The Jackson Memorial Hospital emergency department, wedged between Little Havana and Miami’s vibrant Wynwood murals, has been teeming with Covid-19 patients for weeks.
Patients wait for beds in the hallways and in the classroom. Some need oxygen within minutes of arrival, while others are sent home to rest in bed and be quarantined. The beds in the intensive care unit, whose number has already expanded, are “snatched away” minutes after they become available. Not a single one of the 164 in the hospital is free.
“The past three weeks have been some of the busiest changes in my entire life,” said Dr. Mark Supino of the Jackson Memorial Hospital emergency department. “We have seen some of the sickest patients we have seen.”
The fact that Florida does not contain coronavirus cases has set the state in competition with New York’s peak for the high volume of infections. This spring, New York accounted for a quarter of the nation’s Covid-19 cases.
New York state has recorded 405,000 cases, while the Florida outbreak has 379,000 so far, according to a Johns Hopkins University tracker. But while New York’s latest daily number of cases showed an increase of 811, Florida’s total number of cases increased more than 10,000 in a single day. According to the Kaiser Family Foundation, more than 18% of Florida’s Covid-19 tests are testing positive, indicating that community transmission is “widespread and on the rise.”
But unlike the New York spring outbreak, which met with some of the strictest shelter-in-place orders in the country, Florida is open for business.
“We are not going to restrict business,” Republican Governor Ron DeSantis said Thursday at a press conference where he also said the outbreak in South Florida had “stabilized.”
DeSantis denied that companies, such as restaurants and bars, were contributing to the spread of Covid-19. However, scientific papers linked air-conditioned covered food to Covid-19 cases as early as January in Guangzhou, China, and US health officials describe the current opening of restaurants in Florida as a scenario of “even more risk”.
Nationally, Emergency department cases crashed in March, April, and even May, when most states imposed blockades. But the American College of Emergency Physicians said they are now returning to traditional levels.
That means car accidents, broken bones, heart attacks, strokes, and all the weird and existential personal crises that a normal urban emergency room now sees are crowned by a wave of Covid-19 patients in Miami. Despite the outbreak, Florida has remained open, turning each of Supino’s turns into a “massive casualty incident.”
“It is not uncommon for several ambulances to return again and again,” Supino said. “It is like swimming towards the shore and not seeing the shore.” The “puzzling” unknown: when will it end? – He’s using thin doctors and nurses, he said.
One day this week, entire counties in Florida, many of them rural. Lacked intensive care unit beds. Putnam County does not have open slots in its 11-bed ICU. All eight ICU beds in Okeechobee were full. Similarly, none of the three critical care hospitals in Hernando County have beds available in intensive care units. Neither do the two critical care hospitals in Monroe County, in the Florida Keys.
“The Covid unit was a very difficult unit to work with,” said Barbara Murray, a 40-year-old nurse who spent the last years of her career at a hospital in St. Petersburg, who also running out of beds in the ICU, according to state data.
To limit the spread, the hospital restricted who can enter the floor caring for patients with Covid-19, Murray said. Nurses have taken on the duties of cafeteria workers, who deliver meals, and laboratory workers, who draw blood, to reduce the number of people exposed to Covid-19 patients.
Murray was recently fired for “insubordination” after she expressed concern over the large patient burden. She is seeking an appeal with her union, National Nurses United.
Florida’s high infection rate has also been recognized by pharmaceutical companies, which are now locating studies of experimental Covid-19 treatments there.
Miami’s Westchester Hospital was the first place to announce it would try ifenprodil, an experimental drug from Algernon, because Florida “recently had a significant number of confirmed cases of Covid-19,” said its executive director, Christopher Moreau, in a statement from press.
In reaction to this increase, the Federal Emergency Management Agency (Fema) announced that it would send 1,500 nurses to Florida. Jackson Memorial in Miami was one of the hospitals that received them, as well as some facilities in Tampa.
Meanwhile, the Covid-19 outbreak has also infiltrated many state nursing homes. Over the course of a month, infections among nursing home residents have tripled to nearly 5,000 residents, according to state data.
“When it comes to nursing homes and assisted living facilities, it’s about many vulnerable people,” said Dr. Joseph Ouslander, professor of integrated medicine at Florida Atlantic University and past president of the American Geriatrics Society. “It is a tinderbox: one person can set the place on fire and kill many people.”
Covid-19 has killed more than 140,000 people in the United States, including 5,300 in Florida. While the death toll in New York State, over 27,000 people, is likely to be the worst case scenario, this state has flattened the death rate, where Florida has increased by 100 per day in the past week.
“When we meet someone who died, that’s a look in the rearview mirror of about five weeks,” said Jason Salemi, an associate professor of epidemiology at the University of South Florida University of Public Health in Tampa who has tried to push . The status to improve data collection. “It is not current enough to help us much.
“Furthermore, the deaths are just the tip of the iceberg in terms of the negative results that could occur,” Salemi said. They do not capture people suffering from the recently recognized long-tail effects of Covid-19. “People who had Covid-19 two or three months ago still experience many adverse signs and symptoms, such as shortness of breath and fatigue.”
At the same time, the restrictions on social activities in Florida are tame compared to the northeastern states. There is no state mandate to wear masks in public. In at least one affected county, people can still eat indoors at bars. The dining rooms of the air-conditioned restaurants are open, albeit at half capacity. Gyms, museums, and retail stores are open. By comparison, indoor gyms, museums, and restaurants are still closed in New York City, despite their much firmer grip on the outbreak there.
“The absolute social irresponsibility of people … is causing the problem,” said Ouslander. “You have to look people in the eye and say: ‘It’s true: we understand that the mask is uncomfortable, social distancing is difficult, we understand it and we understand that you have a very low risk of getting sick, but you could infect other people and kill them. “
Not everyone agrees that people are being irresponsible. Ouslander also believes that Florida officials made a “reasonable effort” to keep people safe. And nurse Martin Peebles, who works at Largo Medical Center, said she believes people in her neighborhood are making an effort to be careful and wear masks.
Even as Supino and his colleagues struggle day by day, trying to support each other, he identifies with Floridians.
“This is difficult for everyone,” Supinon said. “I don’t want to overlook the economic impact … Even if they are not getting sick, the fact that this virus takes their lives is sad.”
But there is evidence, despite Governor DeSantis’ best efforts, that reopening as the virus increases will not improve the economy. On Thursday, Florida posted the largest one-week increase in unemployment claims nationwide, with more than 65,000 applying for unemployment benefits.
“I definitely understand this desire that people have to go ahead and reopen,” he said, “but it is very difficult to have a healthy economy when people are sick.”
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