LESSONS LEARNED FROM A TOUGH TIME
Confident city hospitals & nursing homes brace themselves for possible second wave of COVID-19
With lessons learned from a turbulent spring, New York City’s hospitals and nursing homes are gearing up for a pandemic resurgence and trying to keep the city’s health care system from collapsing under a dreaded second wave.
“The measures that were put in place seem to be working,” said Dr. Fritz Francois, Chief Medical Officer at NYU Langone Health. “Even if we see something of a resurgence, the outlook is that it’s not going to be similar to what we experienced in the spring.”
Those were the early days before social distancing was the norm, masks were worn in every corner of a city and business were shut down to keep crowds from gathering.
Despite the progress since those dark days of overflowing emergency rooms and packed funeral homes, anxiety remains among doctors and nurses about a deadly disease for which there is still no cure.
But they are confident that a second COVID-19 wave won’t cripple the city like the first one did, that personal protection equipment will last longer than an overnight shift and that contingency staffing plans will keep them from being caught off guard.
New York has recorded nearly 37,000 new COVID-19 infections in October and is on pace to have more than double the number of people sickened this month as fell ill in September.
But so far that rise has led to only a modest increase in hospitalizations, officials said. On average, about 45 people a day have been admitted to New York City hospitals each day in October, up from an average of 29 per day in September, city statistics show.
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.
“Our hospitals are still quieter than they would have been a year ago because people are avoiding care out of concerns about COVID,” Dr. Mitchell Katz, head of the city’s public hospital system, told The Associated Press. “We can have several hundred additional patients and still not be full.”
Hospitals around the city are rewriting policies and stocking up on supplies while closely monitoring fluctuations in statewide cases and computer modeling to decide whether and when to activate contingency plans.
The city’s public hospital system is installing new cameras and microphones in patient rooms to reduce exposure for nurses. NYU Langone has reduced to a matter of hours the time it needs to open a COVID-dedicated unit. New York-Presbyterian has stockpiled ventilators, even as doctors now recognize that anesthesia machines can be made to function as ventilators in a pinch.
Anxiety levels remain high at New York nursing homes, where the coronavirus spread rampantly for months. New York nursing homes reported 713 confirmed and suspected COVID-19 cases for the four weeks ending Oct. 11, according to federal Medicare data, up from 379 over the previous four weeks.
Seeking to head off new outbreaks, state health officials restricted visitation to nursing homes that can demonstrate they are “COVID-free” for 14 days, meaning no positive tests among residents or staff — a requirement nursing home proprietors said has been exceedingly difficult to meet, given the coming and going of staff from the facilities.
Earlier this week, New York banned visitation to most adult care facilities within coronavirus “red zones” where infection rates have ticked upward.
“The majority of nursing homes
do not have adequate staffing to meet the basic clinical needs of their residents under normal circumstances,” said Richard Mollot, executive director of the Long Term Care Community Coalition, a nonprofit advocacy group.
“We believe that this problem has been exacerbated by the pandemic, and have not heard anything of nursing homes as a whole working to address this problem in the face of current needs, no matter a second wave,” he said.
Still, like hospitals, nursing homes contend they are better poised for a potential second wave than they were the first, pointing to more widespread testing and supplies of PPE.
“Nursing homes have through hard experience learned how to keep their patients and residents and staff safe,” Chris Laxton, executive director of The Society for Post-Acute and Long-Term Care Medicine, told AP.