'Coronavirus in N.Y.: Will a Surge in Patients Overwhelm Hospitals?' diff viewer (16/17)

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Coronavirus in N.Y.: Will a Surge in Patients Overwhelm Hospitals?	Coronavirus in N.Y.: Will a Surge in Patients Overwhelm Hospitals?
2020-06-24 10:16:27 UTC	2020-06-24 15:25:16 UTC (about 5 hours later)
Two of the biggest hospital systems in the Northeast — New York City’s Health and Hospitals Corporation and NewYork-Presbyterian Hospital — plan to cancel nonemergency surgeries. NYU Langone Medical Center’s Tisch Hospital turned a pediatric emergency room into a respiratory ward for adults. Northwell Health, which has a sprawling network of hospitals, is asking retired nurses to return to work.	Two of the biggest hospital systems in the Northeast — New York City’s Health and Hospitals Corporation and NewYork-Presbyterian Hospital — plan to cancel nonemergency surgeries. NYU Langone Medical Center’s Tisch Hospital turned a pediatric emergency room into a respiratory ward for adults. Northwell Health, which has a sprawling network of hospitals, is asking retired nurses to return to work.
But New York City’s hospitals, widely considered among the best in the world, may still be moving too slowly to get ready for a coronavirus outbreak that has already overwhelmed other countries and is now taking root in the New York region, according to many health care experts.	But New York City’s hospitals, widely considered among the best in the world, may still be moving too slowly to get ready for a coronavirus outbreak that has already overwhelmed other countries and is now taking root in the New York region, according to many health care experts.
“We are not prepared to deal with a rapid and severe surge of patients — we’re just not,” said Dr. Christopher M. Tedeschi, a longtime emergency physician and assistant professor at the Columbia University Medical Center. “We’re sort of planning for what’s going on right now, and we’re trying to make up for lost time, but I’m not sure we’re planning for a month from now, or even two weeks from now.”	“We are not prepared to deal with a rapid and severe surge of patients — we’re just not,” said Dr. Christopher M. Tedeschi, a longtime emergency physician and assistant professor at the Columbia University Medical Center. “We’re sort of planning for what’s going on right now, and we’re trying to make up for lost time, but I’m not sure we’re planning for a month from now, or even two weeks from now.”
New York State is a center of the outbreak in the United States, and the number of cases has been spiking in recent days, both because the virus is spreading and because more testing is being done.	New York State is a center of the outbreak in the United States, and the number of cases has been spiking in recent days, both because the virus is spreading and because more testing is being done.
Officials on Saturday reported the first two deaths in New York State linked to coronavirus.	Officials on Saturday reported the first two deaths in New York State linked to coronavirus.
The state had 613 confirmed coronavirus cases, up sharply from Friday, including 269 cases in New York City. Statewide, 50 of those patients were being treated in hospitals as of Friday, including 18 who were in intensive care.	The state had 613 confirmed coronavirus cases, up sharply from Friday, including 269 cases in New York City. Statewide, 50 of those patients were being treated in hospitals as of Friday, including 18 who were in intensive care.
Late Saturday night, officials said that two State Assembly members from Brooklyn, Helene Weinstein and Charles Barron, both Democrats, had tested positive for the virus.	Late Saturday night, officials said that two State Assembly members from Brooklyn, Helene Weinstein and Charles Barron, both Democrats, had tested positive for the virus.
The spike in cases in New York has unsettled some health care administrators and doctors, who are mindful of what has happened in northern Italy, where in less than three weeks, the virus has inundated hospitals with patients, offering a glimpse of what countries face if they cannot slow the outbreak.	The spike in cases in New York has unsettled some health care administrators and doctors, who are mindful of what has happened in northern Italy, where in less than three weeks, the virus has inundated hospitals with patients, offering a glimpse of what countries face if they cannot slow the outbreak.
Mayor Bill de Blasio has predicted that there could be 1,000 cases in the city by next week, and some doctors are expecting many more. The fundamental question for hospitals is not how many New Yorkers will get sick during the pandemic. It is how many at any given time, and whether the hospitals will have enough beds, workers and ventilators, which the most seriously ill will need to breathe.	Mayor Bill de Blasio has predicted that there could be 1,000 cases in the city by next week, and some doctors are expecting many more. The fundamental question for hospitals is not how many New Yorkers will get sick during the pandemic. It is how many at any given time, and whether the hospitals will have enough beds, workers and ventilators, which the most seriously ill will need to breathe.
There are about 53,000 hospital beds in New York State, including about 3,200 intensive-care unit beds, according to the American Hospital Association. About 20,000 of the beds are in the city, according to Mr. de Blasio. And officials have said there are about 5,000 ventilators in New York City — although many are already being used to keep patients — including stroke victims and others — alive.	There are about 53,000 hospital beds in New York State, including about 3,200 intensive-care unit beds, according to the American Hospital Association. About 20,000 of the beds are in the city, according to Mr. de Blasio. And officials have said there are about 5,000 ventilators in New York City — although many are already being used to keep patients — including stroke victims and others — alive.
The issues facing New York’s hospitals echo the challenges facing health care providers across the country. The World Health Organization says there are fewer hospital beds per capita in the United States than in most other nations, including in Italy and in China, where the coronavirus originated with devastating consequences.	The issues facing New York’s hospitals echo the challenges facing health care providers across the country. The World Health Organization says there are fewer hospital beds per capita in the United States than in most other nations, including in Italy and in China, where the coronavirus originated with devastating consequences.
