Covirus 19 coronavirus: the New Zealand doctor in New York City is witnessing a “full-blown catastrophe”

A kiwi doctor in New York says the particular way in which the coronavirus has swept the city offers lessons for New Zealand.

Avinash Sharma works in surgical oncology at the world-leading Memorial Sloan Kettering Cancer Center in Manhattan hospital dedicated to the treatment and study of cancer.

In an investigation period when Covid-19 began to take off, the 38-year-old man was confined to his apartment, reading about the crisis, reviewing the latest data, and listening to friends on the front lines of other hospitals.

A timeline in his pandemic journal points to just over 1,000 cases in the United States on March 11, when President Trump closed the borders to Europe. A week later there were 7,000 confirmed cases. There are now more than 640,000, a third of which are in New York City.

“It was pretty scary,” the 38-year-old told the Weekend Herald. “From something looming in the distance and really bad in Italy, to suddenly a full-blown catastrophe.

“In the last two or three weeks it has been really desperate in terms of the number of cases that have flooded the system: hospitalizations, ICUs have been operating at three or four times capacity, health workers are doing long shifts and they themselves have gotten sick. “

“I have heard of health workers in their 20s and 30s being intubated and, in some cases, also killed by Covid. It has been very common.”

Sharma has a master’s degree in public health from Oxford University and spent time in a teaching hospital in Nigeria as part of a research fellowship. That sometimes involved torchlight surgery, due to power outages that could last for days. A nurse would press a manual resuscitator.

Now there is a similar approach in New York. Operating rooms in some hospitals have makeshift beds in the ICU, staff reuse protective masks, a US Navy hospital ship. USA It is docked off the coast and a convention center at Hell’s Kitchen quickly became a hospital.

“There is a hospital facility in Central Park right now. You would never, never dream of that happening,” Sharma said. “Unless your N95 mask is visibly dirty, you are still wearing it on shift, because even until the last few days there has been a feeling of ‘When is this going to end?'”

Memorial Sloan Kettering Cancer Center has multiple floors and patient bed spaces that also have Covid-19, and, like other hospitals in the city, is using an incident command system similar to the one created after the terrorist attacks of September 11. Non-urgent electives have been canceled to free up capacity and take PPE and equipment where needed.

• Covid19.govt.nz – The official government Covid-19 advisory website

Sharma, who is advised at the hospital by former New Zealand agent Sir Murray Brennan, currently works remotely from his apartment on the Upper East Side, leaving alone to obtain essential supplies. On the day of our interview, New York Governor Andrew Cuomo announced that all residents would have to wear a mask or mask in public. The death toll is close to 15,000 and an order to stay home has been extended until next month.

“It is quite strange,” Sharma said. “There are very, very few people on the streets, and if someone goes out, most people have masks, it’s almost surreal compared to what life is normally like.”

Sharma’s wife returned to Auckland to work in March, and he spends his days calling her and another family, working and monitoring news and research on the virus. Those living in the poorest areas are clearly suffering the worst, he said.

“If you look at New York in all five boroughs, the highest case rates are in places like Queens where people have the lowest household incomes. There’s no question about that: if you take a district like East Elmhurst, its rate has finished 100 times the city average, “said Sharma, whose cutting-edge research has looked at why some groups have higher rates of cancer.

“These areas are poorer, with lower socioeconomic status, and there is certainly more overcrowding in homes, with more underlying diseases. While the virus affects young and old, healthy and sick, they are the patients in these areas the ones that are making the most cases. “

That should act as a warning to New Zealand authorities, he said, as the country anticipates a possible reduction in restrictions.

“If things open, you have to be very careful when looking at them [socio-economically deprived] areas, and keep a very close watch on cases. There has to be really strict isolation for the identified cases.

“We need to make sure we have adequate resources so that we can deal with an increase in cases later on as we get closer to winter.”

Throughout the world, life will not be the same until a vaccine arrives. In New Zealand, any return to level 3 will expand some people’s “bubbles” and allow for takeout. In California, leaders have suggested disposable restaurant menus, temperature tests to enter buildings, and staggered start times for school students.

There are glimpses of hope in New York City: Hospitalization rates have declined, though whether that represents a rounded peak or plateau is uncertain.

“Probably the best way to describe it is very, very cautious optimism,” Sharma said. “But ICUs still have three to four times the capacity. People are still tired and cautious, and it’s really difficult even now.

“Fingers crossed, for the rest of the month we can see a little light at the end of the tunnel.”

Sharma is making plans to return home permanently and will gladly accept the state-imposed quarantine.

“I am very happy to endure my two weeks. Because I would not be able to live with myself if I detected an asymptomatic infection while traveling and passed it on to someone.”