Coronavirus: How one New York hospital is coping at the epicentre of US crisis
In Brooklyn's largest hospital, the ambulances keep coming - patient after patient arrives with breathing problems.
Friday 3 April 2020 19:27, UK
From the moment we approach Maimonides Medical Center in Brooklyn, there are people everywhere.
Doctors and nurses spilling out on to the streets, intensely huddled for snatched conversations, rushing between a triage tent on the pavement and an extremely busy ER room dealing with the coronavirus pandemic.
The ambulances keep coming - the sound of sirens a constant theme.
Patient after patient arrives with breathing problems.
Inside Brooklyn's largest hospital, Dr Eitan Dickman, vice chair of emergency medicine, tells me they have had to rapidly adapt to an overwhelming number of COVID-19 patients.
"We have opened up a new ICU, new intensive care units.
"We've opened up new medical units in order to accommodate for this increased demand of patients who are coming in so ill."
They have already expanded their capacity by 50% and they are prepared to do it by 250%.
There are normally 17 beds in the room we are in.
Today, there are 32 patients, and the doors constantly swing open with new arrivals.
The sound of heart monitors punctuate the air, and there is the coarse clunk of oxygen ventilators being carried through to cope with the deluge.
And then there is the patients, many elderly - but some appear to be in their thirties too - all clearly struggling to breathe.
Most have masks on to help get oxygen in.
"Really the main effect that we're seeing," says Dr Dickman, "is a significant effect on impairing the lungs ability to provide the oxygen that the body needs.
"And then it spreads. It affects the heart. It affects the kidney.
"Ultimately unfortunately often taking the ultimate toll."
New York State has become the epicentre for the COVID-19 pandemic in the US.
At the time of writing, 92,381 have tested positive for the virus, and 13,383 people have been admitted to hospital.
Every day, the death toll reaches a new grim milestone - it currently stands at 2,373.
As a team operating at the epicentre of this crisis, we have sadly become used to seeing bodies brought out on gurneys in the street and loaded into refrigerator trucks.
It is a painful, incongruous sight in one of the premier medical capitals of the world, and a searing symbol of just how intensely COVID-19 has engulfed this city.
The virus does not discriminate and in this city of extremes, it is a brutal equaliser.
"It affects people from all demographics and even people who are who are still intubated for potentially weeks on end if they end up very, very ill. Chronically ill," Dr Dickman says.
Elsewhere in the city, there's a dire lack of personal protective equipment - some terrified nurses forced to make their own or ask to re-use what they are given.
They say it's a risk to them and to the people they're trying to treat.
But not at Maimonides.
They appear to have acted quickly, prepared and organised well and currently say they have enough supplies.
But they are keeping a close eye on the situation - they know it's still at week or more away from the peak of the pandemic and it will certainly put pressure on their system.
It's striking to see up-close how this virus sucks resources.
Everywhere I look, I can see groups of doctors and nurses surrounding each patient.
It is a daunting climate even for the most experienced.
"I've seen the sickest people I've ever seen in my life," his colleague tells me.
"Everyone is really pushing themselves to the limit to try and take care of these patients," Dr. Dickman adds.
They're learning on the job about COVID-19 and it's a sharp and unforgiving learning curve.
He says: "We're finding out more and more that there are no classic symptoms.
"Often times people will have respiratory complaints, but sometimes people had abdominal pain, which didn't make you think that they would have something related in their lungs, but they ended up ultimately being diagnosed."
Those that do make it he says, are in for a "very rock road to recovery".
Everyone in this room is taking a risk.
Frontline medical staff are being exposed to COVID-19 on a daily basis.
As a team, we make sure we observe the two metre (6ft) distance rule throughout - we know the air is full of the virus.
As we leave the room, we start the process of removing our protective equipment - doffing as they call it.
:: Listen to the Daily podcast on , , ,
It is an anxiety-inducing protocol we have to follow.
One misstep - we are told - and we can easily expose ourselves to the virus.
There are goggles, gloves, N95 masks and other protective clothing to take off.
We have been told to establish a clean area to dispose of it all, disinfect the camera equipment and avoid any cross-contaminating by touching each others items.
As a team, my producer, Emily Purser Brown, and cameraman Guy Siggers, have to keep a close eye on each other.
We have been spending our days watching each others behaviour - making sure we are not getting too close to anyone, that we do not touch our faces, that we are constantly washing our hands.
As we get in car, we all look visibly shaken.
We have just witnessed a packed room of people struggling to survive, and I can still hear the whir of the machines.
After four weeks spent reporting on the virus, the reality of what it can do to the body has really hit us.
The emergency room was packed with people our parents' age.
I recently spent a month in London on an ICU ward after my mother-in-law had severe complications following heart surgery.
It was traumatic and deeply upsetting, but eventually, surrounded by family, she miraculously pulled through.
But here, they cannot have relatives standing by their bedside to encourage them.
Everyone is alone - it is too riAG百家乐在线官网 to have visitors at the hospitals. It is a horrifying thought.
:: Listen to the Daily podcast on , , ,
I feel in awe of the medical professionals we have met at Maimonides Hospital.
I have never seen a more kinetic, demanding and surreal situation.
As we walk to the car park, we suddenly see the refrigerator truck parked, ready to carry the bodies of the dead.
But we know, the doctor and nurses inside are doing everything they can, adjusting rapidly to a dynamic and unpredictable situation with bravery and dexterity, to stop anyone getting there - to save as many lives as possible.