New York City's hospitals were not sufficiently prepared to respond to COVID-19, with inadequate access to supplies, confusing guidance and poor coordination all hindering the local response, city Comptroller Scott Stringer wrote in a report to Gov. Andrew Cuomo.
Stringer's probe focused on the public NYC Health + Hospitals system but found issues with the federal and state response to COVID-19 as well as the broader private hospital system.
The report is one of the first by local officials seeking to explain why the city and the state were so adversely affected by COVID-19. The city had confirmed 18,754 deaths from the disease as of Thursday, and the toll expands to more than 23,000 when including deaths that are presumed to be from COVID-19 but lack a positive lab test.
Stringer's report documented the ways in which the city and the state have sought to prepare for a pandemic throughout the past 20 years and ultimately found those efforts fell short.
"This review found that H+H, and the larger system within which it has operated during the pandemic, faced an unprecedented situation for which no one was fully prepared," Stringer wrote. "The lack of preparedness forced all players to improvise responses, sometimes successfully, sometimes not—but inevitably at a cost in human lives."
He said COVID-19 exposed inequality in the health care system, and Health + Hospitals is responsible for providing a disproportionate amount of care to lower-income communities of color. Furthermore, there have been a series of 16 hospital closures since 2000 that left the city with 20,000 fewer beds.
As a result, it was unable to obtain adequate supplies, including ventilators, ahead of the outbreak's onset, and some of its facilities, including Elmhurst hospital, were overwhelmed with patients before it developed a process to transfer patients and supplies among its 11 public hospitals more efficiently.
Stringer recommended that the state and the city work on identifying key roles to coordinate emergency response across the local hospital system, including public and private hospitals. That would include formalizing procedures for transferring patients among city hospitals and making them permanent. It should also prepare staff to be cross-trained for different responsibilities during an emergency so they can support the intensive-care unit.
"We owe it to all those impacted by H+H's struggle to address this crisis—especially its frontline healthcare workers and patients—to ensure that the city's public health care system is as well prepared as humanly possible for a possible resurgence of Covid-19 patients as well as the next health crisis," Stringer wrote.
COVID-19 is now more well controlled in New York City. There were 367 new cases identified Thursday, which represented a positive testing rate of just 1%. That compares to thousands of new cases each day and a positive testing rate in the double-digits when Covid-19 was peaking in New York in mid-April.
But there are foreboding signs around the country, with more than 71,000 cases identified July 16, compared with around 23,000 a month ago, according to the Covid Tracking Project. Hospitalizations and deaths are also trending upward.
"Viruses respond to science and data—not political opinion. We know the prescription: masks, social distancing and hand washing," Cuomo said in a statement Friday. "That's how we bent the curve in New York, and that's how we've kept our numbers so low as we see frightening spikes in the rest of the country."