Report from Harlem, part II

I had another conversation with my son about the situation in New York. As you all know, he is currently working in the Emergency Room in Harlem as a medical surge worker. They have assigned him to be a part of the Red Team, meaning that he sees the most serious 25% of the patients that come into the ED. Please keep in mind that this is not data- this is the story of medical people who are in the trenches. For this reason, the information can't be verified, but he IS my son, so I trust what he has to say.

Here was what I got out of his report:

Nearly every patient who comes into the hospital has COVID. They remain in PPE for the entire shift. It takes 20 minutes to decontaminate, remove PPE, and then put it back on. That makes it difficult to take a quick bathroom break and even discussed wearing catheters with urine bags taped to their legs, but since no one is drinking fluids at work because of the risk of infection from the water bottle, they don't have to go too often and the idea was shelved. Yesterday, he took one break where he chugged a bottle of water, ate 5 slices of pizza, and went back to work.

They are out of everything- almost no medicine left that can be used. This isn't just because of COVID- apparently every bit of medical supplies that come in are being confiscated by the Feds. He complained about the lack of supplies, and a hospital administrator told my son that a large shipment was taken right from the docks in the port. (I am getting reports from medical people all over who are telling me similar stories. The Feds are taking a lot of supplies and not handing ANY of them out. I can't understand that one.)

The hospital is out of rooms. They have beds in the hallways to handle the overflow. Those are full. So now they hold the patients in the emergency room. When those are full, they will be putting the patients outside in tents.

The USNS Comfort, the hospital ship that is in New York to help with the crisis isn't really doing anything. The ship has room for 1,000 patients, but only 64 are actually being treated onboard. The reason for this is that the ship has set strict criteria and documentation requirements, and the bar is so high that the hospitals have stopped trying. The criteria? Each patient:
- must be an adult
- cannot have any mental health history. At all. (1 in 8 Americans is on antidepressants)
- can not be a user of street drugs (1.1 million New Yorkers are regular users of marijuana)
- must test negative for COVID (remember the part where I said everyone is positive?)
- must arrive with a 5 day supply of all medications (remember that the hospital doesn't HAVE any)
So this is why the ship is not really making a difference.

It isn't just COVID patients, the regular patients keep coming in, only now they have COVID on top of their other problems.
- One patient had been having an affair with a married woman. The husband found out, he and his friends held down the amorous man and sliced his face from the edge of his mouth to the earlobes on both sides. When asked if he knew who did it, the man replied that he did, but also stated that he wasn't going to tell because the cops aren't throwing anyone in jail, and the guy would then know who snitched and would beat him even worse. He did say that they see very few shootings (even before COVID) because of New York's draconian drug laws, but there are A LOT of stabbings, beatings, and other physical attacks. Criminals are going to commit crimes.

- One woman came in complaining of shortness of breath. Her numbers looked fine sitting in the triage area, but then asked to get some water. She walked from her bed 30 feet to the water fountain, turned pale, and was then found to have an Oxygen saturation of 56% on 4 liters of O2. They can't give meds, CPAP doesn't work, so they go to high flow O2 60 (sixty) liters per minute by high flow cannula. Within 2 hours, this is what her numbers looked like:

Breathing 51 times a minute on 60 liters of oxygen, and still only having an oxygen saturation of 76 percent means that she is not doing well at all. They had tried everything. This woman was dying, so the decision was made to intubate her and place her on a ventilator. Ventilators are a last ditch attempt and a virtual death sentence. Due to isolation protocol, no visitors are allowed in patient areas, so they have a set of iPads for patients to use that are connected by Facetime to iPads in the visiting areas. They let the woman and the family say their goodbyes, and then they placed the woman in a medically induced coma and put her on the ventilator. She will likely die within the next few days.

At the end of his shift, he was standing on the corner waiting on a ride back to his hotel, and people who walked by were thanking him for coming to NYC to help them. A group of young men actually stood with him until his ride got there, saying that they were making sure he was safe, because it isn't a neighborhood where white dudes should be waiting alone after dark. (Their words as relayed by my son.)

That was about it. He is doing well and is feeling like he is being challenged. He also says that he feels like he is earning "street cred" by being a part of this, and it will look good on his resume. He is definitely smarter than his old paramedic dad. I can't express how proud I am of what he has accomplished, and what he is doing now. I just worry for his safety. I have friends and former coworkers who work for NY EMS and for FDNY. They will look out for him as well.