01x09 - Pandemic

[bunniefuu]

[reporter 1] A SARS-like virus,
which has infected hundreds in China,

has now reached the United States.

[reporter 2] There are now 16 new cases
of the coronavirus

that have been confirmed
in New York this morning,

bringing that number in that state to 105.

[woman] All right. Good morning,
everybody. I think we have everybody here.

Who's on the phone?

[woman 2] Irene is on the phone.

- [woman 3] Dan Baker.
- Good morning, guys. Welcome.

Thank you to anybody in this room

who dedicated their time over the weekend.

We first had the patient
from Greenwich Village

on Friday night into Saturday.

Um, quite ill.

He was tested.
There were some issues yesterday.

We are going to have his results by...

Very soon today.

We are down ten people a shift,

and that's calling every per diem
and every part-timer in.

- [Jill] This is including extra per diems?
- Yeah.

We're looking at who we can pull.
Every day last week,

for almost every shift,
we were down seven to ten people.

[woman] So the ER nurses have concern
with the masks.

We're really starting to feel
that shortage in the emergency department.

My recommendation is to require
to wear the surgical mask over the N95

so that you can reuse the N95.

We're doing a lot around respiratory,

- but we really should be focused on...
- [ambulance siren wails]

[reporter] First, we have an update
on the spread of the deadly coronavirus.

A short time ago, the World Health
Organization declared the outbreak

an international
public health emergency...

[man] I wanted to shut down last week.

I actually texted the superintendent
of my school,

and I tweeted at eleven o'clock on Friday.

Let's...

call this week, which is March 9th
through, whatever, Friday 13th,

"coronavirus containment week."

Shut down the country.

We are exactly where Italy was
a couple of weeks ago,

which was silently spreading
throughout the entire country.

We have 140 cases now in New York.

We're trying to stamp them out.

[man] What about social distancing?

...on several decisive new actions
we're taking in our very vigilant effort

to combat and ultimately defeat the...

corona.

Following the advice
of our medical professionals,

we're suspending the entry
of foreign nationals...

[woman] Now, are you still planning
on keeping on the surgical patients

that are on your calendar?

Canceling elective surgeries
has not been recommended yet.

If you wanna do it, it's up to you.

[woman] As of this moment,
elective cases for next week are...

On.

And actually, I would keep it because
they're never gonna get operated on.

They're not gonna be operated on
till probably, you know...

September, at this rate.

[reporter 1] Here in New York, the current
American epicenter of this pandemic,

the first data tonight suggesting
that maybe,

just maybe social distancing is helping
to slow the onslaught of coronavirus.

And yet, officials say
the worst days are still to come.

The numbers are still rising,

leaving the region's medical system
on the edge of being overwhelmed...

[woman] Hi, Immanuel. [sighs]

Um, Stace, is this room clean?

Should be, right?

Looks like it is.

Can... Yeah, it's clean, right?

Can I go in here? Okay.

Gonna get a surgical gown.

Let's see.

You know, I'm gonna be honest with you.
Like, I...

The way I feel right now
is that I trained my whole life for this.

It's not very often that a pandemic
happens during your career

in emergency medicine.

And we are trained for disaster
and critical medicine.

I feel like it's my duty.
I feel a little obligated to be here.

But at the same time,

you know, I don't wanna be exposed
because of the pregnancy.

Sort of a...

a wounded soldier. [chuckles]

So it's not... It's not ideal.

I feel great.
Like, right now if I wasn't pregnant,

I'd be in Queens helping out
with whatever they needed.

Um...

So right now, it's... For me, it's more
the emotional, the anxiety, the stress.

I mean, everybody
that's coming in now is positive.

You can't...
You can't really avoid it anymore.

[Mirtha] How are you?

Yeah? Everything's good?

Did you get our patients out?

Instead of them boarding here.

Eighty-four people.

I know this week is worse.
There are sicker people.

You can feel that stress already building
in your colleagues.

Ay, yi, yi. [sighs] All admitted.

