As the tragic impact of the COVID-19 on New York City continues to dominate the news, a former Yuman is on the frontline as a physician in the Emergency Department of one of the area’s hospitals.
“The hospital is beyond capacity and the nurses and technicians are working harder than ever … exceptionally hard around the clock,” said Dr. Eli Cohen, who grew up in Yuma and is now an Emergency Physician at Mount Sinai South Nassau in Oceanside, N.Y. (Long Island). As for his own workload, he noted, he’s actually seeing slightly fewer patients during his 12-hour shifts, likely a result of the home quarantines imposed on the population.
“There’s fewer car accidents or kids breaking their arm,” he said. “I think people are trying to stay home. They’re not driving or tripping on curbs or falling off playground equipment.”
Instead, with rare exceptions the patients he is seeing are suffering from COVID-19 or what they fear is the virus and most need hospitalization. “The total number coming in has gone down but they don’t leave,” he said. “Normally we admit about one of five patients. Now 50 percent of our patients are being admitted. It’s completely opposite of the way we normally operate. We have 40 or 50 people staying in the Emergency Department waiting for a place for us to put them.”
That left the hospital, as with all hospitals in the area, scrambling to find rooms and beds for the patients, Cohen said, adding that the governor mandated that all hospitals expand their capacity by 50 percent. “All elective surgeries have been cancelled and pre-op rooms are being used for patients … all kinds of spaces are being used.”
What he is seeing most often, he said, is that patients are coming in with blood oxygen level so low “it’s not normally compatible with life. That’s why they need to stay in the hospital. What doesn’t make sense is that they’re so low on oxygen but they’re walking around for days before they come in.”
The practice had been to put such patients on mechanical ventilators, but even as officials warn about the shortage of the devices, physicians are beginning to question their use. “We’ve found that 80 percent of patients put on ventilators don’t survive,” Cohen said. “So the thinking is to provide oxygen for people in other, less invasive ways. It’s a basic shift to other devices. One is the CPAP (breathing masks used in sleep apnea) connected to oxygen or nose plugs with oxygen.”
The biggest takeaway as an emergency room doctor, he said, is the head scratching about the virus. “The coronavirus is actually the common cold so why does this one seem to behave so differently? It’s much more lethal, much more contagious with much more severe symptoms with respiratory failure.”
A major concern, he said, is that doctors “are seeing acute or immediate damage to lungs, heart, kidneys and liver. It is unknown what long-term will be like but there are reports of permanent heart and kidney damage.”
In the meantime, health-care professionals are doing the best they can to take care of patients with the new disease while trying to protect their own health. “It’s challenging in many ways,” Cohen said. “Medically we’re doing something new while having to wear all the protective gear makes it more stressful. It feels overwhelming at times.”
Having deployed with the military in Afghanistan for seven months, he’s used to working under pressure. “I’m more pragmatic. I realize sometimes things will be dangerous. We don’t know enough about the bug to know how it attaches to people. I take precautions and hope for the best.”
Asked if the staff has enough protective gear, he responded not if they use it the way it is traditionally used – one time for each patient visit. But they have enough for the way it is now recommended, which is wearing the same mask and gown for the entire day. When he goes home, he takes off his scrubs in a designated room and showers before entering the rest of the house to avoid contaminating it. “That’s not my normal routine. I’m taking some precautions but you can only take so many.”
While he doesn’t think the disease is on the down slope, he’s hopeful “we’ve somehow peaked. The plateaued numbers seem to be holding level.”
On a final note, he shared how the public has been supportive of the hospital and its staff from physicians to those doing the cleaning. “A large number of people have been donating meals for the staff, protective gear and masks. It’s heartwarming. And people have been recognizing we’re people, we’re not just doctors and nurses. Everyone needs to keep going, including the technicians and cleaning people. It’s nice to see.”