'You're on your own': New York doctors told to choose who lives and dies amid ventilator shortage, leading medical group says

The Medical Society of the State of New York said emergency room doctors "are reporting being told the equivalent of 'Use your best judgment. You're on your own'" amid a ventilator shortage that's crippling hospitals amid the rapid spread of the coronavirus pandemic, WNBC-TV reported.

In effect, doctors treating critically ill COVID-19 patients are tasked with choosing who lives and who dies, the station said.

"Ventilators as lifeboats are reaching capacity. At this point, the most difficult decisions facing physicians will have to be made," and that "we will be seeing increasing depression and PTSD that will eclipse today's physician burnout," the premier medical group said Thursday, WNBC reported.

'In escapable warzones'

Emergency rooms have become "inescapable warzones," the station said, citing a Manhattan doctor, while a Queens physician told WNBC his ER is so flooded that ventilators are being managed in hallways. Other doctors said they've intubated their own colleagues, the station said, adding that nurses have walked out demanding more personal protective equipment.

In addition, an EMT group issued new guidelines telling paramedics to not transport cardiac arrest patients to emergency rooms if they can't revive them in the field, WNBC reported.

New York Gov. Andrew Cuomo (D) said the spike in COVID-19 patients necessitated that the 2,500-bed Javits Center field hospital — intended for non-coronavirus patients to ease the strain on other hospitals — now will exclusively treat coronavirus patients, the station said, adding that the U.S. Army will run it.

Rising numbers

WNBC said New York City — now the epicenter of the coronavirus outbreak in America — accounts for 26% of the nation's death toll and nearly a quarter of its overall cases. The city had 51,809 cases and 1,562 dead as of Thursday while the state had 92,381 cases and more than 2,500 deaths, the station said.

State consultants said New York will need 75,000 to 110,000 COVID-only beds when the apex of the outbreak hits, WNBC reported, adding that Cuomo said his team estimates the apex hitting at the earlier end of a seven-to-30-day range.

New York City Mayor Bill de Blasio (D) said on MSNBC Friday he expects 5,000 or more patients in need of intubation or ventilators in ICUs by next week, the station said.

"We have enough ventilators just to get to Sunday/Monday," the mayor said, the station reported.

"I'm guaranteeing you that next week is going to be a lot tougher. Next week in New York City is going to be very tough," de Blasio added, according the WNBC. "We have days to set up a structure to truly mobilize the medical community of this nation ... If that is not done in the coming days, you're going to see people die who did not need to die."

The need for ventilators

More from the station:

New York needs three things — beds, equipment and staff, Cuomo says. Beds are the easiest to acquire. Nearly 100,000 retirees have returned to work to shore up medical staffing; some colleges are graduating medical students early. De Blasio called for a national medical personnel enlistment program Friday, saying the country needs a wartime footing for a wartime threat.

But equipment to save lives? Cuomo says he has 2,200 ventilators in the state's stockpile. "At the current burn rate" of 350 new patients a night, Cuomo said Thursday the state supply could run out in six days.

The governor says he knows "where every ventilator is in the state." He's leveraging creative techniques like co-venting and retrofitting anesthesia machines to stretch supply. And he's still trying to buy more.

"I need roughly 30,000 ventilators which I can't get, but I only need 30,000 ventilators for two or three weeks at the top of my curve. I need backup public health professionals. But I only need them for two or three weeks at the top of my curve," Cuomo said on MSNBC Thursday, according to WNBC.

Cuomo added that he doesn't believe the federal government has enough ventilators to outfit what states will need in the coming weeks, the station said, and that they should be sent where they're needed first — and then reallocate.

"No state is equipped to handle this situation. States don't do public health emergencies," Cuomo said on MSNBC, according to WNBC. "There is no capacity in my state health system that runs 50,000 beds to create and maintain an additional 50,000 beds, just in case once every 20 years there's a pandemic. It doesn't work that way."

A Gates Foundation-funded Institute for Health Metrics and Evaluation projection predicts New York could lose a total 16,000 people through the second week of May, the station said.

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