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Global Statistics

All countries
695,781,740
Confirmed
Updated on September 26, 2023 9:04 pm
All countries
627,110,498
Recovered
Updated on September 26, 2023 9:04 pm
All countries
6,919,573
Deaths
Updated on September 26, 2023 9:04 pm

Global Statistics

All countries
695,781,740
Confirmed
Updated on September 26, 2023 9:04 pm
All countries
627,110,498
Recovered
Updated on September 26, 2023 9:04 pm
All countries
6,919,573
Deaths
Updated on September 26, 2023 9:04 pm

One Rich N.Y. Hospital Got Warren Buffett’s Help. This One Got Duct Tape.

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Rassie: There are various benefits for SA rugby to go north

As SA Rugby moves to determine which franchises will go to Europe in future, Rassie Erasmus has noted several potential benefits for the local game should that route be followed.The national director of rugby believes the high world rankings of Wales, Ireland and Scotland mean PRO Rugby is competitive and that fans will eventually identify…

A Once-in-a-Century Climate ‘Anomaly’ Might Have Made World War I Even Deadlier

(John Finney Photography/Moment/Getty Images) An abnormally bad season of weather may have had a significant impact on the death toll from both World War I and the 1918 Spanish flu pandemic, according to new research, with many more lives being lost due to torrential rain and plummeting temperatures. Through a detailed analysis of an ice…

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A vehicle that was hit in the accident. A truck driver was killed in a horrific sequence of events following an initial crash in Pinetown. While trying to move the truck after the accident, it appeared to lose control. He died after falling out of the truck which ploughed into several cars and a wall.A truck driver…

42 people in court for R56m police vehicle branding scam

Forty-two people have been implicated in a police car branding scam. Forty-two people have been arrested for their alleged involvement in a police vehicle branding scam. They face a range of charges including corruption, fraud, money laundering, theft and perjury.Of these, 22 are serving police members.Forty-two people are set to appear in the Pretoria Magistrate's Court on…

the overextended transport team from the morgue has yet to arrive.

The nurses on duty have too many other worries. University Hospital of Brooklyn, in the heart of the city hit hardest by a world-altering pandemic, can seem like it is falling apart. The roof leaks. The corroded pipes burst with alarming frequency. On one of the intensive care units, plastic tarps and duct tape serve as flimsy barriers separating patients. Nurses record vital signs with pen and paper, rather than computer systems.

A patient in Room 2 is losing blood pressure and needs an ultrasound. A therapist is working to calm a woman in Room 4 who is intubated and semiconscious and who tried to rip out her breathing tube when her arm restraints were unfastened.

Genevieve Watson-Grey, the head nurse on duty, says she relies on faith and prayer to fill the gap between need and reality. “Knowing there is a higher force above,” she says, gives her hope.

Image

University Hospital, which is publicly funded and part of SUNY Downstate Health Sciences University, has tried to raise money for protective gear through a GoFundMe page started by a resident physician.

Most of the hospital’s patients are poor and people of color, and it gets more than 80 percent of its revenue from government programs like Medicare and Medicaid.

Dr. Robert Foronjy, the hospital’s chief of pulmonary and critical care medicine, oversees the unit with the plastic tarps and duct tape. He said that he did not believe that any patients were lost because of inadequate resources. But the “aged and crumbling” facilities, he said, had made the job of caring for such patients much harder.

“Why shouldn’t an African-American have facilities that are at the same level of other patient populations?” he said.

When George James, a 60-year-old former public housing superintendent arrived at University Hospital in March to have an infection unrelated to the coronavirus treated, he did not have Covid-19 symptoms. Within days, though, he tested positive for the disease. As he gasped for breath one night in his hospital bed, he panicked when he was unable to call a nurse.

“I didn’t go to sleep the whole night because I was scared,” he said. “I couldn’t breathe.”

Instead of a modern call button or intercom system, all he had was a silver bell, the kind used in hotels decades ago to summon the concierge.

It was late February and Dr. Wayne J. Riley, president of SUNY Downstate Health Sciences University, was at a conference in Atlanta when his phone began to ping with ominous messages. It was becoming clearer that the novel coronavirus, which had ravaged parts of China and Italy, had begun to spread rapidly in the United States.

“I said, ‘My gosh, if this thing really does take root in the United States then, here in Brooklyn, we’re going to have a problem,’” he recalled.

Not only did Dr. Riley worry about the resources that would be needed to provide care during a pandemic, he feared that the hospital’s patients would be particularly susceptible to the disease.

The central Brooklyn neighborhoods where most of University Hospital’s patients live, East Flatbush and Prospect Lefferts Gardens, have higher-than-average concentrations of chronic diseases like diabetes, hypertension and obesity, which preliminary studies have shown make Covid-19 most deadly.

The hospital opened in 1963 and it was meant to accommodate about 60,000 visits a year. Despite having almost no physical improvements, it now handles about 200,000 visits annually. The bunkerlike concrete building is crumbling from within. Earlier this year, a leaky roof forced a temporary evacuation of premature babies from a neonatal intensive care unit.

“It is too, too old compared to other hospitals across the water,” Dr. Riley said. “We need a new hospital to be prepared for the next pandemic and to better serve our community.”

Signs inside the hospital are written in English, Spanish and Creole, a reflection of the large number of immigrants in the area, particularly from the West Indies.

Many of the patients work but are poor or receive government assistance. Many are uninsured and use the hospital for emergencies and primary care. They come from a men’s shelter up the street or from a nearby home for domestic violence survivors to fill prescriptions or to have their diabetes checked.

“The day-to-day stress on these communities is just incredible, and that is driving these conditions,” said Dr. Moro Salifu, the chairman of the hospital’s department of medicine.

