Hospitals on Long Island reported that they are making the final preparations to ensure that there are sufficient beds for patients, nurses and doctors to treat patients and personal protective equipment for staff as the hospital approaches. peak of the COVID-19 pandemic.
Health systems as a whole add hundreds of health professionals – including doctors and registered nurses – to the front lines of the COVID-19 battle, as they also find creative ways to convert machines to ventilators and to treat patients with coronavirus.
The tempered optimism that New York could see “a flattening of the curve” is shared by senior executives, although they added that any relaxation of social distancing could be devastating for this progress.
“The early indication is that we may peak a bit sooner than the models had expected,” said Dr. Patrick O’Shaughnessy, executive vice president and clinical director of Catholic Health Services, who operates six hospitals on Long Island. “But I think it is still too early to say if this is really the top. “
The CHS has offered pay differentials to staff willing to take the extra shifts needed to deal with the crisis, said O’Shaughnessy. The health system based at Rockville Center has also reassigned staff from areas of the health system that receive few patients.
“We are also trying to add staff to join our workforce, but every health system is trying to do it,” he said.
There is a need across the region for more nurses and respiratory therapists, said Dr. Joseph Greco, chief of hospital operations at NYU Winthrop. The Mineola hospital added 60 nurses from outside agencies on Monday to help, said Greco.
“This is a welcome relief for our nurses,” said Greco, adding that the hospital will also add medical graduates from the NYU next week.
He said staff at NYU Langone’s offices are also joining hospital staff because “these offices are all down.”
Northwell Health is adding ambulatory staff to its hospitals, said Dr. Mark Jarrett, responsible for health system quality. Only about 200 of Northwell’s 800 ambulatory services are operating, he added.
“The doctors, nurse practitioners, medical assistants and nurses in these offices are filling in the gaps,” said Jarrett.
Northwell is also starting to add nurses from health systems to areas of the country that are not yet affected by COVID-19, he said.
Staffing has become “difficult” at Stony Brook Hospital, said Carol Gomes, Executive Director.
With the total number of beds going from 624 to 902, the expansion has focused on staffing levels. “We are running out of staff,” said Gomes.
She said they will work with New York Governor Andrew M. Cuomo and FEMA to access some of the volunteer health workers who have come from other regions.
Long Island Community Hospital in East Patchogue posted a message on its website looking for volunteers and received a dozen inquiries, said Richard T. Margulis, the hospital’s executive director.
Long Island hospitals need personal protective equipment such as masks and gowns, medical providers said.
They are expanding their current supply by cleaning and reusing certain items as part of the “crisis capacity strategies” published last month by the Centers for Disease Control and Prevention.
In Stony Brook, Gomes said, “We are working through the appropriate government channels to try to get” more masks and dresses. But while the hospital is waiting for reinforcements, “We are also doing what we can internally to try to create our own. “
Among the innovations, she said, are 3D face shields mass-produced by the university’s fleet of 3D printers.
President Donald Trump announced Sunday that 200,000 N95 masks are being sent to Suffolk to help hospitals in the region.
At LICH, Margulis said that about seven days of protective equipment remained in the hospital. He was happy to hear that the federal government was going to help.
“It will just give us a little more confidence that our inventory will be larger if it materializes,” he said.
Health systems have been tasked with increasing bed capacity by 50% to cope with the pandemic. They reoriented the halls, converted the gymnasiums and removed 300 seats from an auditorium to create space, if necessary.
Catholic health services have identified places where more COVID-19 patients could go, if necessary, said O’Shaughnessy. The CHS has a multidisciplinary and ambulatory office at 2200 Northern Blvd. to Manhasset who has not yet been converted. He could also move patients to a section of his Our Lady of Consolation nursing and rehabilitation center in West Islip.
Northwell Health has said it could add hundreds of beds to the North Shore University Hospital in Manhasset if the summit requires it, said Jarrett. He designated an empty auditorium, a rehabilitation center and a tented hospital in North Shore.
“It’s all in a hospital,” he said. “Other hospitals can also add them. “
The number of COVID-19 patients at Northwell reached 3,300 on Monday, compared to 3,100 on Friday. About a week ago, Northwell reported an increase of almost 300 a day.
NYU Winthrop could still convert patient rooms to COVID-19 treatment areas if necessary, said Greco.
Health system leaders have said they will continue to upgrade other types of breathing apparatus in case they run out of ventilators for patients who need to be intubated.
Northwell Health said it converted two-stage positive positive pressure machines (BiPAP) by designing and 3D printing a small plastic T-adapter, which is then attached to the devices at one end. The adapter connects to an endotracheal tube, which is used to intubate a patient.
Northwell said it has about 350 machines in the system and that their conversion could save thousands of lives.
Catholic Health Services and NYU Winthrop are also converting BiPAP devices, as well as anesthesia machines, to help COVID-19 patients breathe.
“We are cautiously optimistic,” said Greco.
At LICH, as many as 49 of the 57 fans are used, said Margulis. These include eight state-owned fans. He said the hospital had asked for 15 more ventilators on Sunday, and is waiting to find out how much the state will provide.
Healthcare providers said they are learning best practices for COVID-19 treatment in real time.
O’Shaughnessy told CHS that they “deploy drugs sooner rather than later.” He added that the drug used depends on many factors.
Long Island hospitals have been involved in clinical trials of COVID-19.
There is no vaccine or antiviral medication approved to specifically treat patients who test positive.
Many of the drugs tested have been approved by the FDA, such as hydroxychloroquine (Plaquenil) for malaria and arthritis and the antibiotic azithromycin (Zithromax). The combination of the two has helped some patients recover from their illness, but the scientific community has been careful to point out that it is not a “quick fix” for the virus.
Remdesivir, an investigational drug developed to treat people infected with the Ebola virus, may also benefit COVID-19 patients. It is being tested in hospitals operated by Northwell, Stony Brook, NYU Langone Health, Catholic Health Services, as well as Mount Sinai South Nassau.
Researchers are investigating whether antibodies in the blood of patients who have recovered COVID-19 could stop the infection in another patient or prevent the infection.
Known as convalescent plasma, Northwell, Stony Brook and Catholic Health Services are about to use it in clinical trials.
Meanwhile, Gomes said she finds hope in the good news she receives during their morning operations meeting: the number of people who returned home on the last day.
“We see a lot of sadness,” she said, “but we also see people who have recovered after being intubated and are returning home. Some patients go home. ”
With Lisa L. Colangelo