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'It’s what was happening in Italy': the hospital at the center of New York's Covid-19 crisis

<span>Photograph: John Minchillo/AP</span>
Photograph: John Minchillo/AP

New York is the center of the Covid-19 pandemic in the United States, and Elmhurst hospital in the New York City borough of Queens is the center of the center.

In just one 24-hour period this week, at least 13 patients were reported to have died at the hospital, where the medical examiner’s office has stationed a refrigerated trailer to act as a makeshift morgue. Officials have described the hospital as “overwhelmed”, “overrun” and calling out for one thing: “Help.”

Related: New York now the center of the US coronavirus crisis – can it cope?

“People are going to die,” said Francisco Moya, the New York City council member who represents the Elmhurst neighborhood. “The rate in the next few days [will] continue to go up, and people are going to get scared and get shocked.”

The US surpassed virus hotspots China and Italy with 82,404 cases of infection on Thursday night, according to a tracker run by Johns Hopkins University. Hours earlier, New York’s mayor, Bill de Blasio, had announced there were 23,112 Covid-19 cases in New York City alone, and 365 deaths. Queens accounts for one-third of cases in the city.

“Elmhurst hospital is at the center of responding to this crisis. It’s the No 1 priority of our public hospital system right now,” de Blasio said on Thursday.

The hospital is located in one of the poorest and most diverse areas of the city, home to 20,000 recent immigrants from 112 different countries. It was already operating at 80% capacity before the coronavirus pandemic, with plans to expand its emergency department. One doctor told BuzzFeed the facility is “held together by a shoestring”. It was operating at 125% capacity as of Thursday morning, with dozens more people lined up outside seeking tests and treatment.

People wear face masks as they wait in line for coronavirus testing at Elmhurst hospital on 25 March.
People wear face masks as they wait in line for coronavirus testing at Elmhurst hospital on 25 March. Photograph: John Minchillo/AP

In the Elmhurst and the nearby Corona neighborhood, one in four people lack health insurance. One in four live in poverty. Those numbers have probably grown since Covid-19 put a record 3 million Americans out of their jobs, with more expected to file for unemployment next week.

“That is a highly immigrant neighborhood,” said Do Jun Lee, a professor of urban studies at Queens College whose research focuses on immigrant delivery workers. “A lot of the Latinx immigrant workers come from that part of Queens – Elmhurst, Jackson Heights, Corona – and they work all over the city delivering food.”

New York City is home to 560,000 undocumented immigrants. There is a gulf between the sort of healthcare an undocumented immigrant and a native-born American can access . A city report found 94% of US-born New Yorkers had health insurance, compared to only 42% of undocumented immigrants, in 2018.

“A lot of the workers who are going to be vulnerable live in Elmhurst, which is a hotbed of what’s going on with the virus right now,” said Lee. “If they need emergency care, they’re going to be going to a hospital that is already overwhelmed.”

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Moya was born at Elmhurst hospital, worked there before he joined the city council, and has represented the hospital for 10 years. He has had daily phone calls with the hospital’s CEO.

“It’s what was happening in Italy or Spain, but it’s happening in our backyards – in Queens,” he said.

“It’s real and troubling and scary and when you have a high rate of undocumented people who have to work,” said Moya, citing the many food delivery workers, recent immigrants, low-wage and contract workers who live in the area, “they’re not given the right protection.”

Moya and fellow council member Carline Rivera wrote a letter to Donald Trump on Thursday saying the hospital and others in Queens were “besieged” and calling for more resources.

“Elmhurst and Queens hospitals is besieged by this disease. If you speak with any of the staff there, the desperation in their voices is unmistakable,” they wrote.

“Doctors describe scenes in apocalyptic terms. Patients are reportedly dying in the emergency room still waiting for a bed. Residents line the block, standing inside barricades and in the rain waiting to get tested.”

Like so many other hospitals in the US and across the world, Elmhurst has also been struggling with a lack of vital equipment and protective gear for medical workers, to help prevent them contracting the disease.

Under normal circumstances, Elmhurst has a 15-bed intensive care unit. Now, it is full with Covid-19 patients who require invasive intubation to be on ventilators. As of Thursday morning, 45 of the hospital’s now 63 ventilators were in use, a person with knowledge of hospital inventory said.

The patients that come into the hospital, an official said, are extremely sick and deteriorating quickly. No visitors are allowed in the hospital, and the wards whirr with mechanical ventilators.

In the last 48 hours, 50 additional hospital staff have been sent to Elmhurst hospital, and 60 patients transferred elsewhere to try to alleviate the strain on hospital staff. De Blasio said he is transferring another 40 ventilators to the hospital.

“The staff are giving their all to save every patient, but tragically this disease continues to take a terrible toll on the most vulnerable,” de Blasio said. “To the men and women working at Elmhurst right now: your city sees you, your city thanks you and more help is on the way,” he added.

Doctors who have spoken to the New York Times and other US media reported almost running out of ventilators; working with a “motley” assortment of protective equipment; and admitted patients being left in waiting rooms for hours before a bed is available – often when someone dies.

Elmhurst hospital on 26 March.
Elmhurst hospital on 26 March. Photograph: Dan Callister/REX/Shutterstock

While Elmhurst appears to be one of the hospitals taking the brunt of the New York outbreak, facilities around the city and state are braced for a surge in patients as the number of cases continues to increase.

“It is extraordinary. This is like nothing I’ve ever seen,” said Dr Dara Kass, an emergency medicine professor at Columbia University medical center. “Every day is escalating in emergency rooms all over the city.”

“We’re seeing an increased number, where 75% of all patients being seen are being seen for some condition related to the coronavirus,” Kass said. “I saw 20 patients in four hours, and 16 of them had symptoms of viral syndrome of Covid.”

Kass said she believed outer borough hospitals may be getting hit harder by Covid-19 patients because, unlike in Manhattan, patients there would not have had the resources to leave when the city shut down.

“Manhattan is not seeing the same volume of patients as Brooklyn, Queens and upper Manhattan and the Bronx,” she said.

Moya said many of his constituents live in tightly-packed apartments, renting only a single room, or care for elderly relatives. Immigrant food workers, like those Lee interviewed, typically earn between $2-$4 an hour before tips and have no health insurance. And they are not necessarily young. The median age of a Chinese immigrant food delivery worker is 46.

Michael Czaczkes, who lives five minutes from Elmhurst, walked past families huddled together in a line that stretched down the entire block on Monday, even as the weather turned cold and rainy. He said two older residents in his building have told him they’re afraid to go to Elmhurst – in case they too might get sick.