New York is entering the next phase of the coronavirus crisis. The spread of infections is landing people in hospital beds.
The nightmare scenario all along has been the situation in Italy, where the sheer number of COVID-19 patients has overwhelmed the hospital system. New York’s hospital capacity is about 53,000 beds, with around 3,000 being specially equipped ones for intensive care. A majority of those are already in use. But the state estimated this week that New York will need between 55,000 and 110,000 beds, and perhaps as many as 37,200 ICU beds as the crisis peaks.
While bed utilization is not yet rising in correlation with confirmed cases, the lesson already learned from around the world is that we should respond with an all-out assault to add capacity. That means the smart cancellation of non-necessary procedures, the conversion or creation of new space in existing facilities, and maybe even the “field hospitals” mentioned by President Donald Trump. The president’s announced deployment Wednesday of a naval hospital ship to New York was a good move, although the ship is currently undergoing maintenance and reportedly might not arrive for weeks.
ICU beds critical
No less important: making sure hospitals have the supplies they need.
That starts with the ventilators common in ICU facilities to help patients breathe. They cost tens of thousands of dollars, are complicated to operate, and have been rationed in Italy as need outpaces supply. Doctors overseas have had to make heartwrenching decisions about who should get the mechanical help and who might be left to die.
That cannot be an option in New York. A 2015 report found some 10,000 ventilators around the state. But most were being used. That doesn’t bode well.
New York needs ventilators from the federal Strategic National Stockpile. The state is one of the U.S. hotspots for the disease.
New York can’t manufacture or procure goods like this alone on a large scale. And it’s not just ventilators that are necessary. Hospitals need protective equipment like gloves and gowns to prevent the spread of infection, and the N95 respirators or masks that keep health care professionals and patients safe. All hospital personnel in contact with patients need masks, not just those treating the outbreak, to ensure that infections are not spread among the medical professionals on the front lines.
Federal regulators have eased some restrictions to allow the medical use of non-medical masks. The Centers for Disease Control and Prevention has published crisis guidance on its website for extending the life of the masks: “Use N95 respirators beyond the manufacturer-designated shelf life for training and fit testing,” for example. And: “Extend the use of N95 respirators by wearing the same N95 for repeated close contact encounters with several different patients.”
That’s disturbing and a sign of the depth of the shortage, which could get worse. The supply chain could be disrupted for some masks made in China, according to a recent report from the Healthcare Financial Management Association. And some suppliers appear to be jacking up prices.
Rectifying this problem is beyond the state’s powers. It’s not enough to ask construction companies to donate their mask inventory to local hospitals, as Vice President Mike Pence suggested Tuesday. Companies in other countries are retooling their manufacturing processes to create vital supplies. Trump’s use of the Defense Production Act of 1950 to support domestic production of key medical supplies would be a necessary first step. We need to be operating on a wartime footing. Overpreparation is the goal.
LI hospitals prepare
Many of Long Island’s hospitals say they prepared ahead for shortages. We hope they’re ready — from the largest, most powerful hospital networks to the smallest providers. The supplies should be balanced across all facilities, so the more powerful institutions don’t gobble up the inventory. Veterans Affairs facilities in the region should also be tapped for staff, supplies and beds.
The next few weeks could be challenging ones. Our analysis of New York Health Department data estimates that Long Island has some 7,250 hospital beds and 550 intensive care-specific beds. That would be approximately 2.55 hospital beds per 1,000 people, slightly lower than the U.S. average of 2.8.
We might need all those and more as COVID-19 spreads, and every ventilator and mask and protective device that the country can create.
— The editorial board