Things would've been very different
during this.

[man] Follow the train.

[indistinct TV reporter talking]

[woman on phone]
...which are waiting for COVID testing.

So we have a large number of people.

Our problem is that we are now covering
three units in many of these places.

And it's not a safe situation
I think anymore

for our intensivists, especially at night,
so we're looking for help.

We appreciate any help that we can get...

Reasonably,
everybody's gonna get infected.

[John] We have to.
We'll get infected and get better.

And then you get back to work.

That's what I'm saying.
We should get sick now.

[David] Yeah, let's just f*ck'
take the masks off...

[John] That's what I think. We're going
to be called to cover as people fall.

We just have a... There's a COVID call.

So, uh, as soon as we're done here,
we'll bring the staff in.

- [David] Why don't... We can stay here.
- [woman] Just stay here?

[David]
We'll wait till the PAs are cleared out.

- [woman] Yeah.
- [John] I told Alex...

[David] I just don't want...
You guys can go.

The whole purpose of this
was to make sure...

We're not supposed to be
this close to each other.

[John] But I do... We wanna make sure
this room gets cleaned.

- [David] This is f*ck' crazy.
- [John] There's too many people here.

We just got off the phone call.

What's happening is the ERs,
doctors, and the hospitalists

are already getting infected.

So once that first line of defense goes,
they re-credential us,

and then I head down
to the emergency room.

[woman talking indistinctly]

[man] Yeah. So I would hang tight
with that rate.

[woman] ...complicated by cardiac arrest.

He also had transaminitis at one point.

And then he was trach'd on the 30th.

They found the trach
had some leaking issues.

[woman 2] Okay. Very good.

She was critically ill in our ICU
on a ventilator.

She has her tracheostomy.
She has her feeding tube.

She had kidney failure.

It's gonna take you a while to recover.

[woman] They don't even know
what a bakery is, right?

I'm not baking 20 pounds of challah.

[Linda] No, you're not, but you will be.
You'll get back to that.

[woman] I hope so. It's just scary to me.

I have a business. I don't know.
I was a power house. I was...

- I'm not used to this. It's terrifying.
- [Linda] Yeah.

[Cuomo] The bad news isn't just bad.

The bad news is actually terrible.

Highest single-day death toll yet,


And there's no doubt that we can't stop
doing what we're doing.

[David]
Well, this country is under attack.

So everyone's trying to help a little bit.
I'm doing the clinical trials for COVID.

We're trying to contribute
in meaningful ways.

[man] Have you used IV immunoglobulin
for a cytokine storm?

[doctor talking indistinctly on monitor]

[John] But, you know, if one of us...

was sick...

What's your schedule?
You gonna start working from home?

[woman]
We're still keeping a staggered staff.

[John] I know,
but I'm not interested in your...

I'm interested in the fact
that you are a vector

that can work from home.

Do you understand?

- [woman] Got it.
- [John] This is our obligation.

[woman] Understood.

[woman 2] About six weeks ago,
I had a conversation

with one of my GI doctors

who said that there was
gonna be a pandemic.

So I ordered masks for my family,

not thinking that they would
one day be monetized.

This is the N100 mask
that I'm putting together for my husband

who has asthma and who is at high risk,

because who would think that our
government wouldn't be prepared for this?

- [David] So you cross them?
- [Nancy] You cross them.

[Nancy] You have to fit it to your mouth.

[David] Okay.

- [Nancy] You good?
- I'm good to go.

[David] We're beginning to see
what we were all afraid of.

This is real.

[woman] All right, and stand closer.

- [machine whirring]
- [woman] Ten seconds of normal breathing.

[woman] Bend over. Touch your toes.

[David] Units are really being overflowed
with COVID patients.

So every one of these orange dots
is a positive corona patient.

This used to be medical intensive care.
This is our neuro ICU and the SICU

which have now been turned
into corona units.

[man] There's China, there's Italy,
and then there's the United States.

And if you look at the United States,

the cluster is really where New York is.

