Yves came to this article to clarify something that is not difficult to infer from the reports of Covid pressure on hospitals: In the first wave, the limiting factor was physical ability, especially the number of beds. Now, the more restrictive is staffing… which is harder to measure well and can be extended in the short term.

Author: Greg B. Smtih ([email protected]).Originally published on Cities on December 29, 2021

With the rapid increase in the hospitalization rate of COVID patients, the number of available beds in several municipal hospitals has fallen to a level that may lead to the suspension of elective surgery.

In areas with high COVID hospitalization rates, the State Department of Health has the authority to impose this restriction on hospitals with a small number of available beds. Regions where an average of more than 4 new COVID patients per 100,000 people per day exceed the 7-day average trigger potential intervention by the department.

According to data from the New York City Department of Health and Mental Hygiene, New York City exceeded this threshold on Sunday. In the past 7 days, the average number of new COVID patients entering city hospitals reached 4.76 per 100,000.

City data showed that on Monday, the rate was even higher, reaching 5.48 new COVID patients per 100,000 people. Both are well above 4 new patients per 100,000 cut-off points.

The State Department of Health told New York City on Wednesday that so far, the influx of patients with new coronary pneumonia has not triggered a suspension of elective surgery.

Agency spokesperson Erin Silk wrote in an email response: “New York City currently does not meet any of the threshold criteria for inclusion in elective surgery guidelines.” She did not specify these criteria.

On Tuesday, Mayor Bill de Blasio (Bill de Blasio) mentioned Sunday’s 4.76 interest rate, but did not mention the updated data. He admitted that the rate was “very high”, but insisted that hospitals in New York City have controlled the situation. “Thank God, our hospital is handling this situation well due to all actions taken, all vaccinations,” he said.

Nervous nurse

Health care workers think the situation is more serious.

On Wednesday, nursing union officials expressed concern that as the number of COVID hospitalizations increased, staffing would again reach an insufficient level, which is reminiscent of the spring of 2020, when medical staff were struggling to cope with the overwhelming number of COVID patients.

“If there is no nurse to take care of the patient occupying that bed, what is the use of a physical bed?” said Pat Kane, a registered nurse and director of the New York State Nurses Association.

“As the number of COVID-19 cases has surged and our healthcare system is again under tremendous pressure due to the highly spread variant of Omicron, health systems and policy makers should respond to the challenge by safely staffing and protecting the front lines.”

Kane said the union is “very concerned that federal and state agencies and hospital administrators will cut corners on staffing, infection control, and other health and safety measures when we most need to protect medical staff and patients.”

The squeeze of patients seemed to hit public hospitals the most.

Tuesday’s 7-day average bed capacity data showed that the total number of available beds reported by New York City hospitals was 26%. In contrast, 5 of the 11 hospitals operated by the city’s health and hospital company have bed availability of 15% or less. National Digital Display.

In the past few days, several public hospitals have reported bed availability rates of 10% or less-a level that Governor Kathy Hochul marked as a “danger zone” on Wednesday.

The most recent single-day data indicates that the situation has become more urgent.

On Tuesday, Brooklyn’s Coney Island Hospital fell to the 7% mark, while the open bed capacity in Kings County of Brooklyn was 9%. On the same day, Elmhurst in Queens (one of the hospitals most affected by the first arrival of the 2020 spring pandemic) reached the 10% “danger zone” mark.

State hospital capacity data does not distinguish between COVID and non-COVID patients—but federal statistics show that COVID is playing an increasing role. The US Centers for Disease Control reported for the week ending December 26 that 11% of all hospital beds in Brooklyn and Queens were occupied by COVID patients, 8% in the Bronx and Staten Island, and 7% in Manhattan.

According to data from the state health department, as of Tuesday, 3,178 people were hospitalized with COVID-19 in New York City, compared with approximately 1,000 in mid-December.

HHC spokesperson Stephanie Guzmán (Stephanie Guzmán) said that the agency is ready to rearrange staffing and increase beds if needed.

She wrote in an email: “We are accelerating safe emissions and using our horizontal loading to ensure that the capacity can be managed in the second stage.” “In addition, we are ready to continue to expand the necessary capacity, and we are currently still Did not do so.”

Guzman said that the 10% capacity standard “is equipped with existing beds. As a reminder, we doubled the capacity of the ICU at the beginning of the pandemic, and there is a mechanism to increase this more quickly two years after the pandemic. This kind of conversion is flipped over.”

City Health and Mental Hygiene Department spokesperson Michael Lanza said the agency “supports the state’s efforts to maintain hospital capacity for critically ill patients, especially those with severe COVID-19.”

Lanza added that the department is working with the Greater New York Hospital Association to coordinate the efforts of all city hospitals, “providing support as we work together to end this wave.”

Insufficient gear

The hospital is also struggling to respond to the state government’s requirement that at least 60 days of personal protective equipment (PPE) supplies are on hand.

Hospitals must report their supply levels to the department on the first Tuesday of each month. According to records obtained by the city through the Freedom of Information Act, in November and so far this month, more than 20 hospitals have reported non-compliance with the rule.

Two are in the city: the public Woodhull Hospital in East Williamsburg and the Brooklyn University Hospital, which is part of the State University of New York’s Lower State Hospital system.

Woodhull also lacks beds: on Monday, Woodhull reported 10% of the 7-day average available beds.

Guzman said that because all 11 HHC hospitals operate under the same management, Woodhull can obtain any personal protective equipment it needs from the central warehouse that serves all the medical centers operating in the city.

“We operate as a health system consisting of 11 hospitals and use a central inventory to ensure that our medical staff have the appropriate personal protective equipment at work,” she said. “We stay within the requirements of the state government.”

Dawn Skeete Factor, a spokesperson for SUNY Downstate, said: “One factor that may contribute to the surge in hospitalization is the ease with which the Omicron variant spreads. A high percentage of patients admitted to the hospital for non-COVID-related issues in New York City have tested positive for COVID. One result requires that all COVID-specific patients receive the same strong response.”

The number of new COVID patients arriving at New York City hospitals every day is far less than the number when the pandemic first peaked in the spring of 2020, when the seven-day average number of new hospital admissions reached 1,667 on April 4. , The number dropped sharply, then rose again in the winter of 2020 with the arrival of the Delta variant, and reached a peak of 385 on February 10.

In the past Thanksgiving Day, city hospitals added an average of about 53 COVID patients every day, but then a highly contagious variant of Omicron appeared. Since then, the number of hospital admissions has risen sharply, reaching an average of 332 in the seven days as of Tuesday.

One model remains the same: unvaccinated people are 10 times more likely to be hospitalized with COVID infection than people who are fully vaccinated.