When Hospitals Are Overwhelmed Emergency Services Cut Low Likelihood Resuscitation
As of 1 April, 2020 EMTs in NYC have been instructed to not resuscitate cardiac arrest patients if they cannot get a pulse at the scene.
ABC 7 New York explained the reasoning behind this call best: “
“When you’re doing the CPR, you’re pushing really hard on the patient’s chest and they’re expelling some air in the process as well, so if they are COVID patients, they’ll be spreading it all around,” said Dr. Vinayak Kumar with the Mayo Clinic. “This is the risk-benefit math you have to take into account.”
The orders to stop CPR in the field is shocking to veteran doctors who are used to doing whatever it takes to save a life.”
Why is New York City doing this?
Healthcare Systems Overwhelmed
The healthcare system in New York City is overwhelmed. Cultural barriers have impacted the use of masks publicly, the adoption of social distancing, and the nature of SARS-CoV-2 allows it to spread silently in a densely populated city.
New York City is flattening the curve too late to have not overwhelmed their medical system. This is the city in the United States that has been argued to have the best medical care. With the actions of every day people, such as social distancing, stay at home orders, adopting mask wearing, and hygiene awareness campaigns, they are finally flattening the curve.
Unacast rates the state of New York at a B- in Social Distancing. Their grade is based on the following:
At this time the majority of social distancing is focused in the City of New York. But COVID-19 is spreading up Long Island. As this virus spreads up into the rural areas away from the city, we need to assume that it is being carried by asymptomatic reservoir hosts or minimally symptomatic. The rest of the state of New York is mostly rural. In this case, we run into the rural hospital problem or we run into poverty in smaller dying former industrial cities, such as Buffalo.
But are we at the peak yet? No. But we can examine milestones and projections for changes overtime. Milestones can be used in the process of forecasting for making quick decisions.
At this time New York is projected to hit its 500,000th case on 12 or 13 of April 2020. That said – this is a graph based on many data points that can be broken up.
There’s a lot of hope in that graph shape. The slope is changing. If we look at only the last few days, we have extended how long it takes to reach that 200,000 cumulative case milestone to the 13th or 14th of April 2020 – the same timing as what the previous graph projected would be the timing for the 500,000th case.
This post is dedicated to my friends currently in New York City. I love you Elly, Liz, Greg and Naomi. Please stay safe. I owe all of you hugs the next time I see you.
- New York is flattening the curve. If the curve does not flatten more, we could hit 500,000 cases by around 13 April 2020 unless things improve (remember that testing backlog?). At this time it does not look like New York is hitting a peak.
- Keep up the social distancing if you can. Adopt mask wearing if you can and have to go out (this will link to another piece I’m writing later). Thank anyone working because they can’t social distance.
- People in New York City will be dying because resuscitation is no longer safe for emergency medical workers. This is tragic.
- People are still sick with heart disease, cancer, bacterial infections, influenza, and everything else under the sun and because the medical system is overwhelmed, those people aren’t getting sufficient care.
Thank you to anyone that reads this. Without you I’m just shouting into a void.