So we are in the thick of it. Laurie?

[Laurie] Okay, today we tested
188 patients for COVID

who've been sick by positive assessments.

[Alex] Anything on those new tests
that they're talking about in the news?

Wherever you see an X,

that means that room needs
to be terminally decontaminated,

terminally cleaned,

because somebody
with virus has been there.

It's an entire process. It takes a while.

Kudos to the environmental team
who clean and disinfect everything for us

and make it nice and safe.

There seems to have been a resuscitation
here, which somebody was critical.

- [woman 1] You are? You're coming with us?
- [woman 2] Yeah.

[woman 1] So I'm assuming
he goes in the COVID,

and then we all just go in the regular...

[woman 3] No, I was told
that we all gotta get in the elevator.

[Mirtha] All of us our finding ways
to keep positive,

but the anxiety is high.

Yeah, it's high, and it's...

higher because some of us
are being separated from our families.

I mean, a couple of other people
have taken the decision to do that.

[Charles] I'm gonna break off
and call the wife, okay?

'Cause, right...
This isn't going well, and she knows.

This is a...

terrible story
because this patient's related to...

one of our employees.

Oh, hi. It's Dr. Carpati.

Um, he's getting worse.

We're having trouble now keeping his...

pH in a normal range.

That means he's building up more acid
in the blood.

So I think you have to be prepared now.

We're still doing everything we can,
but it's not working.

Okay, I'll see you soon.

Okay, bye.

[Mirtha] Many of us are going through
very personal and emotional changes.

All of us have family.
All of us have a loved one.

I've had to send my son and my husband
to live with my parents

'cause I cannot risk exposing them.

If I were to get exposed,
then they get exposed.

That's been a lot to deal with.
I haven't seen them in two weeks,

and I probably won't see them
for another month.

It's completely life-changing.

I'm sure this whole experience
will change our lives forever,

even when this virus is gone,
if it ever will be.

[reporter] All hands on deck situation
doctors and medical professionals

of all stripes are being told
their help may be needed

in emergency rooms,
especially as staff on the front lines

start to get sick themselves.

Dr. John Boockvar is vice chair
of neurosurgery

at New York's Lenox Hill Hospital.

He is with us tonight.
Doctor, it's good to have you with us.

How are you feeling this evening

about what's happening
in our nation's hospitals?

[John] We will all sacrifice
and do whatever it takes

and cover any locations necessary.

But you're gonna be seeing emergency rooms

and critical care units staffed
by specialists and other physicians.

[reporter 2] The battle's not over.
The w*r goes on.

The NYPD just announced a 13th member
has now died from the virus.

And more than 500 New York
Fire Department personnel have it.

[John] I got a call about a young man.

He's 45 years old.

- [John] Vera.
- [Vera] Good, hon. How's the family?

[John] Just a terrific human being. He's
the father of three kids and a husband.

- [John] How's he doing?
- [woman] He's on the Vimpat in high doses.

He's on the Dilantin.

He started valproic,
the early dose, today.

And he's on the Keppra, high doses.

[John] He got sick with COVID

when he was on the phone
with the Department of Health

with the results of his COVID test.

Either had a massive heart attack
or syncopized, and he collapsed.

[John] So wait.
His pulmonary status is worsening?

[woman] Yeah.

- [David] Okay.
- [John] Okay.

[John] And I'm gonna call the wife.

[woman] You could tell him I just spoke
with her son and her sister about that,

and I'd be glad to give him a call, too,
if he...

[David] I think the trouble is when you go
and you just show up one day

and go work
in an intensive care unit like that,

where you have no relationship
with the patients.

You didn't know them ahead of time.
You didn't know who they were.

You develop relationships
with the families,

and you have a lot of empathy for them,
but you didn't know the patient.

Because they're all intubated,
and they're not conscious,

you can't talk to them.

Hey, buddy. How you doing?

Put your head back.

Okay.

Did you want any food?

You've gotta eat. Did you eat anything?