The hospital has been in financial disarray for years. A 2013 audit by the state comptroller’s office found that it was on a path toward insolvency. It was bleeding millions of dollars every week, the audit found, and only infusions of state money were keeping it afloat. It has also been poorly managed. Subsequent audits found that hospital leaders had used government money on a lavish birthday celebration in Bermuda for a consultant who was paid tens of millions of dollars, but who did very little to improve the hospital’s finances.

Dr. Riley, who became president in 2017, after the Bermuda birthday celebration, insisted that the limited resources had not affected the quality of care. The hospital, though, has at times been accused of violating safety standards.

Last July, the hospital suspended its transplant program after a review uncovered high mortality rates and serious safety concerns. Two doctors, the surgery department’s former chairman and another surgeon, filed wrongful termination lawsuits, accusing hospital officials of firing them as retaliation for their complaints about lax safety standards. The program has since been reactivated.

Even so, the hospital is vital to the community. Together with its affiliated teaching university, it is Brooklyn’s fourth-largest employer. The university, which is part of the State University of New York system, is the largest medical college in New York City, and it produces a large percentage of the doctors working here.

When the pandemic first hit the city, Andrew M. Cuomo, New York’s governor, ordered the hospital to take only patients who had the virus. The decision rankled medical workers and others, who complained about having to shoulder the heavy burden with limited resources.

“We’re now in a situation where an under-resourced hospital is being asked to manage the epicenter of the crisis,” said Zellnor Myrie, a Democratic state senator whose district includes University Hospital. “The dollars that we failed to invest years ago are affecting life-and-death decisions now.”

The first patient with Covid-19 at University Hospital, a 74-year-old woman on dialysis with hypertension and diabetes, was identified on March 12.

“I got the first call at 5:51 p.m. that we had our first case,” said Dr. Salifu, the department of medicine chairman. “I remember exactly where I was on 9/11, and I knew exactly where I was when I got this call.”

Within days, the cramped emergency room, which looks much the same as it did when the hospital first opened, was inundated. At times, more than 100 coughing, feverish patients were packed into hallways and side rooms, or clustered around the nursing station, spewing virus into the air.

The hospital came close to running out of ventilators. Julie Eason, the director of respiratory therapy, said she had to “get a little bit creative” as she tried to ration resources while keeping up with all of the Code 99s, the term used when a patient needs to be intubated.

“It was just endless,” she said. “Code 99s would come in three, four different rooms all within a few minutes of each other, all day long.”

Medical workers began to get sick, and several nurses ended up intubated in the hospital’s I.C.U.

“We were stewing in it,” an emergency room doctor, Lorenzo Paladino, said.

Doctors and nurses complained that the conditions put them at greater risk than colleagues at other hospitals.

Dr. Foronjy, the I.C.U. physician, said he knew a doctor at a well-funded Manhattan hospital who walked around without a mask, assured that the sealed-off negative-pressure rooms there would protect him from the virus-infected patients inside.

Not so at University Hospital.

“Having to work with such an antiquated infrastructure is incredibly stressful,” Dr. Foronjy said. “You have to worry more about your own safety.”

The city and state health departments have not released data on mortality rates by hospital, but given the high instance of pre-existing conditions among patients at University Hospital, doctors there estimated that its mortality rates must be among the highest in the city.

As the death toll began to mount, the bodies overwhelmed the hospital’s small, 10-person morgue. Then they filled not one, but two refrigerated tractor-trailers parked outside.

The hospital’s mortician, Michael McGillicuddy, had to hire six additional staff members to help manage the morgue. Recently, a steady stream of black hearses has arrived at the hospital each day to pick up bodies, but new ones soon replace those that are taken away.

“I’m doing it with dignity, trying not to pile the bodies up,” Mr. McGillicuddy said. “This is someone’s mother or grandmother.”

Although the rate of new infections is dropping in New York, the intensive care units at University Hospital are full. Nearly 50 patients remain in serious condition, attached to ventilators. Some have been hospitalized for weeks, their limbs nestled in yellow foam cushions to prevent bed sores. (Reporters with The New York Times spent two days at the hospital but did not have access to patient information because of privacy regulations.)

Nurses on the units said they were overworked and understaffed. In normal times, their jobs are so demanding that they are required to care for no more than two patients at once. Now, they are tending to three or four at a time, increasing the risk of mistakes.

Ventilators, which take over for virus-battered lungs and have been crucial in the pandemic, require constant calibration to keep patients’ oxygen levels just right. Nurses must monitor endotracheal tubes, which can get clogged and block airways. In Covid-19 patients, the heart or the kidneys can fail without warning.

A lack of protective gear remains a problem. Much of what the nurses are wearing is mismatched, donated from friends and neighbors or brought from home. One nurse complained that she had bought her mask herself and had been wearing the same bootees on her feet for the past three days.

“As you know, we are a state facility. We don’t have a lot of money,” said Rose Green, a nurse who was helping to staff the unit on her day off.

The hospital has begun to celebrate some successes. Recently, a nurse and a nursing assistant were taken off ventilators. On April 16, the hospital posted a video on Twitter of another nurse who had been intubated after coming down with Covid-19. She was being wheeled out of the emergency room to applause from colleagues.

On a recent day, a man in his 50s who had just come off a ventilator was sitting up in his room drinking a bottle of juice.

A nurse passed by and waved excitedly.

  • Updated April 11, 2020

    • When will this end?

      This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • How can I help?

      The Times Neediest Cases Fund has started a special campaign to help those who have been affected, which accepts donations here. Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • How do I get tested?

      If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Can I go to the park?

      Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

    • What should I do with my 401(k)?

      Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”


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