstate Health Sciences University, has tried to raise money for protective gear through a GoFundMe page started by a resident physician.
Most of the hospital’s patients are poor and people of color, and it gets more than 80 percent of its revenue from government programs like Medicare and Medicaid.Most of the hospital’s patients are poor and people of color, and it gets more than 80 percent of its revenue from government programs like Medicare and Medicaid.
Dr. Robert Foronjy, the hospital’s chief of pulmonary and critical care medicine, oversees the unit with the plastic tarps and duct tape. He said that he did not believe that any patients were lost because of inadequate resources. But the “aged and crumbling” facilities, he said, had made the job of caring for such patients much harder.Dr. Robert Foronjy, the hospital’s chief of pulmonary and critical care medicine, oversees the unit with the plastic tarps and duct tape. He said that he did not believe that any patients were lost because of inadequate resources. But the “aged and crumbling” facilities, he said, had made the job of caring for such patients much harder.
“Why shouldn’t an African-American have facilities that are at the same level of other patient populations?” he said.“Why shouldn’t an African-American have facilities that are at the same level of other patient populations?” he said.
When George James, a 60-year-old former public housing superintendent arrived at University Hospital in March to have an infection unrelated to the coronavirus treated, he did not have Covid-19 symptoms. Within days, though, he tested positive for the disease. As he gasped for breath one night in his hospital bed, he panicked when he was unable to call a nurse.When George James, a 60-year-old former public housing superintendent arrived at University Hospital in March to have an infection unrelated to the coronavirus treated, he did not have Covid-19 symptoms. Within days, though, he tested positive for the disease. As he gasped for breath one night in his hospital bed, he panicked when he was unable to call a nurse.
“I didn’t go to sleep the whole night because I was scared,” he said. “I couldn’t breathe.”“I didn’t go to sleep the whole night because I was scared,” he said. “I couldn’t breathe.”
Instead of a modern call button or intercom system, all he had was a silver bell, the kind used in hotels decades ago to summon the concierge.Instead of a modern call button or intercom system, all he had was a silver bell, the kind used in hotels decades ago to summon the concierge.
It was late February and Dr. Wayne J. Riley, president of SUNY Downstate Health Sciences University, was at a conference in Atlanta when his phone began to ping with ominous messages. It was becoming clearer that the novel coronavirus, which had ravaged parts of China and Italy, had begun to spread rapidly in the United States.It was late February and Dr. Wayne J. Riley, president of SUNY Downstate Health Sciences University, was at a conference in Atlanta when his phone began to ping with ominous messages. It was becoming clearer that the novel coronavirus, which had ravaged parts of China and Italy, had begun to spread rapidly in the United States.
“I said, ‘My gosh, if this thing really does take root in the United States then, here in Brooklyn, we’re going to have a problem,’” he recalled.“I said, ‘My gosh, if this thing really does take root in the United States then, here in Brooklyn, we’re going to have a problem,’” he recalled.
Not only did Dr. Riley worry about the resources that would be needed to provide care during a pandemic, he feared that the hospital’s patients would be particularly susceptible to the disease.Not only did Dr. Riley worry about the resources that would be needed to provide care during a pandemic, he feared that the hospital’s patients would be particularly susceptible to the disease.
The central Brooklyn neighborhoods where most of University Hospital’s patients live, East Flatbush and Prospect Lefferts Gardens, have higher-than-average concentrations of chronic diseases like diabetes, hypertension and obesity, which preliminary studies have shown make Covid-19 most deadly.The central Brooklyn neighborhoods where most of University Hospital’s patients live, East Flatbush and Prospect Lefferts Gardens, have higher-than-average concentrations of chronic diseases like diabetes, hypertension and obesity, which preliminary studies have shown make Covid-19 most deadly.
The hospital opened in 1963 and it was meant to accommodate about 60,000 visits a year. Despite having almost no physical improvements, it now handles about 200,000 visits annually. The bunkerlike concrete building is crumbling from within. Earlier this year, a leaky roof forced a temporary evacuation of premature babies from a neonatal intensive care unit.The hospital opened in 1963 and it was meant to accommodate about 60,000 visits a year. Despite having almost no physical improvements, it now handles about 200,000 visits annually. The bunkerlike concrete building is crumbling from within. Earlier this year, a leaky roof forced a temporary evacuation of premature babies from a neonatal intensive care unit.
