As the New York metro area has 60% of all the new coronavirus cases in the United States and is responsible for half the cases all over the country, New York Governor Andrew Cuomo said Tuesday the number of hospitalizations is expected to peak in the next 40 days as hospitals are already encountering shortages of equipment needed to protect medical workers and to keep patients alive when the city’s COVID-19 cases peak in the coming weeks. We’re joined by two people on the front-lines of the pandemic: Sean Petty, a registered nurse in the pediatric emergency room of a public hospital in the Bronx and member of the New York State Nurses Association board of directors, and Kelley Cabrera, an emergency room nurse at a public hospital in the Bronx.
AMY GOODMAN: We’re broadcasting from the epicenter of the coronavirus pandemic in the United States, New York City, with my co-host Juan González in New Jersey, with the second most coronavirus cases in the country. The New York metro area has 60% of all the new coronavirus cases in the United States and is responsible for half the cases all over the country. The death toll in New York is 271 with more than 26,000 confirmed cases. Almost half the cases in New York are among people between the ages of 18 and 45 years in age. Federal officials say anyone who travels from New York City should self-quarantine for 14 days.
New York Governor Andrew Cuomo said Tuesday the number of hospitalizations is expected to peak in the next 40 days. Four temporary hospital sites will be built to address the shortfall of hospital beds, including one at the Jacob Javits Convention Center in Midtown Manhattan. Cuomo blasted the Trump administration for failing to respond to the magnitude of the crisis and said hospitals are already encountering shortages of equipment needed to protect medical workers and to keep patients alive.
GOV. ANDREW CUOMO: FEMA is sending us 400 ventilators. Four hundred ventilators? I need 30,000 ventilators. You want a pat on the back for sending 400 ventilators? What am I going to do with 400 ventilators, when I need 30,000? You pick the 26,000 people who are going to die because you only sent 400 ventilators!
AMY GOODMAN: Many hospitals in New York say they’re already down to their last weeks of personal protective equipment to keep frontline medical workers from contracting COVID-19. Some are being forced to reuse single-use masks. If they get sick, hospitals will face even greater staff shortages amidst the outbreak.
For more, we’re joined by two people who are working on the frontlines of this pandemic. Sean Petty is a registered nurse in the pediatric emergency room of Jacobi Hospital in the Bronx. He’s a member of the board of directors of the New York State Nurses Association. Next to him is Kelley Cabrera, an emergency room nurse there, as well. And, of course, co-hosting from his home in New Brunswick, New Jersey, is Juan Gonzalez.
Sean, let’s begin with you. Can you describe the conditions at your hospital? What do you need? What do you have?
SEAN PETTY: Absolutely. Well, the first thing that we need, first and foremost, is we need N95 masks. N95s are the only proven prevention in terms of masks for healthcare workers for N95 — or, for COVID-19. In Wuhan, China, once they realized that healthcare workers were becoming infected, and they imported 42,000 healthcare workers to help with the crisis, they outfitted them with N95 masks and full protective equipment, personal protective equipment, or PPE, as we call it. And they achieved an unbelievable zero out of 42,000 infection — noninfection rate. So zero healthcare workers out of 42,000 with full PPE were infected after they were imported into Wuhan, China.
So, we know that N95s are the only significant protection that we have against this virus. And they are the item that is in most severe shortage in this country. Just this morning, as I was walking into the hospital, and we heard of — we started hearing about reports of this just last night — our command center has been telling nurses that the one N95 mask that they are distributing is the only N95 mask that they’re going to be getting for an entire week. So, this is a profound —
AMY GOODMAN: Now, I just want to be clear on how unusual this is. The head of the American Medical Association said, if you did something like that — reuse, reuse, reuse a mask — it would have been grounds for dismissal in the past. Talk about the significance of what it means to reuse your mask, Sean, seeing patient after patient who are suffering from this highly contagious disease.
SEAN PETTY: A hundred percent, Amy. We would have absolutely been brought up on charges and possibly terminated for reusing a mask in the future. The CDC guidelines from the beginning of this outbreak — at the beginning of this outbreak were that COVID-19 patients were to be treated with airborne and contact precautions, which necessitates an N95 mask by federal guidelines. They rolled those back, caving into pressure from the hospital associations that were talking about their shortage. So, they rolled their guidelines back, not by science, but because of — not because of science, but because of the shortage. And so, that allowed the hospitals to ration these masks in that way.
