Sky News went to northern Italy to see what it looks like when an entire region’s hospitals are filled with people dying in a pneumonia epidemic. This is what they found. Watch, then read on.
One projection this morning estimated that all beds in New York City hospitals will be occupied by this coming Tuesday. The Wall Street Journal says the situation is already dire, with New York doctors noticing the same thing as the Italian doctors in the Sky News clip: People sick with COVID-19 go downhill fast.
“We’re getting pounded,” said Mangala Narasimhan, a doctor at the Long Island Jewish Medical Center, part of Northwell Health, the largest hospital system in New York. “I’ve been in ICU care for 15 years, and this is the worst I have ever seen things.”…
With the onslaught has come a surprise for many health-care workers: Far more young people than they expected are falling very ill. According to data published Friday morning by the New York City Department of Health and Mental Hygiene, 56% of confirmed cases of coronavirus in the city at the time involved patients under the age of 50…
The swiftness in which patients turn from mildly sick to struggling to breathe and requiring a ventilator is shocking, health-care workers said. “Things have gotten really bad this past week,” one Manhattan nurse said. “We’re all on edge.”
It would be a small mercy if the age disparity in death rates also extended to hospitalizations, with few younger adults needing ER care so that gurneys were open for the elderly. That’s not what they’re seeing in NYC, though. It may be that the percentage of under-50s who need emergency care is small relative to the percentage that’s infected, but the raw number isn’t. And that wouldn’t be great news even if it were true, as it would mean a lot of under-50s who don’t need the ER to recover are out there passing the virus around.
Anyway, now we know why Cuomo finally gave that shelter-in-place order. The only way to slow the stream of patients right now is to strangle all activity in New York. NYC is giving its economy high doses of radiation in hopes of sending its COVID-19 cancer into remission.
The remission had better start soon:
Here’s the latest influenza surveillance data from NYC. These are people in hospitals reporting Influenza Like Ilness (ILI). As you can see we’ve now shot past the peak of flu season. This is why this is not like the flu. pic.twitter.com/WRw1tTxa3H
— Chris Hayes (@chrislhayes) March 19, 2020
This is what NYC needs by early April:
* 3m N95 masks
* 50m surgical masks
* 15k ventilators
* 25m each of:
– surgical gowns
– face masks
We make none of these things in NYC. We need the federal gov't to mobilize production immediately.
— Mark D. Levine (@MarkLevineNYC) March 19, 2020
The Journal’s story also flagged a major shortage of protective equipment in New York, with some doctors forced to reuse masks and gowns. The most urgent shortage is the shortage of masks since they’re the most basic form of protection for medical personnel. And we don’t want medical personnel to be without protection right now:
THREAD: How can we protect healthcare workers? Evidence suggests risks of #COVID19 to providers grow when healthcare systems get overwhelmed. In Italy 9% of all infections are among medical personnel. In Lombardy alone, 20% of providers were infected. https://t.co/X4AW974blR 1/n pic.twitter.com/jPk04SVa27
— Scott Gottlieb, MD (@ScottGottliebMD) March 19, 2020
How will that shortage be eased? One near-term way to do it is start buying back masks from dentists and veterinarians and redeploying them to hospitals. Another is to have the FDA ease off on inspection protocols: According to Tom Rogan, there are pallets of medical supplies — including masks — sitting in warehouses right now that can’t go out because an FDA inspector hasn’t approved them yet. The bill Trump signed on Wednesday will also help by allowing manufacturers to sell masks directly to health-care workers without fear of legal liability. And then there’s the “wartime mobilization” factor, with 3M announcing today that it’s doubled its mask production to roughly 100 million per month.
There are masks in Chinese factories too, of course. But they’re hoarding those masks for themselves:
China made half the world’s masks before the coronavirus emerged there, and it has expanded production nearly 12-fold since then. But it has claimed mask factory output for itself. Purchases and donations also brought China a big chunk of the world’s supply from elsewhere.
Now, worries about mask supplies are rising. As the virus’s global spread escalates, governments around the world are restricting exports of protective gear, which experts say could worsen the pandemic…
Other manufacturers say the Chinese government is still claiming all the masks that their factories in the country make. “Mask exports are still not authorized, but we are following the situation every day,” said Guillaume Laverdure, chief operating officer of Medicom, a Canadian manufacturer that makes three million masks a day at its Shanghai factory.
It’s curious that the ChiComs are still clinging to protective equipment at a moment when they’re crowing about having zero native infections of coronavirus. Either they’re lying about having contained the disease and want the masks for a second wave or they’re deliberately withholding masks in order to worsen the crisis in the west, a little “bonus” for the world after the Chinese government’s incompetence and secrecy gifted it a pandemic to begin with. Could be both, of course — they’re lying about having the epidemic under control and they want to make things as painful as possible for the U.S. and Europe.
I don’t mean to suggest by focusing on the shortage in NYC that this isn’t a problem everywhere. It is. New York is the site of the biggest outbreak right now but the Times reported last night that a clinic in St. Paul, Minnesota is considering closing down entirely because they lack protective gear for their staff. One doctor in California compared the lack of gear to fighting a war without ammo. Some doctors are reusing the same mask over and over with intermittent treatments of Lysol in hopes that that’ll keep them protected. Meanwhile, the feds’ order for 500 million N95 masks imagines incremental delivery over a span of … 18 months, which is right around the time we should be getting past this crisis anyway thanks to a vaccine.
It’s all too little and much too late. Good luck to heroic MDs and RNs everywhere, not just in treating the sick but in trying not to die themselves. And to pharmacists too: They also need masks to produce sterile medications for vulnerable groups like senior citizens. Not gonna have a ready supply for awhile.
Update: It’s already bad. I can’t imagine what it’ll be like on Monday.
In the Bronx, doctors at Lincoln Medical and Mental Health Center say they have only a few remaining ventilators for patients who need them to breathe. In Brooklyn, doctors at Kings County Hospital Center say they are so low on supplies that they are reusing masks for up to a week, slathering them with hand sanitizer between shifts…
As it prepares for the worst-case projections, the state is asking retired health care workers to volunteer to help. The city is considering trying to turn the Jacob K. Javits Convention Center in Manhattan into a makeshift hospital.
“The most striking part is the speed with which it has ramped up,” said Ben McVane, an emergency room doctor at Elmhurst Hospital Center in Queens. “It went from a small trickle of patients to a deluge of patients in our departments.”
State officials think the peak won’t come until … early May.