“It is too, too old compared to other hospitals across the water,” Dr. Riley said. “We need a new hospital to be prepared for the next pandemic and to better serve our community.”“It is too, too old compared to other hospitals across the water,” Dr. Riley said. “We need a new hospital to be prepared for the next pandemic and to better serve our community.”
Signs inside the hospital are written in English, Spanish and Creole, a reflection of the large number of immigrants in the area, particularly from the West Indies.Signs inside the hospital are written in English, Spanish and Creole, a reflection of the large number of immigrants in the area, particularly from the West Indies.
Many of the patients work but are poor or receive government assistance. Many are uninsured and use the hospital for emergencies and primary care. They come from a men’s shelter up the street or from a nearby home for domestic violence survivors to fill prescriptions or to have their diabetes checked.Many of the patients work but are poor or receive government assistance. Many are uninsured and use the hospital for emergencies and primary care. They come from a men’s shelter up the street or from a nearby home for domestic violence survivors to fill prescriptions or to have their diabetes checked.
“The day-to-day stress on these communities is just incredible, and that is driving these conditions,” said Dr. Moro Salifu, the chairman of the hospital’s department of medicine.“The day-to-day stress on these communities is just incredible, and that is driving these conditions,” said Dr. Moro Salifu, the chairman of the hospital’s department of medicine.
The hospital has been in financial disarray for years. A 2013 audit by the state comptroller’s office found that it was on a path toward insolvency. It was bleeding millions of dollars every week, the audit found, and only infusions of state money were keeping it afloat. It has also been poorly managed. Subsequent audits found that hospital leaders had used government money on a lavish birthday celebration in Bermuda for a consultant who was paid tens of millions of dollars, but who did very little to improve the hospital’s finances.The hospital has been in financial disarray for years. A 2013 audit by the state comptroller’s office found that it was on a path toward insolvency. It was bleeding millions of dollars every week, the audit found, and only infusions of state money were keeping it afloat. It has also been poorly managed. Subsequent audits found that hospital leaders had used government money on a lavish birthday celebration in Bermuda for a consultant who was paid tens of millions of dollars, but who did very little to improve the hospital’s finances.
Dr. Riley, who became president in 2017, after the Bermuda birthday celebration, insisted that the limited resources had not affected the quality of care. The hospital, though, has at times been accused of violating safety standards.Dr. Riley, who became president in 2017, after the Bermuda birthday celebration, insisted that the limited resources had not affected the quality of care. The hospital, though, has at times been accused of violating safety standards.
Last July, the hospital suspended its transplant program after a review uncovered high mortality rates and serious safety concerns. Two doctors, the surgery department’s former chairman and another surgeon, filed wrongful termination lawsuits, accusing hospital officials of firing them as retaliation for their complaints about lax safety standards. The program has since been reactivated.Last July, the hospital suspended its transplant program after a review uncovered high mortality rates and serious safety concerns. Two doctors, the surgery department’s former chairman and another surgeon, filed wrongful termination lawsuits, accusing hospital officials of firing them as retaliation for their complaints about lax safety standards. The program has since been reactivated.
Even so, the hospital is vital to the community. Together with its affiliated teaching university, it is Brooklyn’s fourth-largest employer. The university, which is part of the State University of New York system, is the largest medical college in New York City, and it produces a large percentage of the doctors working here.Even so, the hospital is vital to the community. Together with its affiliated teaching university, it is Brooklyn’s fourth-largest employer. The university, which is part of the State University of New York system, is the largest medical college in New York City, and it produces a large percentage of the doctors working here.
When the pandemic first hit the city, Andrew M. Cuomo, New York’s governor, ordered the hospital to take only patients who had the virus. The decision rankled medical workers and others, who complained about having to shoulder the heavy burden with limited resources.When the pandemic first hit the city, Andrew M. Cuomo, New York’s governor, ordered the hospital to take only patients who had the virus. The decision rankled medical workers and others, who complained about having to shoulder the heavy burden with limited resources.