You want some soup?

No? Something to drink?

Here, try a little sip
of something to drink.

No? Okay.

Get some rest, okay?
I'll come back tomorrow.

- [man] Okay.
- [David] Okay.

We realized this guy was like...

his story and where he came from,

all these articles about him in
the New York Times, about his restaurant,

El Sabroso,
a not-so-secret Latin lunch counter.

He was on Colbert.

I mean, you know, here's a guy that
you'd never know. You know, he was...

just another name and another sick person,

and yet he had this life,
and it resonated with me.

It really tipped me into...

more of an approach
of just doing everything you can.

[line ringing]

- [David] Hi.
- [woman] Hi. How are you?

He was a little too tired.

[woman] Yes. Okay.

I just had a quick talk with him.
We can always go back tomorrow.

- I don't want to t*rture the poor guy.
- [woman] Okay. Okay.

He's doing fine. He's gonna...

Like I said, he's gonna
vacillate from day to day, you know?

You know, when people get infections,
they lose all their...

And just to run your heart and your brain
and to breathe requires energy, right?

And his calorie intake is,
you know, not...

He's not eating what he probably ate
when he was running his store,

so he just gets tired.

He needs the rest.

[woman] Thank you so much. Thank you.

[David] These families are home,
and they can't talk to their loved ones

when they're dying or sick.
They get no information.

It's hard for the units to do this.

We're used to talking to people about
end-of-life decisions in neurosurgery.

I can understand the medical problem.

I can understand
the complexity of the medical diagnosis

and translate that and be a liaison
to the families from the care team.

You've gotta find
a way to participate and help.

[Charles] Did we call the parents?

- [man] Yeah.
- [Charles] We did? Okay, good.

I don't wanna give you false hope.
I just want you to be realistic

and make sure you understand
where we are with him.

I don't want you to have expectation
that he's gonna get better.

I need you to understand that
the likelihood of him passing from this

is extremely high,
if not almost inevitable.

Look, I... You know, this is hard enough
to do when we're face-to-face

and when you're seeing him every day,

but by being remote
and being far away and...

talking to someone who you don't even
know and who's jumping in like this

is obviously really tough.

All right. Bye-bye.

Oh, man. [sighs]

[John] You can see the empty subway.

This is a bustling corner.
It usually has mobs of people crossing.

There's nobody out.

Subways are empty.

It's... It's a ghost town.

Sad, actually.

[David] How old?

[man] Like in his 60s or something.

So he passed today...

while I was in his room, holding his hand.

[David] Yeah.

[man] Horrible.

And now... they can't find his belongings.

Or his cell phone.

- Which has all his contacts...
- [David] It's so chaotic.

They lose track of like cellphones,
belongings.

Especially when they come in really sick.
People are crashing the ER.

[man] It's the worst.

- [David] All right.
- [man] Good luck.

- [David] Yeah.
- [man] Bye.

- [Linda] How was your night?
- [woman] It was okay.

- [Linda] Yeah? It was all right?
- [woman] Yeah.

- [Linda] Yeah, you're hanging in there?
- Yeah, the best we can.

- [Linda] Yeah.
- [Rose] Proud of our team.

- [Linda] Yeah. Amazing, right?
- [Rose] Yeah, we held it down.

- [Linda] Have you had any time off?
- [Rose] Just regular schedule.

You're off for two, three days,
and then you're itching to come back.

You know what I mean?

[Linda] Yeah, you don't stop thinking
about the patients.

- [Rose] Yeah. Yeah.
- [Linda] I know.

[Rose] You call, you check, and, you know,

"How's bed nine doing, and are they okay?"

- [Linda] Yeah. Right.
- [Rose] 'Cause, you know...

[over PA] This is the New York City
Police Department.

Due to the current health emergency,
members of the public are reminded

to keep a safe distance of six feet
from others while in public places

to reduce the spread of the coronavirus.

Please help us keep you safe.

Thank you for your cooperation.

