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NYC Hospitals Struggle with Coronavirus Surge

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March 26, 2020 — On a sunny, early spring day in Woodside, Queens, you’d expect to hear the shouts of children at recess from a nearby school, rumbling trucks making deliveries, music blasting out of car windows. Instead, right now the only sound is the occasional wail of a siren, another ambulance transporting another patient to one of the city’s COVID-19-crowded hospitals. Elmhurst Hospital, the closest one, lost 13 patients to COVID in a single day.

New York state, and in particular New York City, has become the epicenter of the outbreak in the U.S. and a harbinger of what other hotspots can expect. By noon on Thursday, the state had 37,258 confirmed cases, more than half the cases in the entire country. And 21,393 of them are in New York City alone — 3,537 diagnosed just yesterday. Across the state, 358 people have died. Of that number, 281 were in the city.


Not Enough

As of Wednesday evening, 3,922 people had been hospitalized in New York City.

The influx of cases threatens to overwhelm certain hospitals in the city, where emergency rooms run out of gurneys and patients have waited up to 60 hours for a bed. In the 3 weeks since the virus hit the city, Brooklyn Hospital Center has seen 800 COVID-19 patients, according to the New York Times.

To meet the anticipated need for inpatient treatment, the Jacob K. Javits Convention Center in Manhattan is being turned into a medical center with four 250-bed hospitals, the Times said. A 1,000-bed Navy hospital ship has been promised, but it won’t arrive until mid-April. Governor Andrew Cuomo said the goal is to have an overflow capacity of at least 1,000 beds in all five of the city’s boroughs plus surrounding counties.

In order to treat all those patients, hospitals will require more workers. Cuomo put out a call for retired health care professionals to volunteer. More than 50,000 have signed up.


Intensive Care

For the most critical cases, the situation is grim. Ventilators, which breathe for patients who can’t breathe on their own, are in demand. Non-coronavirus cases usually remain on the machines for 3 to 4 days. But COVID-19 patients tend to need ventilators for 11-21 days, stretching the limited supply even further. In response, the state has approved a splitting technology for the machines so each one can breathe for two patients. Hospitals are also converting anesthesia machines to work as ventilators.


“The number of ventilators we need is so astronomical, it’s not like they have them sitting in a warehouse in the federal government,” Cuomo says. “You have to find those ventilators or convert them, or get companies to manufacture more.”

All of the more than 1,800 intensive care beds in the city are expected to be filled by Friday, according to a report in the New York Times. The city is scrambling to add more ICU beds to the system, Mayor Bill de Blasio said.



“ICU’s are not a fixed asset anymore,” the mayor said in a press briefing. The City is converting regular rooms to be used for intensive care. “We conceivably could have a hospital that’s all ICU.”


Scrambling to Meet the Needs

The tsunami of cases affects more than just the hospitals’ facilities. For some health care workers, personal protective equipment (PPE) is in short supply. At Mt. Sinai West hospital, a nurse assistant died from COVID-19 on Tuesday. Pictures on social media had shown staff at the hospital using garbage bags as gowns, according to media reports. But Cuomo says that for now, the state has what it needs.

“For the past few days, distribution may have been start-and-stop, but we have enough PPE for the New York City hospitals,” he said. “We have enough for the immediate need, but not past that.” Cuomo has been tweeting thanks to companies that donate goods and services.

And for patients who don’t survive, New York City is also making preparations. Forty-five refrigerated trailers are being dispatched to hospitals whose morgues are overwhelmed. Each can hold up to 44 bodies.



Sources


New York Times: “13 Deaths in a Day: An ‘Apocalyptic’ Coronavirus Surge at an N.Y.C. Hospital,” “‘We’re in Disaster Mode’: Courage Inside a Brooklyn Hospital Confronting Coronavirus.”

Andrew Cuomo, governor, New York, press briefing, March 26, 2020.

Bill de Blasio, mayor, New York City.

NYC Health: “Coronavirus Daily Data Summary.”

New York 1 News: “Mount Sinai West Nurse Assistant Dies from Coronavirus.”

Bloomberg News: “Morgue Space in NYC Expanded With 45 Cooler Trucks.”



© 2020 WebMD, LLC. All rights reserved.





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Rashmika Mandanna Latest Workout Live Chat With Fitness trainer | Rashmika workout | Filmylooks

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Watch Rashmika Mandanna Latest Workout Live Chat With Fitness trainer | Rashmika workout | Filmylooks

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Key Drugs Join PPEs on List of Front-Line Shortages

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What your doctor is reading on Medscape.com:

APRIL 02, 2020 — First it was a critical shortage of personal protective equipment. Then pleas for more ventilators to sustain patients with COVID-19 and providers to care for them. Now, multiple sources are reporting deepening shortages of the drugs needed to help ventilate patients and keep them sedated.

Shortages are already evident for albuterol; neuromuscular blockers and sedatives, including fentanyl, midazolam, and propofol; and vasopressors for septic shock, even as orders increase exponentially.

The rates at which hospitals traditionally had been able to fill orders for ventilator-associated drugs was 95%, Dan Kistner, PharmD, told Medscape Medical News

“These classes of drugs have dropped to 60 or 70% in the last month alone,” said Kistner, senior vice president for pharmacy solutions at Vizient, a group purchasing organization that negotiates medicine contracts for about 3000 hospitals and healthcare facilities in the US.

“Every day it’s dropping 2 or 3 additional percent,” he continued.


Demand “Unprecedented”

The demand is simply “unprecedented,” he said, adding that the shortages are piling up even after elective surgeries have been put on hold.

A California nurse’s tweet in a nationwide thread of tweets under #WeNeedMeds poignantly described the consequences of severe shortages of some of these drugs. “Please do not put me on a vent if you can’t keep me sedated,” she writes. “I understand the alternative is death.”

Esther Choo, MD, MPH, an emergency physician at Oregon Health &  Science University in Portland, tweeted: “Those ventilators can’t really be used without a similarly vast supply of coupled medications to get people *on* the vents — and keep them on humanely. Hospitals are already experiencing shortages, before we even hit disease apex.”


15 Drugs at or Near Short Supply

Healthcare improvement company Premier, based in Charlotte, North Carolina, this week released a report that found 15 drugs used for COVID-19 care are in shortage or close to being in short supply at the same time demand is skyrocketing, particularly in New York.

Their data differ slightly from Vizient’s but still show increasing numbers of orders going unfilled.





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What a great live class with @tracyandersonmethod and @anneclaire.nelson today!!…

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What a great live class with @tracyandersonmethod and @anneclaire.nelson today!! So much energy and realness at real time! The balancing moves with the chair and broom stick are so nostalgic (and really challenging!). I love it when I forget about myself for being so concentrated and into the workout – “runner’s high” or “Tracy’s high” as you might call it! And love love love her little outdoor studio in Florida 🌴 makes this entire crazy situation feel more special, I guess in a couple of years we will say “remember that time Tracy used to teach outdoor under palm trees”? It will make reframing this situation into a positive phase in our lives much easier! Enjoyed every second of it! @tracyandersononlinestudio #tracyandersonmethod #tracyandersonforlife #outdoorworkout #homeworkout #stayhomestayactive



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