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ER doctor in NYC says ‘everything is transformed’ as COVID-19 grips hospitals

New York hospitals are being hit with a crush of patients suffering from COVID-19. There are over 30,000 confirmed cases in the state, and more than 280 people have died. While the hospitalization rate has slowed, it is still doubling every four or five days. William Brangham discusses the crisis with Dr. Craig Spencer, director of global health in emergency medicine at Columbia University.

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  • Judy Woodruff:

    Hospitals in New York state, meantime, are getting hit with a crush of sick patients struggling with COVID-19.

    Overall, there are more than 30,000 cases in the state, and more than 280 people have died. While the hospitalization rate has slowed, it's still doubling every four or five days.

    William Brangham gets a view from the front lines of this health emergency.

  • William Brangham:

    While many of us are locked up in our homes, and seeing images on television of shuttered businesses and quiet streets, there is, of course, a very different scene unfolding in many hospitals around the country.

    For a sense of what one New York City emergency room looks like, I'm joined now by Dr. Craig Spencer. He's the director of global health in emergency medicine at Columbia University Medical Center.

    Doctor, thank you very much for being here.

    You posted recently this incredible, visceral portrait of what one shift for you looks like in the emergency room. And I wonder if you could just give our viewers a sense of what a day looks like for you.

  • Craig Spencer:

    Yes, thanks for having me on.

    Generally, a day in the emergency department starts with a walk to work. Here in New York City, the streets are pretty empty, which is great. That's the best way to stop the spread of this virus.

    But when you cross that barrier from the street to the hospital, everything is kind of transformed. I walk into a place where I have worked for nine years, and now I see my colleagues in goggles and in gowns as soon as I walk in. It's just something that you can't get used to.

    And, throughout the day — you know, a week ago, it used to be, we were looking for the one or two patients that might have coronavirus. Now it's hard to find one or two patients in the emergency department that don't have coronavirus.

    It presents as everything. It's young. It's old. Everyone can get this virus, and everyone can get sick from it.

  • William Brangham:

    The description you gave in your dispatch was the sense of never-ending nature of it, that it was one patient after another. Is it really that much of an onslaught?

  • Craig Spencer:

    Yes, over the past couple of days, there has been an increasing volume of coronavirus patients.

    What's tough about them is that so many are severe. They have respiratory failure, meaning that they are having difficulty breathing. They need assistance to help them breathe. So, that often means putting on a mechanical ventilator, putting in a breathing tube, and putting people on life support.

    We do that to give them the best chance of surviving this disease. It's really one of the only things that we can do for people. What we know now is that we are not at all near the end of this. We are really just beginning.

    We're seeing case numbers climb on a daily basis. The emergency departments and ICUs throughout the city are being inundated and overwhelmed. If this continues at this rate, it's going to be really tough for all of us, on all the health care providers, on all the patients that are coming in the emergency rooms, and all the families that are impacted by this virus.

  • William Brangham:

    Do you have enough of the equipment? You talked about putting people onto ventilators, and I know that there's a shortage.

    Your governor, Andrew Cuomo, has talked about that. Do you have enough of those in your hospital? Do you have enough protective gear to protect you and your colleagues?

  • Craig Spencer:

    Throughout New York City, I have colleagues at nearly every hospital.

    What I'm being told is the same. Most are given one N95 respirator a week, which is that thicker, kind of stronger variant that helps filter out particles more.

  • William Brangham:

    One per week?

  • Craig Spencer:

    One per week, and are being asked to put one surgical mask over that per shift to kind of just keep it clean.

    That's because the supply chain is limited. We're hearing that we're getting hundreds of thousands or millions more of these masks being sent, which is great. The problem is, is that we're going to need an estimated 3.5 billion of these masks if this pandemic continues into next year.

    So we really need to do something to increase capacity, whatever we can, to get masks to people on the front line.

    Ventilators are certainly a big concern. We know that we're short. There are really wonderful, creative engineering solutions for how to turn one ventilator into two for two patients. The problem is, is, we can't turn them into four or eight.

    We know that ventilators are the only thing that are going to help some of these people survive.

  • William Brangham:

    The president yesterday seemed to indicate that we were near the end of this fight against coronavirus. He was hoping that, perhaps by Easter Sunday, that we would be so far along that churches could be packed with worshipers again.

    From your perspective, it sounds like you're seeing a much different trajectory to all of this.

  • Craig Spencer:

    You know, working in the emergency department is scary. The idea of churches being packed on Easter is in some sense more scary.

    We are just at the beginning of this. Our first case in New York City was just over three weeks ago. To think that, in three weeks, we will be in any place where we can have people in such a small confined area, where the disease, the virus spreads so well, it's really, really worrying. And it's only going to get worse. It's only going to get worse.

  • William Brangham:

    As we have been talking, I hear there's a young child in your family, obviously. How is it that you, personally, if you're dealing with this virus and theoretically covered with this virus repeatedly throughout the day, how are you protecting your own family when you come home at night?

  • Craig Spencer:

    It's a really great question. It's something that a lot of my colleagues have been mulling over for weeks.

    Some of them have separated their family. So, it's a consideration all of my colleagues have had. Personally, we're just being really thoughtful about how we're cleaning, about bleaching things down, about, when I get home, making sure I remove all my clothes before coming in, immediately go and take a shower.

    I'm just being really, really thoughtful. We know that the personal protective equipment is not perfect. In addition to the physical exhaustion of long days, the mental anguish of thinking with every patient, is this the time, is this a person where I become infected, we don't talk about it.

    We don't let ourselves be vulnerable. And I just want to share that message with my other health care colleagues throughout the country taking care of patients. You are not alone. Find someone to be vulnerable with. Reach out to a colleague. Have those discussions, because everyone is feeling and thinking the same way as you.

  • William Brangham:

    All right, Dr. Craig Spencer, director of global health at Columbia University Medical Center, thank you very, very much for your time, and good luck out there.

  • Craig Spencer:

    Thank you.

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