[Mirtha] Pretty much every emergency room
in the city has gotten one of these trucks

which is a refrigerated morgue.

It's confirmed.

Last week, everybody was like,
"What is that?" Um...

They've built a tent around the ramp
to try to...

If we need to start holding bodies,
they can go through the ramp.

[David] What happened in Italy
is that they ran out of room for bodies.

In Spain, they actually use an ice rink.

I was here yesterday
when they were building this.

They literally built this in like...

'Cause they have to be able
to wheel the bodies out of the hospital

from there and store them here.

[Mirtha] I haven't seen you in so long!

- [woman] I'm here. Yeah.
- [Mirtha] Yeah?

- [woman] I just had a COVID patient, so...
- [Mirtha] Oh, okay.

[woman] You may wanna hold your breath.
Don't breathe!

[Mirtha] Dirty room. Dirty room.

So the goggles can go in the resus room.

[woman] Okay. Oh, in the resus room?

[Mirtha] Yeah, for now,

- unless we get an arrest or something.
- [woman] Okay.

[woman] But there's nothing different
that we're gonna do?

[Mirtha] Um...

[woman] Do you stay home?

[Mirtha] Yeah, you quarantine with her,
but you work here.

Who would she have gotten it from?
She would have had to get it from me.

You could be asymptomatic.

[woman] But for how long
can you be asymptomatic?

[Mirtha] Days.

Days. Sometimes throughout
the whole course of it.

I would still want to know.

[woman] I know.

[Mirtha] If you're living...

with somebody who has the COVID!

Oh, it's very nerve-racking.

[Mirtha] I'm getting two to three hours
of sleep a night, on average,

from all the stress and anxiety.

Um...

And more so
because on this shift I found out

one of the nurses
who I'm very close with has symptoms.

And another one of our nurses
is in the intensive care unit at NYU.

And they're some of our best nurses,
you know, and they're being so careful.

Why are they still getting exposed,
you know?

This virus is very contagious.

I don't know. It's...

I just hope
it doesn't get worse than this.

But I have a feeling that it may.

The first thing I wanna do is come home
and talk to my husband and...

see my son sleeping in his crib,
and I can't do that right now.

So I'll give him a call later.

He's definitely very supportive, but...

Um... this is the worst part of the night.

Hi, hi, hi! Hi, hi!

Come on! Come on! Ruby, Ruby, Ruby!
Come on, Rubes!

Come on! Come on, Molly. Come on.

At least I get home to something that's...
[laughs]

They're happy to see me. I know they are.

Come on, Ruby.
You're happy to see me, right?

Okay. All right. Okay. Calm down.

Okay. Okay.

Come on, guys. Let's go.

Let's go. Let's go.

[David] Antonio, can I turn the light on?

So...

Doing better? More awake?

In early April you were so sick,

I wasn't even sure
if you were gonna survive.

I was talking to your daughters 'cause...

the ICU doctors were so busy that it was
hard for them to make all the phone calls.

So I got to know your daughters
way before I got to know you.

Oh, wow.

Your son's tall.

They can't wait for you to come home.

How many days?

[David] Be here?

I think you'll hopefully go home
in about...

Maybe get out of here
within a week to two weeks, hopefully.

There they are.

- Hi, Dr. Langer.
- Hi, Dr. Langer.

[David] He looks great today.

- [woman] How are you?
- [David] I'm doing good.

He's getting a dialysis today,
but he looks great.

[woman] Papi!

[woman] Ah!

[David] He says, "Como esta?"

[woman] Hi. Hi, Papi. Como esta? Oh!

Yeah. [speaking Spanish]

You feel good?

- [Antonio] Yes.
- Oh, that's so good.

I love you, Daddy.

[John] Um...

This young man will die today...

from brain stem... brain death...

after having what's called
an anoxic brain injury.

After being told he had COVID,
he went into some cardiac arrest.

We've treated him for three weeks,
hoping that we can save him,

but his wife is here to...

let nature take its course.

I don't have good things to say, but...