Mr. Cuomo and Mr. de Blasio have repeatedly praised New York’s health care, and the hospitals in the city include storied institutions such as Bellevue Hospital Center, the oldest public hospital in the nation, and a number of top-tier systems. But in recent days, both officials have acknowledged that the outbreak will strain the system in extraordinary ways.	Mr. Cuomo and Mr. de Blasio have repeatedly praised New York’s health care, and the hospitals in the city include storied institutions such as Bellevue Hospital Center, the oldest public hospital in the nation, and a number of top-tier systems. But in recent days, both officials have acknowledged that the outbreak will strain the system in extraordinary ways.
“This is where Italy got into trouble,” Mr. Cuomo said on Friday. “They didn’t have enough I.C.U. beds to handle the number of patients who needed intensive care. That is going to be a problem in this state and in this country. That’s something that we have to watch very, very carefully.”	“This is where Italy got into trouble,” Mr. Cuomo said on Friday. “They didn’t have enough I.C.U. beds to handle the number of patients who needed intensive care. That is going to be a problem in this state and in this country. That’s something that we have to watch very, very carefully.”
Stephen Morse, a professor of epidemiology at Columbia University, said that in New York, preparedness plans are based on the experience in 2009 with the H1N1 influenza, which was far less severe an illness.	Stephen Morse, a professor of epidemiology at Columbia University, said that in New York, preparedness plans are based on the experience in 2009 with the H1N1 influenza, which was far less severe an illness.
“I don’t think anyone, anywhere is sufficiently prepared,” Mr. Morse said. “This is something that is really unprecedented in recent history.”	“I don’t think anyone, anywhere is sufficiently prepared,” Mr. Morse said. “This is something that is really unprecedented in recent history.”
Officials emphasize that most coronavirus cases do not require hospitalization, and that they are trying to slow the spread of the virus through so-called social distancing measures, including closing public spaces, banning large gatherings and asking people to work from home.	Officials emphasize that most coronavirus cases do not require hospitalization, and that they are trying to slow the spread of the virus through so-called social distancing measures, including closing public spaces, banning large gatherings and asking people to work from home.
Still, around the city and country, hospitals have begun adopting plans for a surge in patients. Some may unfurl large tents as triage centers outside emergency rooms — patients with severe respiratory symptoms would be directed one way, those with broken bones and non-coronavirus symptoms another.	Still, around the city and country, hospitals have begun adopting plans for a surge in patients. Some may unfurl large tents as triage centers outside emergency rooms — patients with severe respiratory symptoms would be directed one way, those with broken bones and non-coronavirus symptoms another.
Mark Jarrett, chief quality officer for Northwell Health, which runs 23 hospitals, including Lenox Hill on the Upper East Side, said there was a scramble to find available hospital wings and smaller units. He said he planned to put some coronavirus patients in a wing that had been closed at Glen Cove Hospital on Long Island.	Mark Jarrett, chief quality officer for Northwell Health, which runs 23 hospitals, including Lenox Hill on the Upper East Side, said there was a scramble to find available hospital wings and smaller units. He said he planned to put some coronavirus patients in a wing that had been closed at Glen Cove Hospital on Long Island.
“From my viewpoint, I don’t think anybody knows how many critically ill patients we’re going to have,” Dr. Jarrett said.	“From my viewpoint, I don’t think anybody knows how many critically ill patients we’re going to have,” Dr. Jarrett said.
Doctors said they were also worried that nursing home patients admitted to hospitals with coronavirus will become long-term patients because nursing homes might be reluctant to accept them back, out of a concern that they are contagious.	Doctors said they were also worried that nursing home patients admitted to hospitals with coronavirus will become long-term patients because nursing homes might be reluctant to accept them back, out of a concern that they are contagious.
About a month ago, Dr. Mitchell Katz, who heads Health and Hospitals, the city’s public hospital system, asked each of its 11 acute-care hospitals to come up with a plan for how to take 100 more patients. That could create space for 1,100 additional patients, though nobody knows whether that will be enough.	About a month ago, Dr. Mitchell Katz, who heads Health and Hospitals, the city’s public hospital system, asked each of its 11 acute-care hospitals to come up with a plan for how to take 100 more patients. That could create space for 1,100 additional patients, though nobody knows whether that will be enough.
Hospitals are also bracing for staffing shortages, because health care workers are bound to get sick or have to stay with children who are ill or home because of school cancellations. The public schools are open in New York City, but many charter, private and religious schools are closed.	Hospitals are also bracing for staffing shortages, because health care workers are bound to get sick or have to stay with children who are ill or home because of school cancellations. The public schools are open in New York City, but many charter, private and religious schools are closed.
The Mount Sinai Health System has started requiring employees to seek preapproval before personal vacations, and NewYork-Presbyterian Hospital is now urging workers to avoid travel for any reason, according to workers in those systems.	The Mount Sinai Health System has started requiring employees to seek preapproval before personal vacations, and NewYork-Presbyterian Hospital is now urging workers to avoid travel for any reason, according to workers in those systems.
Mount Sinai has also informed specialists in fields like gastroenterology and cardiology that they may be asked to care for coronavirus patients, one worker said.	Mount Sinai has also informed specialists in fields like gastroenterology and cardiology that they may be asked to care for coronavirus patients, one worker said.
The Greater New York Hospital Association said it was in talks with a large union about hiring retirees to help with day care for the children of hospital workers. Hospitals are asking the state whether it is necessary to send workers home who may have been exposed to the coronavirus when not wearing proper protection. Sending workers home could limit the risk of contagion but also quickly reduces available staff.	The Greater New York Hospital Association said it was in talks with a large union about hiring retirees to help with day care for the children of hospital workers. Hospitals are asking the state whether it is necessary to send workers home who may have been exposed to the coronavirus when not wearing proper protection. Sending workers home could limit the risk of contagion but also quickly reduces available staff.
~~Updated June ~~22,~~ 2020~~	Updated June 24, 2020
	Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
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.	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.
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.)
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.