And so, what it means is that we take — we use a mask, we touch the mask, we take care patients, our hands could potentially become contaminated, our hands then contaminate our mask, and then, when we reuse it, we potentially contaminate ourselves, and then we’re putting other patients at risk. Now, we take care of patients who are suspected of COVID-19, we take care of patients who have COVID-19, and we take care of patients who don’t have any symptoms of COVID-19. So, we, of course, as healthcare workers, then are not only infecting ourselves, not only infecting each other as healthcare workers, because it’s very difficult to practice social distancing in a healthcare setting when you’re, like me and Kelley are, in traumas, in tight quarters taking care of patients, we are infecting each other, and we’re infecting — we’re potentially infecting other patients. So, to contaminate our own masks and to compromise the integrity of those masks repeatedly makes those masks absolutely useless at a certain point. And you’re absolutely right that this is something that is not — something that the hospitals would have disciplined nurses prior to this, and something that they’re mandating us to do in this current context.
JUAN GONZÁLEZ: Kelley Cabrera, I’d like to ask you about another critical component of the best possible care, the issue of ventilators. We heard Governor Cuomo blast the federal government for not providing sufficient numbers of ventilators. What’s the situation in your hospital with ventilators?
KELLEY CABRERA: Yeah, so, I work at the same hospital as Sean in the adult emergency room, and so I am taking care of the older population. And we have been seeing, as you guys have stated before, the numbers, between 18 and 45, like those numbers are a lot higher. We know we don’t have enough. It’s a discussion that doctors are having, that nurses are having. It’s a conversation that is way out in the open. Previously, prior to coronavirus, if there was a patient coming in who we knew needed a ventilator, it was no questions asked. You went in, and you provided that care, and that was it. And we’re starting to see the situations where, unfortunately, we’re really — we have to debate, you know, is it worth — it’s horrible to say it this way, but we really have to debate, like: Is it worth exposing all of our workers, when we know that we don’t have the right equipment and when we know the machines aren’t going to be enough? So those conversations are starting to happen. I’ve heard at other facilities in the Bronx already that ventilators have run out. For us, that hasn’t happened yet, but it’s definitely not looking good. It’s going to happen. And it’s a conversation that, unfortunately, we’re forced to have now.
JUAN GONZÁLEZ: And I’d also like to ask you, Kelley, about the — Governor Cuomo has asked all the hospitals to increase capacity by 50% in terms of beds. Have you seen that process begin in your hospital? And, of course, increasing the number of beds also requires having more staff, as well, to deal with those beds. How has that been playing out in your hospital?
KELLEY CABRERA: Yeah, that is starting to happen now. I think a really big message here is that we have to remember that a lot of the issues that we’re seeing come up now, they’re not new issues. So, prior to coronavirus, we were already holding patients in our emergency room for days at a time, not just our emergency room. I know that this happens across the country in several hospitals, because hospitals have always been stretched to their limit. So now we’re just adding the stress of a pandemic to it, and it’s pushing us to new places we’ve never seen before.
So, we have opened up new spaces in the hospital. Prior to this, we had advocated for that space before for the previous patients that we were holding in the emergency room. And now that space is being used by shuffling other patients in the hospital to that empty space in order to make more rooms on the floors for more ICU patients. I know there’s been conversions of different units into — that are specifically going to be for ICUs. Yesterday, our waiting room started — they started construction in our waiting room to expand an area for where these patients will be taken care of. Like, they are building a wall within our waiting room, because we have to do it one way or another. Like, to increase 50% capacity, it’s making us do the craziest things. We’re putting patients together that perhaps we wouldn’t have put together before. We’re trying to put people — the biggest issue right now is space, lack of equipment, lack of ventilators, but we’re trying to — we know that the surge is going to happen, and all we’re trying to do is best prepare for it. And unfortunately, it’s making us make some really hard decisions.
AMY GOODMAN: Kelley Cabrera, can you talk more about testing of healthcare workers, like you? What kind of access do you have to healthcare tests? I mean, I believe something like four in five cases, people are infected by people who are asymptomatic. Now, certainly, you are on the frontline. You’re using and reusing your protective equipment. If you’re feeling sick, what kind of access do you get to tests? And then, how long do you have to wait and work, while you might not be feeling well, before you get results?
KELLEY CABRERA: So, we’ve been told that if we don’t feel well, we are supposed to — you know, we should be going home. It’s kind of what’s being said. However, we know from — I’ve experienced, like from speaking to other — excuse me — from other workers that have gone through this, it’s basically you have to have a fever, body aches, and they ask you basically the same symptoms as we would ask any other patient that comes into the emergency room. However, for us, we have to — it’s not guaranteed that we’re going to get a test just because we work on the frontlines. So, initially, we were advocating for that, being that we knew that a lot of us were getting exposed, and, obviously, like, we might not display symptoms, and we might be passing it along to other people. But I think from what the mayor had said, as well, it’s just like we have to all basically assume that we have it. From other workers that I’ve heard that have been tested and have been told that they are positive, they are to stay at work — sorry, they’re to stay at home for seven days and then wait the three days — have at least three days without a fever before being able to return to work. It’s not guaranteed that we’re going to get tested at all. Like, we have to go through the same process. We have to call 311. I believe our hospital also has a different hotline for us, as well, but basically we’re following the same guidelines as the general public, even though we have arguably the most exposure.
