Thread by @70sBachchan

Investigative WSJ @shalini report on the catastrophe of New York is also a blaring "DO NOT DO THIS " guideline for hospitals in India, Brazil, Mexico, S Africa etc. Many 10000s of deaths can be avoided. Thread 1/
wsj.com/articles/how-n…

Firstly, New York has been an off-the-scale disaster in terms of deaths and covid cases. Its wealth, expertise and resources did very little to insulate its ppl from catastrophic mismanagement. It took almost 100 days to control the epidemic. 2/

https://twitter.com/70sBachchan/status/1260783004227645440

It was clear to most ppl by March that a dense city like New York would need to adopt the Wuhan model of Corona hotels. Lockdown was necessary but not sufficient to stop infections. It took the city two full months to roll it out. Tragic saga here ⬇️3/

https://twitter.com/70sBachchan/status/1242670018455838721

So what can other places learn from New York’s disastrous coronavirus response? @shalini @LauraKusisto @katie_honan
have a long list, based on interviews w almost 90 health care workers, administrators & officials as well as documents & emails. 4/ wsj.com/articles/how-n…

NYC hospitals faced high rates of attrition due to "Incomplete staff-protection policies. Many hospitals provided staff with insufficient protective equipment and testing". Similar story playing out in Delhi, Mexico City, Sao Paulo; Daily cheers & rose petals not enough. 5/

"Inadequate staff planning: Hospitals added hundreds of ICU beds but not always enough trained staff, leading to improper treatments and overlooked patients dying alone" 6/

"Improper patient transfers: some patients were too sick to have been transferred between hospitals. Squabbling between [city & state] administrations contributed to uncoordinated effort" 7/

"Insufficient isolation protocols: Hospitals often mixed infected patients with the uninfected early on, and the virus spread to non-Covid-19 units." 8/

"Procurement gaps: while leaders focused attention on procuring ventilators, hospitals didn't provide adequate supplies of critical resources including oxygen, vital-signs monitors and dialysis machines" 9/

Many patients died in New York hospitals from untrained staff and improper operating procedures. Shortage of trained workers in cities of developing countries cannot be fixed without importing staff from other cities or countries. 10/

"staffing shortages led to hospitals losing track at times of admitted patients... a family member called the ER to inquire about their mother in her 80s. An ER doctor said that when he looked the patient up, he realized she had died two days prior. “This is happening daily” 11/

Prioritizing PPE for nursing home staff & designing standard operating procedures to reduce risk of infection to elderly residents is an important lesson for rest of world from New York's catastrophe. A full ONE-THIRD of US deaths were in nursing homes 12/ nytimes.com/interactive/20…

Prioritizing resources for elderly is crucial: “Scott Amrhein, a trade-association executive who helped procure PPE for nursing-home workers, became so distraught about the shortage of protective gear, among other issues nursing homes faced, that he died by suicide March 30" 13/

"...a severe oxygen shortage hit mid-surge, said doctors there including Dr.Dasol Kang. He said some Covid patients, including a woman in her 50s and a man in his late 40s, languished without portable oxygen tanks". Similar shortages already evident in India, Mexico, Brazil...14/

Medical Supplies ARE a difference bw US & developing countries. When needed most, US sourced them from productive capacity of Asia; largest ever govt airlift of some 200 planes have arrived from Asia+LatAm. With summer surge in global south, what now? 15/ fema.gov/media-library-…

The first flight carrying medical supplies from Shanghai landed in New York's JFK on 29th March at hour of greatest need. Since then, 205 flights, have brought them from Thailand, Vietnam, Malaysia, India, Mexico,etc 16/fema.gov/media-library/… #viraltime

https://twitter.com/70sBachchan/status/1244300150253727744

New York is the world's metropolis. The lessons from its catastrophe are being learnt —must be learnt —in every country. We are still near start of the pandemic. covid19-projections.com/#rest-of-world…

WSJ investigative report is avlbl here /END. archive.is/1Onkq#selectio…

https://twitter.com/adam_tooze/status/1271769032165859332

Lessons from New York are being learnt very fast across US hospital system. Doctors learn how to treat coronavirus patients out of the hospital. The average hospitalization rate continues to drop and more who are treated recover. propublica.org/article/how-am…

Current situation in Houston hospitals similar to NY in April. ht @charlesornstein
- Serious staffing issues
- creating space by delaying surgeries
- Accelerating inflow creates long waits for beds
- Running out of essential drugs
Fig via @russellgold propublica.org/article/intern…

Really wonder how different things would be if there had been a TV crew broadcasting a NYC hospital from March on. Would Texas, Calif., Florida be suffering as much now?
Take out a few minutes to watch this from San Antonio hospitals ht @miguelmarquez @CNN cnn.com/videos/health/…

Underlying New York's catastrophe was disparity. Public hospitals were overwhelmed, but richer pvt ones w open beds took fewer than 50 patients from public ones. Stunningly, only resignation has come from health commissioner while Mayor/Governor are lauded
nytimes.com/2020/07/27/pod…