Testing Is Biggest Obstacle to Reopening States, Experts Say – The New York Times

interposing voices

Good morning, everyone. Hi.

So every morning in the Intensive Care Unit at the Brooklyn Hospital Center, the doctors gather for something called morning report.

So now, I want you all to present in a straight, true way

The people who were on overnight, they stand around and the head doctor is there, and they kind of give a report of what happened. And then, the new doctors who are coming on, they get that information.

Yeah. When she was at rest this morning, she was breathing 23. Shes very comfortable, thumbs up.

They talk about, you know, who was admitted, who got critically ill.

The overnight patient is not doing well. He had to be re-intubated almost immediately.

And one recent morning report was particularly intense.

OK. All right. OK. Next patient.

There were patients in their 80s and patients in their 30s.

31-year-old female, 30 weeks pregnant, asthma, obesity, admitted to the I.C.U. She was intubated yesterday evening.

Jesus.

All right. Good. Next.

There were patients from nursing homes and patients who were homeless.

She was intubated overnight. Shes on azithromycin, klonopin, ceftriaxone.

OK. Next.

Patients with asthma and diabetes, and patients with no underlying conditions at all.

male. We just past medical history here for acute hypoxic respiratory failure.

But as the doctors race to get through the cases

Next patient.

they all shared a nearly identical description.

He was upgraded from acute hypoxic respiratory failure.

OK, next.

Male, acute hypoxic respiratory failure secondary to confirmed Covid.

All right. Next.

Admitted for acute hypoxic respiratory failure with confirmed Covid-19.

Next.

Male, it looks like acute hypoxic respiratory failure.

Acute hypoxic respiratory failure secondary to Covid-19.

All right. Next.

From The New York Times, Im Michael Barbaro. This is The Daily.

Today: Its been more than a month since the coronavirus descended on New York Citys hospitals and on Brooklyn Medical Center, where the vast majority of patients in critical care have the virus. My colleague, Sheri Fink, followed one doctor through a single day there.

Its Wednesday, April 15.

Morning, everybody. [AMBIENT CHATTER]

Josh, do you want to spend the do you mind? This is Sheri.

Sure.

Shes with The New York Times, and shes gonna spend some time here a little bit.

Pleasure.

Its up to you.

Im fine with

Im a physician.

A physician and a writer.

So for the past few weeks, Ive been embedded in the Brooklyn Hospital Center.

Im going to finish rounding here, and then Im going to go downstairs and cover SI.

OK.

And what Ive been able to see there is incredibly unique whats happening? What is it like inside a hospital during a pandemic?

then well figure out the rest.

OK. All right.

Do you want to give him your mic, or are you willing to wear a mic?

And there was one doctor I met who really embodied that transparency.

Does it beep every time I say a four-letter word like South Park?

Dr. Josh Rosenberg.

I am mildly inappropriate. Im just warning you.

An attending physician in the Intensive Care Unit.

How are you, Peter?

Hi, how are you

I didnt see you hiding over there, my friend.

There are people from all over the hospital recruited to work in the I.C.U., so its not just, like, I.C.U. doctors and nurses who are used to intensive care treatment, but in fact

And shes one of the podiatry residents, so all people who are good with knives and big needles.

When I was there that day, there was a podiatry doctor and two of her residents. Those are doctors who work on the feet.

No, no, no. What I would like to do is that, as much as possible, were going to try to get all of the Covids on one side, and then the whole area is a dirty area.

And the I.C.U. had actually effectively doubled in size, so it was completely full. And they had to turn to other areas of the hospital to turn them into Intensive Care Units. In fact, a big part of the I.C.U. is now in a place that just a few weeks ago was where patients would come for outpatient chemotherapy treatments. Thats now in I.C.U..

Frankie, watch out. Dont trip Dont trip Dont trip. Dont trip. Dont trip.

It was also a bit of an obstacle course.

Dont trip.

There were cords everywhere.

Please be careful, Do you have gloves?

They had pulled apart the ventilators. They had the control parts of the ventilators that were helping people breathe, those were in the hallways so that nurses and respiratory therapists didnt have to go in and out as much and expose themselves to risk.

What?

This is a disaster waiting to happen.

Yes and no, though.

And the nurses were doing the same thing with IVs, with the tubing that the medicine flows through. So they had pulled the IV pumps out of the room so that they can not have to go in and out and use up the personal protective equipment.

Its great. And yeah, I mean, you can trip over it.

You all have to be very careful.

You just have to be careful.

Yeah.

Right. Its making the best of what you can do.

Yeah.

OK, guys, can we start with number two? I appreciate everybody being here and everybodys support massively.

So now, Dr. Rosenberg is taking over for the doctors who were working the night before, and hes beginning to make his rounds.

Lets start with number two, and then just go around the unit please. All right, so lucky number two.

So nearly all the patients in the I.C.U. are on ventilators.

So do we have any history of smoking, shisha use, anything like that?

Some have asthma. Some have diabetes.

All right. What did he do for a living? Occupational exposure?

But a lot of these patients dont have any underlying conditions at all.

Ill just write because I mean, listen, on some of these you have a real reason why. You know, they may have bad lungs, and that makes it worse. Sometimes its just the disease, but if theres something we can do to

So Josh and the other doctors are kind of confounded by some of the patients. They dont understand why, if they dont have a lot of underlying health issues, why their lungs look so bad.

Crap. Reported any asthma?

And they also just dont have that much to offer.

OK. So what are we going to do with him?

Right now, we are well, at this point, Im not too sure what we can do with him. We have we tried to [VOICE FADES].

So what is he on drug-wise?

So, I mean, for most patients, theyre trying this thing called the Covid cocktail, which is that hydroxychloroquine and azithromycin. Thats that combination the President talks about a lot.

I dont think its doing much.

But theres really very little evidence, and Dr. Rosenberg in particular is very unsure that those drugs really help.

Well see about remdesivir, and well see if we get some Covid results and see what we can do.

So they start talking about other possibilities. Theres this experimental drug called remdesivir that you have to apply to the manufacturer for each patient, and they have to meet certain criteria. You have to have a test result. They cant have certain complications.

How do you guys feel about Kaletra or our other PIs?

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Testing Is Biggest Obstacle to Reopening States, Experts Say - The New York Times