/As New York faces coronavirus bullet train, experts warn of challenges ahead

As New York faces coronavirus bullet train, experts warn of challenges ahead

With New York in a race against the “bullet train” of the coronavirus sweeping across it, public health experts warned of the challenges ahead to prevent the state from becoming the next Italy.

Gov. Andrew Cuomo painted a dire forecast of the outbreak Tuesday morning, saying spread of the disease was accelerating and the state was in “desperate” need of ventilators and more hospital beds with the projected apex just 14 to 21 days away.

With cases soaring to more than 25,000, New York is the epicenter of the coronavirus in the country, as officials attempt to slow its spread by setting up field hospitals, calling on hospitals to increase their capacity and urging residents to stay home.

“We are not slowing it and it is accelerating on its own,” Cuomo said during a news conference at the Jacob K. Javits Convention Center in New York City. “One of the forecasters said to me we were looking at a freight train coming across the country. We’re now looking at a bullet train because the numbers are going up that quickly.”

Cuomo said there was a “critical and desperate need” for ventilators and the state would require at least 30,000. The state’s hospital system typically has 3,000-4,000 ventilators and had so far managed to procure about an additional 7,000, he said.

The governor strongly urged the Trump administration to provide its 20,000 reserve ventilators to New York and invoke the Defense Production Act to direct companies to make the much-needed machines.

Later Tuesday, Vice President Mike Pence said during an interview with Fox News the federal government was preparing to send 4,000 ventilators within the next two days.

Cuomo said the projected need for hospital beds could be as high as 140,000 in a state that currently has only 53,000.

On Tuesday, White House coronavirus response coordinator Dr. Deborah Birx said part of what could account for the spread in New York was population density and part of it could be spread as people took the subway and touched metal surfaces.

Dr. William Schaffner, an infectious disease specialist at Vanderbilt University, said there were certainly concerns New York could become the next Italy, where the virus quickly spread to more than 60,000 cases and has seen more deaths from the disease than China.

There have been 6,820 deaths in Italy, compared to just over 3,000 in China. In some areas, hospitals have been so overwhelmed they have not been able to accept new patients as the death toll continues at an alarming rate, with 743 deaths in the last day. While Italy currently has some of the strictest public measures in response to the crisis, the country’s initial incremental measures, such as issuing containment zones, proved to be too little to stop the sweeping outbreak.

“Because you have such a concentrated population in New York City, the virus can spread very readily,” Schaffner said.

Despite a strong hospital system in the state, “they could easily get swamped and just be stretched beyond what their capacity would be,” he added.

Another concern was “the exhaustion of health care workers. We have a finite number of health care workers,” he said.

Schaffner added bringing in retired workers was not always easy to accomplish quickly, given potential licensing or insurance issues.

The state has requested four field hospitals, including at the Javits Center where Cuomo spoke Tuesday in front of supplies. The other three are on Long Island and in Westchester county outside the city. Soldiers from the National Guard were present at the center, helping convert it in a process Cuomo has said could take a week to 10 days.

New York City Mayor Bill de Blasio gave a stark warning Tuesday saying the city was “just trying to get through March right now” especially in terms of its health care system.

Even with new supplies coming in, de Blasio warned of shortages especially in terms of ventilators as the crisis could continue in the city for months. The federal government is giving 2,000 ventilators to the city, on top of another 400 that were given, but the city is asking for 15,000.

“That’ll just get us to the first week of April,” he said during a news conference. “Even with this new supply, it doesn’t guarantee we’ll get through that first week.”

Schaffner urged New Yorkers to practice good hygiene habits and take social distancing very seriously and stay home whenever possible to attempt to slow the spread of the virus.

“Keeping us all very separate, I think, that is the key thing we can do at the present time to try to dampen the curve,” he said.

Dr. Nikita Desai, a pulmonary and critical care physician at Cleveland Clinic, said that although we were in “an unprecedented time,” previous outbreaks show how important social distancing is in slowing the spread of a disease in populous places such as New York.

Desai said slowing the spread would leave the health care system better equipped to deal with ongoing cases. She said hospital systems tended to hundreds of thousands of hospitalizations for the flu in the last year, and were able to handle them because “we need them to not all happen in the same week.”

On Sunday, Trump announced that he approved requests to federally fund the National Guard to assist Washington, California and New York, three of the states hit hardest by the coronavirus pandemic.

He also said large quantities of masks, respirators, gowns, face shields and other items were due to arrive in the three states within days. He added that he has ordered the government to set up large federal medical stations in each of the states.

Katherine Baicker, dean of the University of Chicago Harris School of Public Policy, said social distancing and closing businesses in the short term were essential for the economy to bounce back when the crisis is over.

“Clearly in the short term, everything we can do to stem the spread of the disease is of vital importance,” she said, adding the country and companies would need to figure out how to keep necessary production going as safely as possible, such as production of food and medical supplies.

Baicker, a former member of the Council of Economic Advisers under President George W. Bush, said it was also important for the government to provide social insurance and relief for businesses and families in need in order to invest in the economy in the long term.

Such investments and social distancing would eventually pay off both in public health and in “allowing the ramping up of economic activity sooner” once it is safe, she said.

“The health epidemic is a major crisis but if that were to go away, we could resume economic activity,” she said. “The more effective we can be in slowing the spread of the disease, the faster we can get it under control, the faster we can return to normal economic activity.”

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