ICUs under strain as NYC’s new coronavirus patients are sicker than ever
Coronavirus patients arriving at New York City’s hospitals are increasingly already very sick with the deadly disease — and are pushing intensive care units to their limits or even beyond, The Post has learned.
Councilman Francisco Moya (D-Queens), whose district covers hard-hit Elmhurst Hospital, said the emergency room there “has kind of stabilized since we saw that big tidal wave” but noted that “they’re at capacity in the ICU.”
“So what it’s saying is that the people who are coming in are coming in at critical stages,” said Moya, who formerly worked as the hospital’s director of business development.
“The ICU is now the place where they still have a challenge there.”
A nurse at Manhattan’s Mount Sinai Hospital likewise said that while it’s no longer “so insane in the emergency department,” the ICU was “actually where the crazy s–t is happening.”
“When we take patients up there, it’s insane,” the nurse said.
“They’re putting two patients in every ICU unit. When I brought a patient upstairs — a freshly intubated patient who was critical and unstable — we had to transfer them from a stretcher to a bed in the hallway, which is obviously unsafe.”
The nurse added, “If a patient, God forbid, codes [from cardiopulmonary arrest], there’s no room to do a code. There’s no room because patients are just jam-packed in there.”
The nurse also said that Mount Sinai was scrambling to find space for its non-critical patients.
“They’re putting patients everywhere. We have lots of beds in the atrium, they’re putting beds in the library,” the nurse said.
A spokesman for the New York State Nurses Association said the union had received reports from various hospitals about “people who belong in the ICU who are still in the emergency room.”
Updated Health Department statistics posted online Thursday showed that while new hospital admissions for COVID-19 symptoms dipped below 400 for three days in a row, the number of people in critical care at the city’s public hospitals rose steadily over four days, from 835 to 887.
Other statistics released by City Hall later in the day showed at least 3,070 patients in ICUs in all hospitals as of Wednesday evening, down slightly from at least 3,120 on Monday.
Dr. Pia Daniel, an emergency room physician at the SUNY Downstate hospital in Brooklyn, described the coronavirus patients arriving there as “very, very sick.”
“Right now the biggest strain on the health-care system is upstairs in the ICU on the medical floors because those areas are still really full,” she said.
Many hospitals have had to convert operating rooms and other areas into ICU units for coronavirus patients, including NewYork-Presbyterian/Columbia University Medical Center, where “an entire 36-bed floor (7GN) is now fully renovated for conversion to ICU space,” its chief surgeon, Dr. Craig Smith, tweeted last month.
Elena Gonzalez, an emergency room nurse at Wyckoff Medical Center in Brooklyn, said there have been three or four deaths in the ER there per shift, including people who were dead on arrival when brought in by ambulance.
“I received a patient dead already,” she said.
Gonzalez said the hospital recently received a third refrigerated trailer to expand its temporary morgue capacity, but also noted, “There’s a lot of people dying at home.”
“One of my co-workers, her husband died at home,” she said.
Some hospital physicians said they feared that people may be delaying treatment due to the crush of cases that led to terrifying reports of patients packed in like sardines or giving up rather than spend hours in a waiting room.
“That is the worry,” said Dr. Salvatore Pardo, chairman of emergency medicine at Long Island Jewish Valley Stream.
Last week, Pardo said, “We started seeing that the only patients that we’re getting were very sick patients.”
Dr. Philip Otterbeck, chairman of medicine at Richmond University Medical Center in Staten Island, also said that while the emergency room there was handling a “lower overall volume” of coronavirus patients recently, those showing up were “more likely being admitted versus being triaged and then discharged.”
Otterbeck also noted that in the ICU, “fewer of the patients are being discharged as compared to a month or two ago” and that “some patients with COVID-19 do decompensate quickly.”
“It’s possible that some patients are waiting too long to seek medical care,” he said.
“That’s why it’s essential that patients who are ill remain in consistent contact with their primary care provider who can advise them when it’s time to seek care in an emergency department.”
Dr. Catherine Jamin, vice chairwoman of clinical operations in the emergency department of NYU Langone Health, said she hadn’t seen any examples of people with coronavirus symptoms waiting too long to seek hospital treatment, saying, “The number of patients we need to intubate in the ED is much less than it was.”
Jamin also said that while the hospital network still had enough ICU beds, “we still need to make sure all of our units are versatile to take care of patients in respiratory failure.”
“While many of our patients can go home, the ones that need to stay and stay on a ventilator, have to stay for weeks at a time,” she said.
“And that has been a significant impact of COVID-19 on the hospital system.”
Additional reporting by Lorena Mongelli, Sam Raskin and Joseph Konig
Source: Read Full Article