As New York City officials prepared on Tuesday to roll back openings in COVID-19 hot spots in Brooklyn and Queens, the president and chief operating officer of the city’s Mount Sinai Hospital, David Reich, sent an email to staffers warning of bed shortages and the activation of its surge capacity.
The internal memo, obtained by The Daily Beast, was sent to attending physicians, house staff, nurse practitioners, and physician assistants with the subject line “Current Bed Shortage and Surge Policy Activation.”
“We continue to experience very high occupancy of available inpatient beds and a large number of admitted patients in the Emergency Department,” Reich wrote. “Please look at all possible options for discharging patients as soon as possible. Nursing, Social Work, and Case Management are all aware and will work with you to facilitate patient discharges.”
“Thank you in advance for your assistance with this important patient care and safety issue,” he added.
The hospital did not respond to requests for comment from The Daily Beast on Tuesday and did not answer questions about to what extent those bed shortages were related to the uptick in novel coronavirus cases in what Mayor Bill de Blasio has described as nine zip codes. Even in the event that purported bed shortages were unrelated to COVID-19, the dual threats of a second wave and influenza season could spell danger for one of the city’s major hospitals.
“New Yorkers have been heroic in this struggle, fighting back against the coronavirus consistently,” de Blasio told reporters on Tuesday. “Now we have a challenge. We see a rise in cases in certain parts of our city, and we have to get ahead of this.”
“It will all come down to you, to everyday New Yorkers doing the right thing for yourselves, for your families, for your communities, by practicing the basic rules, basic vision that has worked for us over and over again, the wearing the mask, the social distancing, just doing the smart, basic things … together, we turn the tide in our favor,” the mayor added.
Dr. Louis DePalo—an adjunct professor of infectious disease at the Icahn School of Medicine and a board member of the Pulmonary Wellness Foundation who works as a doctor at Mount Sinai—did not comment on the bed shortage email but said he felt that the virus-ravaged city was progressing well “until the last two weeks,” when what he called “a zip code surge” began increasing cases in various regions of Queens and Brooklyn.
“In other words,” he said, “there are specific pockets of spikes.”
As of Tuesday, the city had reported a cumulative 242,315 novel coronavirus cases, 57,594 hospitalizations, and 19,220 confirmed deaths (and 4,646 probable ones). At its mid-April peak, the city was seeing more than 8,000 confirmed cases each day—likely a significant undercount, considering the lack of available testing and shortage of hospital beds at the time.
As of Tuesday, there were about 400 new cases overnight in the city, where the front lines of the battle with the virus have largely shifted from ICUs and morgues to long-term recovery wards, according to The New York Times.
Gov. Andrew Cuomo said on Monday he refused to give consent to much of de Blasio’s partial shutdown plan—in particular his method of outlining hot spots using zip codes, calling them imprecise units of measurement. Cuomo did, however, agree to allow school closures in those nine areas.
Later Tuesday, Cuomo announced that hot spots considered “red zones” would be reduced to 25 percent capacity at houses of worship, with mass gatherings completely prohibited and non-essential businesses closed. Restaurants in those areas would be forced to return to takeout only, and schools in both red and yellow zones would revert to remote learning.
But whichever areas of the city face opening rollbacks, one thing is clear throughout the five boroughs: Months of treating COVID-19 patients from the very beginning has left many medical providers feeling ragged, even if they aren’t yet again overwhelmed, Dr. DePalo told The Daily Beast. He described the feeling as more “working around resilience… like a war.”
“New York is really a mixed bag of safety and precautions,” said Dr. Noah Greenspan, a cardiovascular and pulmonary clinical specialist at the Pulmonary Wellness Foundation. “I have definitely seen people becoming a little too complacent for my own comfort. Some of the worst offenders have been people drinking in bars, which even though they are mostly outdoors, social distancing seems to be inversely proportional to the number of drinks someone has.”
“The concerning news is that while not yet at the ‘hotspot’ level, we are starting to see a slight uptick in numbers as we open up more and more including restaurants, gyms, other businesses, and schools,” said Greenspan.
And the city is also full of New Yorkers who contracted the virus months ago and are still working to get better—while everyone else ostensibly moves on. Gabriela Ochoa Perez, a 20-year-old actress and dancer who is treated by Greenspan, said she is in her fourth month of recovery and feels “uneasy” watching the city open back up.
“It seems that many have focused more on the fact that the city is reopening and forgotten why it had shut down in the first place,” Perez told The Daily Beast on Tuesday. “Seeing people eager to reopen society with their masks in their hand… It’s very frustrating to watch.”
Perez said she’s only at a “weary 50 percent” now and is often overwhelmed with fatigue.
“I still experience breathlessness with the easiest of tasks; including walking, speaking, eating, or even just standing up,” she continued. “Even with eight hours of sleep, I feel fatigued… I still get coughing fits out of nowhere that result in chest pains that I can only get rid of by lying on my stomach and hoping my inhaler will work its magic.”
“I do not remember what feeling rested is like,” she added.
But the good news, said Dr. Greenspan, “Is that after we were slammed hard, our numbers have come down significantly and have been staying relatively low as compared to some other parts of the country.”