“We’re now in a situation where an under-resourced hospital is being asked to manage the epicenter of the crisis,” said Zellnor Myrie, a Democratic state senator whose district includes University Hospital. “The dollars that we failed to invest years ago are affecting life-and-death decisions now.”“We’re now in a situation where an under-resourced hospital is being asked to manage the epicenter of the crisis,” said Zellnor Myrie, a Democratic state senator whose district includes University Hospital. “The dollars that we failed to invest years ago are affecting life-and-death decisions now.”
The first patient with Covid-19 at University Hospital, a 74-year-old woman on dialysis with hypertension and diabetes, was identified on March 12.The first patient with Covid-19 at University Hospital, a 74-year-old woman on dialysis with hypertension and diabetes, was identified on March 12.
“I got the first call at 5:51 p.m. that we had our first case,” said Dr. Salifu, the department of medicine chairman. “I remember exactly where I was on 9/11, and I knew exactly where I was when I got this call.”“I got the first call at 5:51 p.m. that we had our first case,” said Dr. Salifu, the department of medicine chairman. “I remember exactly where I was on 9/11, and I knew exactly where I was when I got this call.”
Within days, the cramped emergency room, which looks much the same as it did when the hospital first opened, was inundated. At times, more than 100 coughing, feverish patients were packed into hallways and side rooms, or clustered around the nursing station, spewing virus into the air.Within days, the cramped emergency room, which looks much the same as it did when the hospital first opened, was inundated. At times, more than 100 coughing, feverish patients were packed into hallways and side rooms, or clustered around the nursing station, spewing virus into the air.
The hospital came close to running out of ventilators. Julie Eason, the director of respiratory therapy, said she had to “get a little bit creative” as she tried to ration resources while keeping up with all of the Code 99s, the term used when a patient needs to be intubated.The hospital came close to running out of ventilators. Julie Eason, the director of respiratory therapy, said she had to “get a little bit creative” as she tried to ration resources while keeping up with all of the Code 99s, the term used when a patient needs to be intubated.
“It was just endless,” she said. “Code 99s would come in three, four different rooms all within a few minutes of each other, all day long.”“It was just endless,” she said. “Code 99s would come in three, four different rooms all within a few minutes of each other, all day long.”
Medical workers began to get sick, and several nurses ended up intubated in the hospital’s I.C.U.Medical workers began to get sick, and several nurses ended up intubated in the hospital’s I.C.U.
“We were stewing in it,” an emergency room doctor, Lorenzo Paladino, said.“We were stewing in it,” an emergency room doctor, Lorenzo Paladino, said.
Doctors and nurses complained that the conditions put them at greater risk than colleagues at other hospitals.Doctors and nurses complained that the conditions put them at greater risk than colleagues at other hospitals.
Dr. Foronjy, the I.C.U. physician, said he knew a doctor at a well-funded Manhattan hospital who walked around without a mask, assured that the sealed-off negative-pressure rooms there would protect him from the virus-infected patients inside.Dr. Foronjy, the I.C.U. physician, said he knew a doctor at a well-funded Manhattan hospital who walked around without a mask, assured that the sealed-off negative-pressure rooms there would protect him from the virus-infected patients inside.
Updated June 16, 2020 Updated June 22, 2020
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.
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.
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.
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.
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.
Not so at University Hospital.Not so at University Hospital.
“Having to work with such an antiquated infrastructure is incredibly stressful,” Dr. Foronjy said. “You have to worry more about your own safety.”“Having to work with such an antiquated infrastructure is incredibly stressful,” Dr. Foronjy said. “You have to worry more about your own safety.”
The city and state health departments have not released data on mortality rates by hospital, but given the high instance of pre-existing conditions among patients at University Hospital, doctors there estimated that its mortality rates must be among the highest in the city.The city and state health departments have not released data on mortality rates by hospital, but given the high instance of pre-existing conditions among patients at University Hospital, doctors there estimated that its mortality rates must be among the highest in the city.