- [woman] Are you gonna...
- [John] Yeah.

- [John] I'm gonna end his life.
- [woman] It is horrible.

- [John] Are you okay, Father?
- Yeah.

Here...

[Father] Yeah, the small one.

[woman] Small one.
Do you have a small plastic...

[John] Okay.

You know, it doesn't
really get worse than this,

as far as what our efforts
and what news I have to...

He is now showing signs,
though, of brain death.

[woman] What would you do it
if it was your son?

[John] It's time.

[woman] And would you stay?

[John] I would.

I would.

I just wish I could have done more.

[woman] Well, you did a lot.

[John] Send my love.

Thank you, Father, for helping.

[Father] Oh, it's nothing.

- [John] So... It's really tragic.
- [Father] We'll keep praying for him.

- [John] Thank you so much.
- [Father] No problem.

[John] And thank you
for helping all of our patients.

Have a mother ask me
if I would do this for my son...

[inhales and exhales deeply]

It's very painful.

[sighs]

Uh...

Can't do this anymore.

Uh, today was a really bad shift. I...

can't really talk about it. I just...

[sighs]

Um, it was a long shift,
and it was really bad,

and I'm coming home to...

my two wonderful dogs, but I wish I could
see my son and my husband right now.

[Linda] You know,
I think we all have experienced things

this last seven weeks that we never,
ever have experienced before

or even, you know, could have imagined.

[woman]
Mary-Ann would like to come to briefs

just basically to talk about you,

and, you know, the impact
that this has had on all of you.

And some of us may not even feel it yet.

But we will, you know. We definitely will.

This is, you know,
post-traumatic stress syndrome,

you know, in our COVID world.

So I want you all to be very alert

and, you know,
know that if you need anything,

there are plenty of resources for you.

You just need to kind of let us know.

[Linda] Yeah, great.
Thank you. Have a great day.

All right.

[Mirtha] It's a fact
that if we don't work as a team,

if we don't help each other out, if we
don't listen to each other's concerns,

no matter how small they are,

we won't be able to get through this.
I think we have to work together

with the nurses
who just have been excellent.

We keep saying, "When all this is over...
When all this is over..."

This has just brought us, like...

to such...
so much closer together as a family.

[Jill] Those we have lost...

Those we have lost...

That is why we are here tonight.

In tribute.

We have lost patients.

We have lost colleagues...

friends...

and loved ones.

We have so many reasons
to celebrate for Lenox Hill,

and we have celebrated.

But there has been much sadness and loss.

Say their name.

Say their name out loud.

Feel the loss because it's okay.

Say their names.

- [man] Jameson.
- [woman] George.

- [woman 2] Charles.
- [woman 3] Gutierrez.

[woman 4] Robert Charles.

[woman 5] Kate.

[woman 6] Dr. Mahoney.

[man] Neil Stein.

[Jill] We say their names.

We say them to ourselves.
We say them out loud.

And if we could...

we would hug each other...

and hold hands...

which I promise we will do again.

For now...

this is a symbolic hug to each other.

To our building.

To our hospital.

To our home.

- [woman] To our home.
- [all] To our home.

♪ If I surrender ♪

♪ And I don't fight this wave ♪

♪ I won't go under... ♪

[cheering, bells ringing]

[Cuomo] We took dramatic actions:

New York PAUSE program
to close down schools, businesses,

social distancing,

and it's working.

It is Fl*ttening the curve,
and we see that again.

♪ Wave ♪

♪ Wave ♪

♪ Isolation ♪

♪ Isolation ♪

♪ Isolation ♪

♪ Isolation... ♪

[David] It's one of the most incredible
experiences. It's probably the most...

One of the most gratifying
experiences of my life

and the most sad and depressing
at the same time.

You know, honestly,
I don't think I'll ever be the same.

In a good way.

In a good way.

[crowd chanting] I can't breathe.

I can't breathe.

Thank you!

Thank you!

[applause]

Thank you!

Thank you!

[cheering]

[horns honking]