Report from Harlem

As you all know, my son is in NYC working in the ED at Harlem hospital as part of a medical surge team that is trying to get the situation under control. I had a conversation with him last night, and I wanted to share a few things from that conversation.

They have organized the ED into teams that are based upon the severity of the patient. In ascending order, the teams are: Blue, Green, Yellow, Orange, Red. My son is on the red team. (AKA Team 1)

He said that every single patient that comes into the ED is positive for COVID. At this point, it appears like most of the population of NYC has the virus. He believes that they have turned the corner, and we should begin seeing a drop in patients in NYC, simply because there is no one left to infect.

They are not placing COVID patients on ventilators or intubating them, because placing patients on a ventilator is an almost certain death sentence. They are only intubating patients as an absolute last resort, and even then are advising their families that their loved one is about to die and then speaking with them about end of life decisions. Instead, they are finding that the most effective treatment is having the patient lie prone while giving them supplemental oxygen at 6 liters per minute.

They are almost out of all antibiotics, so unless the patient's pneumonia is confirmed to be bacterial by culture, no one is getting antibiotics.

I have recently seen people complaining that the US is padding stats by classifying anyone who dies while positive for COVID as being a COVID related death. This is actually valid, and I will explain using a couple of anecdotes from my son's patients:

His very first patient was complaining about shortness of breath, but was sitting up in a chair, texting.  The doctor he is working with took one look at the patient from across the room and said "COVID." My son said he laughed, thinking the doctor was joking. His oxygen saturation was measured at 68 percent.

Another patient came in with diabetic related symptoms. His blood glucose was 1,000. His blood chemistry was completely abnormal. He also tested positive for COVID.

Many people with aggravating conditions like diabetes, kidney or liver problems, or heart disease are walking around all the time with their body maintaining itself through compensation. What COVID is doing is pushing these patients over the edge.

One takeaway from my conversation with him:
The staff at the hospital wears a head to toe Tyvek suit with mask, goggles, shoe covers, gloves, and faceshield for their entire 12 hour shift. When they enter a patient's room, the put more gloves and a disposable gown over the top of that. He said that eating, drinking, and going to the bathroom is a 20 minute ordeal of decontaminating, dressing down, and then redressing. My son said he dressed down twice during his 12 hour shift- he went to the bathroom, chugged a bottle of water, and grabbed a bite to eat. (First time was a giant cookie delivered by a local bakery, and the second was two slices of pizza)

They had to begin doing this because too many of the hospital staff were getting infected.

What this tells me is that the Wuhan virus is far more contagious than we are being led to believe.