Inside the “Red Zone” of a New York City hospital
CBS News spent seven days at the Montefiore Medical Center in the Bronx section of New York City, from April 16-22. It was the height of the coronavirus pandemic in one of the hardest-hit communities in the nation. Watch the CBS News special, “Bravery and Hope: 7 Days on the Front Line:” Friday, May 15, at 9 p.m. ET/PT.
“Rapid response Northwest 6. Rapid response Northwest 6. Blue zone.”
Dr. Michelle Ng Gong strapped on a face shield as the sound of the Montefiore Medical Center PA system broadcasted an all-too-familiar announcement: a COVID-19 patient was in critical condition. Gong rushed out of the command center, weaved through the hallways, and dodged stretchers as she made her way toward the patient’s room.
Before entering the room, Gong called for gowns, grabbed several herself and handed them out to other nurses who had just arrived. Gong was about to enter the “red zone,” an area where personal protective gear, or PPE, would be the only barrier between her and the virus.
The patient was on a ventilator, but his oxygen levels had fallen. Gong didn’t believe he was moving his chest wall well. She wanted to attempt taking the ventilator out of the equation and manually deliver oxygen. She reached for the patient’s foot.
“He’s got good blood pressure, he’s got a good pulse.” Gong leaped onto the patient’s chest — her feet dangled in the air, her face mere inches from the patient’s, as she exerted her own body weight. Gong wanted to see if the patient could stand being placed in a “prone position” — a process that requires several healthcare workers to rotate the patient onto the patient’s stomach to help get oxygen to the back of the lungs.
Gong determined that the patient would benefit from this process, but he would first need to be transmitted to the Surgical ICU.
In normal times, gowns are discarded each time a nurse or doctor interacts with a patient to minimize contamination in “green zones” of the hospital. But this patient needed to get to the surgical ICU immediately.
“Please clear all corridors,” a voice said over the PA system.
Because he had just been removed from a ventilator, there was a greater chance he would spread COVID-19 into the air. A doctor placed a translucent sheet of plastic over the patient’s face, a technique used to minimize spreading the virus, and a team of four remained clad in full PPE while they wheeled the patient across multiple hallways and down an elevator bank.
While hospitalizations have gone down across New York, the patients who have been admitted are getting sicker.
Said Gong: “These are still not normal times, and these are still very sick patients.” Despite her best efforts, this patient died later that night.
Nurse Jasmine Christakos says she will always remember the first COVID-19 death in the Surgical ICU. Christakos had just gotten married in late February and returned to work as the virus was beginning to spread rapidly.
Christakos recalled a family grieving over the fact that they could not visit, and that the patient would die alone. Christakos remembers that night, when the entire unit sat in front of the patient’s room and waited for the ventilator to be pulled. “We said a prayer, we said goodbye, and we told the family, no, they didn’t die alone. They died with us.”
Many of the patients admitted to the Surgical ICU make it out. When a patient is well enough to breathe on their own, they are “extubated,” or removed from a ventilator, offering cause for celebration from doctors and nurses.
“Since COVID, it’s been a little difficult to find the light in the darkness. But you celebrate the little victories,” Christakos told CBS News.
While witnessing the extubation of one patient, Doctor Jen-Ting (Tina) Chen called for a nurse to ring a cowbell, signaling the good news to the rest of the floor. After an extubation a few days earlier on the same floor, a nurse wrote the time on a white-board, and drew a heart.
At the peak of the pandemic, Montefiore Hospital Center broadcasted “Empire State of Mind” by Alicia Keys over the PA system and Christakos has taken to dancing during the “happy code.”
“It’s an amazing experience to see someone no longer need a breathing tube. No longer need the help of a ventilator,” Christakos said. “I’ve seen patients where I was like, ‘Oh my goodness are they going to make it?’ And they do.” To Christakos, it is victories like these that make the work, “so worth it, just absolutely worth it.”
Cristian Camas is one of many examples of a patient pulling through. The 22-year-old ambulance worker contracted the virus on the job. After 21 days inside Montefiore Medical Center, he was discharged. Nurses wheeled Camas through the COVID ward and out to the street. Camas squinted in the bright light of the sun as healthcare workers applauded his release.
“We’re definitely winning more than we are losing. The majority of patients with COVID are still surviving. But the sheer number of patients with COVID is just unprecedented,” said Gong. “The emergencies continue, we continue to respond, and we take it one day at a time.”
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