A vast continent separates South Peninsula Hospital in Homer and Lenox Hill Hospital in New York City. During the COVID-19 pandemic, the two hospitals have had differences in experience equally as large. Dharti Patel, a Homer physician assistant with roots in New York, has gone back to Lenox Hill to help out in the crisis and bridge that gap in geography and pandemic challenges.
While Homer’s hospital has had only one patient test positive for the novel coronavirus that causes COVID-19, Lenox has saved 7,892 lives, according to its website. South Peninsula Hospital has created 30 beds in the hospital to treat pandemic patients while Lenox Hill has 1,600 beds.
New York City alone has had 157,713 confirmed cases compared to 351 for Alaska, with 11,280 confirmed deaths compared to nine for Alaska.
Last month, Patel, returned to Lenox Hill in Manhattan for a three-week contract. A graduate of St. Johns University in New York, Patel moved to Homer in January 2019 after spending 10 years working in New York as an orthopedic PA at Lenox Hill, and before that at Mount Sinai Hospital. Patel works with orthopedic surgeon and specialist Dr. Brent Adcox, and with elective surgery suspended in Alaska, she got leave to work at Lenox Hill.
“I’m so thankful for South Peninsula (Hospital),” she said in a phone interview. “I felt like I needed to come … It was a calling. I had to go.”
Patel arrived in New York on April 13 and will work until May 4. She said her flight from Seattle to New York had five people on it, two of them health care workers. The first night she stayed at a hotel filled with health workers and is now in a 500-square-foot Airbnb apartment a 15-minute walk to Lenox Hill.
“It’s amazing to see all of us working on the same team,” Patel said of health workers at Lenox Hill Hospital. “I’m working with so many people with so many backgrounds. … Everyone’s trying to help and do as much as we can and keep everyone alive.”
Like South Peninsula Hospital, Lenox Hill created more bed capacity and converted former wards for obstetrics or surgery into COVID-19 areas.
“Every team has come together,” Patel said. “If you’re orthopedics or gynecology, it doesn’t matter right now. Everyone is working as one big team.”
Patel has been working with an internal medicine team treating COVID-19 patients who have been stabilized. Patel works three days on in 12-hour daily shifts.
“We basically manage them day to day,” Patel said of her patients. “We try to wean them off oxygen. … We’re trying to slowly get them off oxygen and get them home.”
The good news is that more and more patients are going home. At Lenox Hill, when a patient is taken off a ventilator, staff call a “Code Sun” — for sunshine. Other New York hospitals play The Beatles song, “Here Comes the Sun,” when a patient is discharged, according to a New York Times article.
As the pandemic has worn on, doctors have gained more experience in treating patients.
“They’re starting to stabilize more people,” Patel said. “Before it was out of control. We didn’t know what to do. We didn’t know how to treat this. It’s not the numbers that are slowing down. They’re not. They have a better way of treating.”
Still, COVID-19 can be sneaky. Patel said patients they think are stable can suddenly get worse, with their blood-oxygen levels dropping, called decompensation.
“You think they’re stabilized and you think they’re OK, and the next minute they’re not breathing and decompensating,” she said. “… It’s really hard to know when someone is going south.”
Many patients are elderly and with underlying conditions, but Patel said she’s had patients in their 30s and 40s with no other health issues have to be intubated and put on a ventilator. Because of the risk of infection, patients can’t see family members.
“I can’t imagine being a patient in a room now. You’re alone. If something does happen …,” Patel said. “Family members are so anxious. They want to know ‘When are they going to come home?’”
South Peninsula Hospital gave Patel a stash of N-95 masks to use at Lenox Hill. She said supplies of personal protective equipment (PPE) have improved. When she got there, she had to make a mask last a week, but now they can get new masks daily. Staff also wear disposable plastic gowns. After suiting up, they stay in their gear going from patient to patient. Patel said she’s constantly worrying about her PPE.
“Is my mask working OK? Is it fitting OK?” she said she asks herself. “… It’s this constant awareness you have to have.”
Doctors don’t know yet how COVID-19 victims will recover in the long run.
“I think a lot of people are curious what these patients who are affected with the virus, what it’s going to be like in the next year or two,” Patel said. “The way it affects the lungs is pretty intense. It’s almost like how TB (tuberculosis) affects your lungs. It’s not like a flu that goes away and next year you’re fine. You don’t have permanent damage from the flu.”
After having been in New York so long and then spending a year in Alaska, Patel said it’s been strange to see the city during the pandemic.
“Emotionally this trip has been something to me,” she said. “Just coming back to New York was a lot. … It’s been an emotional roller coaster coming back.”
Except for people at grocery stores and essential businesses, or delivery bike riders, hardly anyone is on the streets, Patel said.
“It’s completely empty,” she said. “… It really feels like the whole city is on lockdown.”
People do get out and enjoy Central Park, though Patel said she feels uncomfortable going there except in the early morning, and even then it makes her nervous.
“Everyone’s really cramped up here,” she said. “It’s not like Homer where you can get outside on the beach.”
In New York, almost everyone wears face masks, from bandanas to homemade masks. New York comes alive every evening at 7 p.m. with the health worker shift change when people come out on balconies and through open windows and bang pots and pans.
“Yesterday (Thursday) I stepped out of the hospital to see it,” Patel said. “It’s amazing. They clap. The fire trucks go by and make some sound and thank all the health care workers. … It’s amazing.”
Familiar stores and shops from living in New York have been shuttered, she said. Some have signs saying they may not reopen.
“They’re just not going to be able to survive from this,” Patel said. “It will be a hard time to recover from it. It’s better they’re home safe, (but) financially it’s hard on people.”
Still, New York will get through the pandemic, Patel said.
“New York is strong,” she said. “This place is very special. It’s sad to see it. I think we’ll get better. … New York is strong. We’ll get through this.”