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At city-run Bellevue Hospital, on the front lines of coronavirus response, medical professionals are concerned they don’t have all the tools needed to keep themselves and patients safe — starting with masks.
The most effective form of personal protection from airborne viruses is an N95 mask, which is tight-fitting to the face and filters even small droplets. The problem at Bellevue and at the 10 other city-run hospitals is that there aren’t anywhere near enough of them.
Over the last week, nurses and doctors at Bellevue have been forced to ration N95 masks — told to reuse them repeatedly, according to staffers who spoke with THE CITY on the condition of anonymity.
City health officials say they currently have 503,000 N95 masks — a far cry from the 2.2 million they’ve requested from the federal Food & Drug Administration for both city-run and volunteer hospitals.
Amid the shortage, officials late last week approved the use of surgical masks as a substitute. De Blasio defended the move, stating, “Our ideal is to get a substantial number of new N95 masks, but we are more confident now that surgical masks can achieve a lot of what we need for sure.”
Less Protection
But surgical masks offer less protection.
According to the FDA, “While a surgical mask may be effective in blocking splashes and large-particle droplets, a face mask, by design, does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures.”
The FDA notes that surgical masks “do not provide complete protection from germs and other contaminants because of the loose fit between the surface of the face mask and your face.”
On Monday, a nurse at Bellevue told THE CITY “the most pressing issue” for staff is getting proper masks amid changing guidance from health officials.
The entrance to Bellevue Hospital on First Avenue.
Ben Fractenberg/THE CITY
Previously, staffers were directed to protect against germs in the air, requiring the heightened protection provided by the N95 mask.
Now, the nurse said hospital staff was told, the U.S. Centers for Disease Control is lowering the standard to permit a standard surgical mask to be used instead.
That leaves nurses and other personnel anxious they will be exposed to the deadly virus.
“Staff doesn’t trust the change because they think it’s based on supply shortages and not science,” the nurse told THE CITY.
Another source at Bellevue said health care workers have been told not to worry because coronavirus doesn’t hang in the air like measles.
Late Monday, the New York State Nurses Association weighed in, blasting the federal Centers for Disease Control for relaxing standards by giving the hospitals leeway to substitute surgical masks for the N95s.
“Local and state authorities are following the CDC’s lead and issuing local rules with less protection of health care workers,” the union said in a statement. “These changes in guidance and protocols by the CDC are a direct indication that there are not sufficient supplies of N95 respirators available to safely operate our hospitals and other health care facilities in the face of the COVID-19 pandemic.”
Workers on Front Lines
Since the first New Yorker tested positive for coronavirus March 1, de Blasio has consistently listed the health care system as a crucial institution that must be preserved during the growing outbreak.
On Monday, the number of people in New York City testing positive jumped to 463 and deaths rose to seven.
Meanwhile, THE CITY learned that the number of hospitalizations for coronavirus nearly tripled since Friday — from 30 to 102 on Monday.
Over the same time period, the number of patients in intensive care in the city nearly doubled — from 19 to 36.
De Blasio expressed frustration that the federal government isn’t pressuring medical supply businesses to ramp up production.
He singled out ventilator machines crucial to alleviating the respiratory problems that are a key symptom of coronavirus. “Why is it survival of the fittest instead of a federal government that says to the company that produces ventilators, ‘You’re going on 24/7 production’?” de Blasio asked.
Mayor Bill de Blasio gives an update at City Hall about the spread of the coronavirus, March 16, 2020.
Ben Fractenberg/THE CITY
The mayor said the city currently has an adequate supply of ventilators. But sources at Bellevue said that will soon change as the number of patients testing positive grows.
During the same news conference, de Blasio also revealed that both city-run and volunteer hospitals will discharge patients “in a manner that’s appropriate” to help free up beds for potential coronavirus patients.
A source at Bellevue said health care workers began last week releasing patients whose illnesses are deemed to be not life threatening.
A spokesperson for Health and Hospitals Corporation has repeatedly declined to answer THE CITY’s questions about the discharge policy since last week.
A spokesperson for the state Department of Health would not disclose Bellevue or another hospital’s discharge statistics, saying the information is “not publicly available.” The spokesperson noted that the department “is monitoring bed capacity very closely to prepare for an influx of patients.”
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