Transforming the Nation's Health

Nurse’s Reflection: A Time When Every Hospital in the State of New York Worked Together After Her Parents Who Lived in Far Rockaway, NY Died on the Same Day from COVID-19

On March 28, 2020, Far Rockaway, NY was one of the deadliest zip codes with COVID-19 in New York City. That date seems like yesterday to me at times, when I reflect on my experience with my parents during the peak of the New York City COVID-19 outbreak. I recall arriving at their apartment in Arverne, NY, at midnight, after driving from Ithaca, NY for 4 hours, to find my dad in the living room sitting in a chair barely breathing. When he saw me, he called out my name in such a weak voice, with his arms raised to hug me saying, “Elizabeth!”. In that moment I knew I needed to use my critical care nursing skills and act fast. I called 911 immediately and found my mother in another room unable to breathe effectively and requested a second ambulance for her too. As many of you may remember, all hospitals in NYC were overcrowded with patients with COVID-19 in the Emergency Departments (ED) and waiting areas. When my parents arrived at the hospital in Far Rockaway, NY they were among many in the ED packed in like sardines.

As I drove to a hotel in Long Island that night, I discovered a hospital 50 minutes away that had very few patients in their ED and was told if I could find an admitting doctor at that hospital, they would be able to arrange for my parents to transfer to that hospital. Unfortunately, I didn’t know a doctor at that hospital. Over the course of five days, my parents’ condition worsened and both parents needed critical care beds. At this point, the hospital had no critical care beds available. I had no choice but to contact the hospital where I worked at the time as the Director of Critical Care, in Ithaca, NY. I got in touch with a doctor willing to accept my parents as a transfer. They were transferred by plane to a hospital in Ithaca, NY, and lived another 3 days prior to their same-day death on April 10, 2020. I often wonder what would have happened to my parents if they were cared for in the hospital 50 minutes away in Long Island, which was less crowded.

Unfortunately, many people died during the COVID-19 pandemic because hospitals were overcrowded and understaffed. Many hospitals got together and demanded help from the New York State Commissioner of Health and Governor Cuomo. As a result, Gov. Cuomo directed the New York State Department of Health (NYSDOH) to create an innovative Surge and Flex system, designed to create one singular coordinated statewide public healthcare system to prevent the virus from overwhelming any one hospital in the State. The State convened a Hospital Capacity Coordination Committee (HCCC), an around-the-clock command center/hotline, with representatives from each of the State’s hospital systems to serve as the central hub for operations related to patient transfers, supply and equipment deployment, and staffing support.

If this regulation had been in place the day my parents entered the hospital in Far Rockaway, they could have been transferred to the hospital 50 minutes away which had fewer patients. An opposing argument could be that even if this ruling existed on the day my parents entered the hospital, they may not have been chosen to be transferred because of their age (87 and 78 years old). There were many challenges during that time on who should get oxygen or not because of the scarcity at that time. These decisions were usually made by an ethics committee to determine which patient would benefit the most from either a transfer to another hospital or to receive oxygen.

It is reassuring to know that if the state of New York ever has an outbreak like COVID-19 which caused an influx and surge of patients in hospitals, the Surge and Flex system will be activated again. Having all hospitals in a state work under one umbrella to help each other with transferring patients to other hospitals that have a lower patient occupancy may save lives. If you are a resident of Far Rockaway, NY, be assured that your local hospital won’t be working alone, if another pandemic happens again like COVID-19. If you reside outside of New York, find out if your state has a plan in place for such emergencies as the state of New York. If your state does not have an emergency plan like New York, please advocate and recommend that your state create a Surge Flex System with statewide hospital coordination.