NYC hospitals prepared for COVID resurgence

Like battle-hardened veterans, New York City hospitals and nursing homes are bracing for a potential resurgence of coronavirus patients, drawing on lessons learned this spring when the outbreak brought the nation's largest city to its knees. The new playbook derives from the apocalyptic days of March and April, when testing and resources were scarce, emergency rooms overflowed and funeral homes stacked corpses in refrigerated trailers.

Those insights, however hard won, make it far less likely that the city's hospitals would collapse under a second wave of COVID-19, health care leaders said. Even without a vaccine, doctors are touting increasingly effective coronavirus treatments, three-month supplies of personal protective equipment and contingency staffing plans.

Similar preparations are underway at New York's hard hit nursing homes, which accounted for a staggering percentage of the state's coronavirus deaths. Widespread testing for the new coronavirus is underway throughout the city and because people are wearing masks, those who are infected will have less severe cases because their exposure to the virus is less intense.

Data shows many new infections are among young people and they are less likely than older patients to need hospitalization. NYC Health + Hospital runs eleven hospitals, five skilled nursing homes, a long-term acute care hospital and 70 clinics in New York City. To battle the coronavirus, they've implemented new measures across their system. At Bellevue Hospital, they've upped the number of Intensive Care Unit rooms from 55 to 92.

The rooms now have thick glass doors and negative pressure can be introduced into each room with the flip of switch, meaning air infected with the coronavirus can be safely contained and decontaminated. They've upgraded the capacity to deliver large amounts of oxygen to large amounts of patients without having to ration. COVID-19 patients often suffer kidney failure, so there is now extensive plumbing to support dialysis.

Health care workers say they are much more conservative now about when to put a patient on a ventilator. Pre-COVID-19 pandemic conventional wisdom was to put a patient with low oxygen levels on a ventilator. But the COVID-19 sickness is unique in that patients can often recover using non-invasive ventilation such as high flow nasal cannula or BiPAP (Bilevel positive airway pressure).

The hospital also has on hand large supplies of Remdesivir and convalescent plasma to treat COVID-19 patients. New York has recorded nearly 37,000 new COVID-19 infections in October and is on track to have more than double the number of people sickened this month than those that fell ill in September. But so far, that increase has led to only a modest uptick in hospitalizations. On average, about 45 people a day have been admitted to New York City hospitals in October, city statistics show, up from an average of 29 per day in September.

That compares to an average 1,600 per day during the worst two weeks of the pandemic in March and April — a time when the state also recorded its highest daily death tolls and ambulance sirens became an ominous soundtrack, seemingly playing on repeat, to the city's out-of-control pandemic. Last week, by contrast, the city's 11 public hospitals had six total intubated patients — down from a peak of 960.

(Image Credits: AP)