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Mayor de Blasio at a briefing earlier this week. The city has provided guidance on when to seek testing. Many are not following it.Since the first positive COVID-19 test in New York City on March 1, the fear of contracting the virus has rapidly increased to a panic. For emergency room workers, the fear has made their job increasingly difficult as many asymptomatic New Yorkers flock to emergency rooms because they have traveled to outbreak regions or been in contact with someone that has been to areas of concern.
“Things have escalated to a state of confusion, worry, and are quickly becoming panicky even with the slightest symptom,” said one Mount Sinai-West emergency room employee who has been in direct contact with patients during the triage process and has asked to remain anonymous. “The uncertainty has them in a frenzy, and even when we tell them they are not showing symptoms, they insist on being tested or seen by a doctor. We can’t turn them away, so they’re seen even if they aren’t symptomatic, making the ED [Emergency Department] spend time on healthy patients when doctors and nurses could be using our time and resources on people that need it.”
One example of this was after a John Jay College student tested positive, and the school sent out notice. According to the emergency room employee, students and staff from John Jay college immediately began going to the emergency room in fear of being exposed to COVID-19.
Though the emergency room did not see the patient who tested positive, John Jay College is located directly across the street from Mt. Sinai-West.
ERs mean exposure
As of Monday afternoon, the number of New York City residents who have tested positive for COVID-19 had reached 463, with seven recorded deaths. De Blasio reports that the number is expected to go to 1000 cases by the end of this week.
To a degree, the fear is understandable as so many New Yorkers have tested positive with the virus.
However, Dr. Robyn Gershon, a professor of epidemiology at NYU, believes that despite the increasing number of patients who have tested positive, rushing to the ER without showing symptoms for COVID-19 is a decision that comes with its own risk.
“It’s a bad idea for people who are asymptomatic to run to the ER because they are putting themselves at risk by being around people who are sick, that is how a virus spreads. They need to stop,” urged Gershon, who also researches occupational and environmental health and safety.
While seeking testing poses a risk to the patient seeking it, it creates deeper issues for the sick people who would otherwise get that bed.
“It’s a real problem because these hospitals are forced to triage asymptomatic patients and it will become a terrible diversion of resources,” continued Gershon. “You don’t want to have hospitals waste their protective supplies and resources on patients that aren’t sick, when they already don’t have enough masks, to begin with.”
Limited supplies have already become a concern for emergency-room workers amid fear this situation might spiral out of control if New York City residents do not strive to avoid emergency rooms.
“It’s a little chaotic right now with organization and protective equipment, because of limited supply, but what can you do when it’s the job? We just have to take whatever measures to protect ourselves regardless,” said an emergency room nurse from Mt. Sinai-St. Lukes, who also asked to have their name omitted. “Still though, patients need to follow whatever guidelines the city has set for us right now because we honestly do not have enough supplies if the droves continue or get bigger.”
The city is already anticipating the need for more hospital beds and other supplies, asking the federal government for 300,000 additional masks and other protective gear. On Monday afternoon Mayor Bill de Blasio announced that the city is ramping up efforts to open about 8,200 more hospital beds.
This includes 350 beds from a Health and Hospitals facility on Roosevelt Island, which will be ready in about three weeks; 600 more will come from a newly-built Brooklyn nursing home that is yet to be occupied. Lastly, two hospitals in the Bronx will provide an additional 270 beds.
De Blasio continues to urge New Yorkers to make concerted efforts in order to “flatten the curve,” of the virus. Avoiding the emergency rooms is perhaps one of the best courses of action for individuals not showing symptoms.
When to seek testing
The New York City Department of Health and Mental Hygiene (DOHMH) created guidance for New Yorkers to follow in order to take preventive measures in spreading the virus, within which staying home is echoed throughout as the most critical action.
According to the DOHMH guidance, distinguishing the most commonly reported symptoms are a key factor in understanding if someone has COVID-19. Indications include fever with temperatures over 100.4 degrees, coughing, shortness of breath (difficulty breathing) or a sore throat.
Testing should only be used for people who need to be hospitalized for severe illnesses like pneumonia. The guidance also suggests staying home if you have mild to moderate symptoms rather than seeking medical care or even trying to get tested. By staying home, you reduce the possibility of transmission to others, including health care workers who are needed to care for the more seriously ill.
Anyone over 50 years old or with chronic conditions must consult a doctor to see if they may want to monitor you more closely. Whether you have mild symptoms or know you have COVID-19, the DOHMH is asking for anyone under the age of 50 to remain home and monitor your symptoms, before coming in contact with anyone.
“They do not need to go to the emergency room. That is the first thing they need to know. But they certainly should consult with their family doctor over the phone to discuss whatever symptoms they have,” said Gershon about New Yorkers under the age of 50 with mild or no symptoms during this health crisis.
Two extremes seen
The advice may not be enough to deter New Yorkers from making life more arduous for emergency room workers.
“There is a nervous vibe and people are legitimately on edge right now, and even though some people think this will blow over, I see it getting worse before we see it getting better,” cautioned the Mount Sinai-St. Luke’s emergency room nurse. “People are either not taking it serious enough and going to spaces that can expose them to the virus, or they are panicking to the point that they are making it difficult for those who actually need medical attention. Either way, we are a long way from seeing this through.”
City Limits reached out to Mt. Sinai for a response but was told their experts and staff were extremely busy and unavailable for comment.