JUAN GONZÁLEZ: Well, I’d like to ask Sean — going back to this issue of hospital capacity, over the last few decades, and certainly during the period that Governor Cuomo has been in office, the number of beds available per patient in the United States in many states has declined dramatically, mostly because hospital managers see empty beds as not money-making, so they want to reduce the number of empty beds as much as possible, so they staff fewer and fewer beds. Could you talk about these past policies and now, with this sudden crisis, how the chickens have come home to roost in terms of this maximum bottom line for hospitals?
SEAN PETTY: Yeah, absolutely. And I would just add that it’s just not hospital managers. It’s actually all of our — all of the people who are making political and economic decisions around public health in the city and the state. So, for instance, I would call Governor Cuomo probably the single most important person in terms of the drive to close down hospital beds in this state over the last 20 years. In New York state, we’ve gone from 73,000 beds to 53,000 beds from the year 2000 to the present time. So, specifically because of policies that Governor Cuomo has pursued, we are now 20,000 beds behind where we need to be in terms of trying to scale up our capacity to these unprecedented levels. Governor Cuomo estimates, I think, this week that we need 140,000 hospital beds to have enough capacity to treat patients that need oxygenation and hospitalization during this crisis. So, we’re starting at 53,000 instead of 73,000 to scale up to this, to scale up to the need that is being estimated. So, the way Governor Cuomo did that is he came up with a hospital bed closure commission. It was called the Berger Commission. And he also has had now two rounds of Medicaid cuts. The first — they’re called the Medicaid Redesign Teams. The second Medicaid Redesign Team just made a recommendation for massive Medicaid cuts, including specific cuts to the city hospital system, where we work, just in the last two weeks. So Governor Cuomo is currently trying to reduce Medicaid spending in the state by almost $2.5 billion during this pandemic. And this will absolutely result in a decrease in healthcare capacity and keep the state from getting matching federal dollars for Medicaid spending.
So, it’s unfathomable to somebody like myself, somebody who has worked in a public hospital for 12 years and has seen these cuts, seen the resulting decrease in staffing, seen the resulting decrease in services. We had to fight a couple years ago just to keep our pediatric trauma center open in the Bronx, the only pediatric trauma center that serves the entire borough of the Bronx and southern Westchester County. We had to fight to keep it open because of these Medicaid cuts. We thankfully won that fight, but we have been at a severe state of precarity when it comes to having these services available over the last decade going into this pandemic. And these are because of these specific policies of Medicaid cuts and hospital closures that have been explicitly pursued. And it’s very easy to find all of the quotes from Governor Cuomo, from the Medicaid Redesign Teams, from the Berger Commission, about these hospital closures in New York state over the last two decades.
AMY GOODMAN: And we don’t want to keep you, Sean. We know you’re right now scheduled to go on duty. What gives you the courage to be there, day after day, with the massive exposure that you have?
SEAN PETTY: Well, I think, a sense of duty to my patients. If we don’t show up, if we’re not there, nobody else is going to be. And I would also just add that I know nurses are getting a lot of attention right now, but it’s also our housekeepers are heroes right now, our nurses’ aides are heroes right now, the doctors. We all are coming to work. We all are doing Herculean — making Herculean efforts to make this thing work. We all are exposing ourselves to these risks. And we know that we’re at the very tip of the iceberg. And so, you know, but if not us, who else is going to do it? And we only ask — and we do this — you know, I’ve done this for 12 years. Kelley has done it for six years. We do this every day. We face adverse conditions every day. We face going into battle short-staffed. We face these things. So it’s something we’re used to. It’s something we’re prepared for. What I think undermines that courage and undermines that morale for us and our co-workers is that our government doesn’t have our back, that the Trump administration and the federal authorities have done virtually nothing to get us the armor and the supplies that we need in this war against coronavirus.
AMY GOODMAN: Sean Petty, I want to thank you so much for being with us, joining us from Jacobi Hospital in the Bronx, pediatric emergency room nurse. And thank you so much to Kelley Cabrera, emergency room nurse, as well.
When we come back, we go to Spain, which now has more than 47,000 confirmed cases, nearly 3,500 deaths, the second-highest number in the world after Italy. Among the hardest hit in Spain are the healthcare workers, as well. Stay with us.
Originally posted by Truth Out on 2020-03-25 11:10:31