As the death toll began to mount, the bodies overwhelmed the hospital’s small, 10-person morgue. Then they filled not one, but two refrigerated tractor-trailers parked outside.As the death toll began to mount, the bodies overwhelmed the hospital’s small, 10-person morgue. Then they filled not one, but two refrigerated tractor-trailers parked outside.
The hospital’s mortician, Michael McGillicuddy, had to hire six additional staff members to help manage the morgue. Recently, a steady stream of black hearses has arrived at the hospital each day to pick up bodies, but new ones soon replace those that are taken away.The hospital’s mortician, Michael McGillicuddy, had to hire six additional staff members to help manage the morgue. Recently, a steady stream of black hearses has arrived at the hospital each day to pick up bodies, but new ones soon replace those that are taken away.
“I’m doing it with dignity, trying not to pile the bodies up,” Mr. McGillicuddy said. “This is someone’s mother or grandmother.”“I’m doing it with dignity, trying not to pile the bodies up,” Mr. McGillicuddy said. “This is someone’s mother or grandmother.”
Although the rate of new infections is dropping in New York, the intensive care units at University Hospital are full. Nearly 50 patients remain in serious condition, attached to ventilators. Some have been hospitalized for weeks, their limbs nestled in yellow foam cushions to prevent bed sores. (Reporters with The New York Times spent two days at the hospital but did not have access to patient information because of privacy regulations.)Although the rate of new infections is dropping in New York, the intensive care units at University Hospital are full. Nearly 50 patients remain in serious condition, attached to ventilators. Some have been hospitalized for weeks, their limbs nestled in yellow foam cushions to prevent bed sores. (Reporters with The New York Times spent two days at the hospital but did not have access to patient information because of privacy regulations.)
Nurses on the units said they were overworked and understaffed. In normal times, their jobs are so demanding that they are required to care for no more than two patients at once. Now, they are tending to three or four at a time, increasing the risk of mistakes.Nurses on the units said they were overworked and understaffed. In normal times, their jobs are so demanding that they are required to care for no more than two patients at once. Now, they are tending to three or four at a time, increasing the risk of mistakes.
Ventilators, which take over for virus-battered lungs and have been crucial in the pandemic, require constant calibration to keep patients’ oxygen levels just right. Nurses must monitor endotracheal tubes, which can get clogged and block airways. In Covid-19 patients, the heart or the kidneys can fail without warning.Ventilators, which take over for virus-battered lungs and have been crucial in the pandemic, require constant calibration to keep patients’ oxygen levels just right. Nurses must monitor endotracheal tubes, which can get clogged and block airways. In Covid-19 patients, the heart or the kidneys can fail without warning.
A lack of protective gear remains a problem. Much of what the nurses are wearing is mismatched, donated from friends and neighbors or brought from home. One nurse complained that she had bought her mask herself and had been wearing the same bootees on her feet for the past three days.A lack of protective gear remains a problem. Much of what the nurses are wearing is mismatched, donated from friends and neighbors or brought from home. One nurse complained that she had bought her mask herself and had been wearing the same bootees on her feet for the past three days.
“As you know, we are a state facility. We don’t have a lot of money,” said Rose Green, a nurse who was helping to staff the unit on her day off.“As you know, we are a state facility. We don’t have a lot of money,” said Rose Green, a nurse who was helping to staff the unit on her day off.
The hospital has begun to celebrate some successes. Recently, a nurse and a nursing assistant were taken off ventilators. On April 16, the hospital posted a video on Twitter of another nurse who had been intubated after coming down with Covid-19. She was being wheeled out of the emergency room to applause from colleagues.The hospital has begun to celebrate some successes. Recently, a nurse and a nursing assistant were taken off ventilators. On April 16, the hospital posted a video on Twitter of another nurse who had been intubated after coming down with Covid-19. She was being wheeled out of the emergency room to applause from colleagues.
On a recent day, a man in his 50s who had just come off a ventilator was sitting up in his room drinking a bottle of juice.On a recent day, a man in his 50s who had just come off a ventilator was sitting up in his room drinking a bottle of juice.
A nurse passed by and waved excitedly.A nurse passed by and waved excitedly.