At least 340 resident physicians in New York City have confirmed or suspected coronavirus cases, according to a new report that cites a lack of adequate testing and safety equipment among young doctors.
Taken during the height of the crisis last month, the survey of program directors identified 101 resident physicians testing positive and 163 “presumed” to have COVID-19 “based on symptoms but awaiting or unable to obtain testing.” Another 76 resident doctors had “suspected” virus infection.
The new report, by the New York City Residency Program Directors COVID-19 Research Group, gives one of the first quantitative looks at what it was like for doctors as hundreds of patients each day were dying of the COVID-19 disease.
“Anecdotally, we heard about increased risk to health care workers, but we really didn’t know,” said Dr. Royce W.S. Chen, an ophthalmologist and spokesman for the group. Resident physicians are qualified postgraduate doctors in training at hospitals and clinics under the supervision of a more senior physician and often deal with the sickest patients.
Overall, 45% of the 91 programs responding to the survey — representing 2,306 resident physicians around the city — reported having at least one resident with the disease. Of these, 16.8% were quarantined because of virus symptoms.
The survey of program directors also shows that 15% of resident physicians failed to be quarantined even though they tested positive.
Among those 101 resident physicians with confirmed cases, 56% sought help at clinics or primary care facilities and 17% visited emergency rooms, but only 2% were hospitalized. There were no reported deaths among residents in the study, researchers said.
Nearly all of the resident programs responding said they had to reuse masks or use them for an extended time, rather than the ideal single use. About 60% of these residents “felt that personal protective equipment was suboptimal,” the report found.
As an example, it reported 19 programs with 323 residents “used only surgical masks during patient encounters” rather than N95 respirators considered more effective in preventing infection.
Though Long Island suffered much of the same onslaught of COVID-19 during this time, Chen said the report includes only some resident physicians in Nassau and none from Suffolk. The report covers the time period from March 2 through April 12, when New York City was the “epicenter of cases and mortality.”
Though many doctors showed symptoms themselves, the study found that 113 “were waiting for or unable to obtain testing” among 1,673 residents in hospital programs responding to that question.
In an interview, Chen said the study couldn’t determine if resident doctors with inadequate equipment may have infected others but acknowledged “it probably had some role.”
The study found use of PPE such as surgical masks varied among programs. “Protocols mandating universal wearing of surgical masks were introduced as early as the week of March 2-8 in only 3 programs [3.5%], and as late as March 30-April 5 in 20 programs [23.5%],” it stated. Half of the supervising doctors for these programs said they felt the safety equipment for these young doctors was “suboptimal” and below appropriate standards.
In an interview, Chen said the study raises concern about the lack of PPE and further spread of the virus. “Maybe some institutions had better access to PPE earlier on, and some people were not able to get it until later,” Chen said. “You would assume if some programs had less access to PPE — and they have infected doctors or other infected patients — then it could allow for more transmission of the disease.”
Terry Lynam, a spokesman for Northwell Health, the largest hospital system in the state, said it did not participate in the study, though Chen indicated some Northwell doctors did respond to the survey. Joe Calderone, a spokesman for Mount Sinai South Nassau hospital in Oceanside, said, “We provide the same level of protection to our medical residents as we do to all other staff members in terms of personal protective equipment.”
Dr. Samuel Sandowski, who oversees the Mount Sinai South Nassau hospital residency training program, said at the height of the crisis about 80% of the internal medicine residents missed time from work because of symptoms but that the current level of infection among residents is “much, much lower.” In March, Sandowski said he, too, suffered COVID-19 symptoms and self-isolated for 14 days.