New York City became the main focus of the Covid-19 pandemic in the United States last week, with nearly 40,000 people tested positive and nearly 1,000 dead. Many hospitals in the first American city are already overheating, and must manage the influx of patients, with very uneven resources from one hospital to another, as these testimonies show.
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Trisha, nurse: “I paid from my pocket on Amazon for masks, gowns, gloves”
A nurse for sixteen years in an intensive care unit of a Brooklyn non-profit hospital, Brookdale University Hospital Medical Center, located in the underprivileged neighborhood of Brownsville, Trisha (1) now sees her hospital, with a capacity of 300 patients, treating around a hundred people who tested positive for the coronavirus, but also nearly 80 who are awaiting their results. So far, at least 20 people have died from Covid-19 in the hospital.
“We have 18 cases in my intensive care unit alone. These are the most serious cases in the hospital: renal failure, respiratory failure, failure of several organs … The first death was a 49-year-old man, but we also have patients of 30 or 40 years, with or without pre-existing pathology. . This disease does not discriminate on age, social status, or skin color.
“The unit is full. We had to increase our capacity, by adding beds where we could, in open spaces, which is problematic for patients who should be isolated. At first, patients who tested positive for Covid-19 were put in boxes closed by windows, but we can no longer do that because there are too many of them. The only thing you can do is draw the curtains between the beds.
“The lack of protective equipment, which is a problem across the country, is being hit hard by health care workers. In my hospital, the supply is very limited: you cannot have an N95 mask if you are not directly caring for a patient with Covid. Like other nurses, I ordered, and paid for out of pocket, materials from Amazon: masks, gowns, gloves. My mask, once I put it on, I don’t take it off all day.
“I have two sons at home. I stay in my room so as not to be in contact with them, we talk to each side of the door, I text them when I have to go out so that they are not in the living room. Today I am on leave, and I feel very guilty that I am not with my colleagues, but I am exhausted. One of them just called me in tears. We try to support each other, but all this stress, all these patients, it shakes us up a lot.
“Everyone is afraid to approach patients. We try to limit the time we spend near them as much as possible, but it is very difficult to work in these conditions. In my unit, a patient’s condition deteriorated very quickly. The doctor contacted his family, and when he told us they had signed a DNR [un do not resuscitate order, une ordonnance de ne pas réanimer, ndlr], the whole team was extremely relieved. It’s terrible to recognize him, but otherwise, we knew that it meant that by trying to resuscitate him, we were going to be very exposed to the virus: this patient was coughing blood. This is perhaps the most traumatic moment of the past few days. ”
Nils Hennig, doctor: “We use all available spaces: the cafeteria, the corridors”
Dr. Nils Hennig, Associate Professor of Pediatric Infectious Diseases, is Director of the Public Health Education Program at Mount Sinai Hospital, a network of seven facilities in New York City, treating a total of 1,250 patients with Covid-19 . The one in Brooklyn is already nearing its limit, with 87% of fans used.
“The number of Covid-19 patients doubled every two days, but now that doubling is only happening every six days, which is a very encouraging sign. We do not know if we can explain this positive development by the confinement of New Yorkers, but in any case we are seeing it in our hospital.
“At the moment we are using all available spaces to accommodate patients; in the cafeteria, in the hallways. This is how we have been able to triple the number of intensive care beds since the start of the crisis. Pastor Franklin Graham’s Christian Association has set up tents in Central Park to receive our new arrivals and we are starting to set up beds in Saint John the Divine Cathedral, near Mount Sinai. From a material point of view, our hospitals are better off than other facilities in New York because we usually have two days of stock in advance. Mount Sinai board members have been able to use their contacts in the business world, especially in China, to secure supplies of ventilators. But it is not enough to receive them: it is also necessary to ensure their rapid distribution in the various hospitals of our network, from one floor or from one building to another on time, depending on the condition of the patients .
“At present we expect to reach the peak of the disease in two to three weeks, followed by a plateau phase which could last three months. There is a chronic shortage of beds in American hospitals, which are constantly close to saturation. More generally, people visit their doctors less here than in other countries because of the problems of medical coverage. We therefore receive many patients affected by pre-existing diseases that increase their vulnerability to Covid-19.
“For now, we are holding on, because we are better supplied than other hospitals and I must acknowledge the hard work of our staff. Everyone is requisitioned. All researchers except those directly assigned to research on the virus, have stopped their work to take care of the sick. All elective surgeries are on hold and unfortunately we all have much less time to follow our other patients. We can hold on for now, but I can’t go too far for the next few weeks. We are also very worried about other states that are less well equipped than us from a hospital point of view. ”
(1) The first name has been changed.
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