Medical experts suggest big picture, long-term approach to fighting COVID-19

Photos by Kevin P. Coughlin, Office of Governor Andrew Cuomo
Gov. Andrew Cuomo and health Commissioner Howard Zucker recently toured the Northwell Health Imaging at the Center for Advanced Medicine in New Hyde Park, Nassau County. Dr. Rachel Vreeman and Dr. Aaron Carroll say medical facilities should be provided with resources they need to contain the spread of COVID-19.

With New York on the frontline of the coronavirus outbreak in the U.S., with cases doubling every few days, doctors are supporting Gov. Andrew Cuomo’s initiatives to alleviate growing pressure on hospitals.

Two respected doctors and medical researchers held a virtual press conference on Wednesday, March 25, to discuss their recommendations for combating the COVID-19 pandemic in New York state.

New York reached over 44,000 cases as of Friday morning with more than 500 deaths reported so far.

More than 6,400 patients are hospitalized in New York hospitals as of Friday.

While the peak of those infected with the coronavirus is expected to be in the next two to three weeks, Dr. Rachel Vreeman, an adolescent HIV/AIDS researcher and Chair of the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai, and Dr. Aaron Carroll, a pediatrician and professor at Indiana University School of Medicine, and a frequent contributor to the New York Times, are urging leaders to take a long-term approach to the pandemic.

“We can’t have a short-term view for this [COVID-19] even if we advocate for some short-term differences and how things are being managed. We have to keep thinking about the big picture,” said Vreeman. “In the long-term [we have to recognize] how incredibly hard [this] is for all of us.”

On March 22, Cuomo officially ordered all non-essential employees to stay at home and for all non-essential businesses to indefinitely close their doors.

Restaurants offering takeout, healthcare facilities, transportation, news media and grocery stores are some of the businesses that remain open during the state of emergency.

Vreeman and Carroll support Gov. Cuomo’s recommendations for New Yorkers to practice social isolation as much as possible, protecting health care workers, and increasing beds and ventilators in hospitals.

“It’s important we take this incredibly seriously and bring all the tools that we have to bear to give health care professionals and health care facilities that are caring for [COVID-19 positive patients] everything they need,” Carroll said.

In New York City the disease is spreading at the highest rate, with more than 21,000 of the state’s positive cases as of March 26.

To prepare for a surge of hospitalizations Cuomo has initiated turning the Jacob K. Javits Convention Center in Manhattan, the Westchester County Center, SUNY Stony Brook and SUNY Old Westbury into temporary hospitals.

More potential hospital sites were announced on Friday morning.

The biggest necessity addressed by Cuomo and health professionals alike is the need for more ventilators. Ventilators are a life-saving medical instrument to help patients breath as the virus can lead to respiratory problems.

New York state hospitals currently have access to approximately 3,000 – 4,000 ventilators. Cuomo is requesting the need for 30,000 ventilators to be prepared and ready for the worst to come of COVID-19. The state is currently experimenting with ventilator splitting, Cuomo announced at Thursday’s press conference, which allows one ventilator to treat two patients.

With the greatest concern of overwhelming the health care system, if full hospital capacity is reached, treatment for people suffering with other serious conditions such as heart attacks, cancer and strokes could be neglected for coronavirus cases.

“If you’re doubling every few days, it will not take [long] to hit capacity, and that’s the biggest concern,” said Carroll. “What happens when we hit capacity is… [we have to decide] who do we treat and who do we not treat and who gets the ventilator and who does not.”

There has been bi-partisan consensus that the federal government needs to step up during the COVID-19 pandemic as Democrats and Republicans attempt to pass a $2 trillion rescue package for states.

Carroll and Vreeman believe that every state will need considerable help from the federal government to battle the virus.

“[We] need the federal government to create the hundreds of thousands of ventilators we might need, to create the test to empower the public health system [and] to start to create ways to do those tests and monitor what’s going on,” Carroll said.

Health care professionals are agreeing that testing the population-at-large, after the rate of infection slows, will help New York return to some form of stability.

“[What] we need to do to actually beat this is a much broader real national pause and also a massively coordinated testing effort that would be built on a public health infrastructure model,” Vreeman said.