Nurses and doctors clear the area before defibrillating a patient with COVID-19 who went into cardiac arrest, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y. The emergency room team successfully revived the patient. (AP Photo/John Minchillo)

ER staff saves lives, suffers in hot spot

YONKERS, N.Y. (AP) — A nurse furiously pushes down on a man’s chest as five other staff in full protective gear surround the patient’s bed.

Suddenly, one throws up his arms and steps backward.

“OK, move! Everybody move!” are the instructions.

Moments after they back away, the patient’s heart is shocked, his arm spasms and he shakes on the bed. Soon after, he is placed on a ventilator. He has been saved — for now.

Many more at Saint Joseph’s Medical Center have not.

“It’s been a nightmare. We have a volume of sick people like you can’t believe. In one shift, I pronounced six people dead,” said Dr. Anthony Leno, the hospital’s director of emergency medicine, who on average pronounces one dead in a 10-12 hour shift.

The Yonkers hospital, which sits near the Bronx border and serves one of the poorest sections of Westchester County’s largest city, has been besieged by the new coronavirus. Half of the approximately 280 staff members who were tested for the disease were positive — with another 25 to 30 still awaiting results, according to Dean Civitello, the vice president for human resources.

The Associated Press was granted access to the facility’s emergency room, which at one point earlier in the pandemic had 28 patients waiting to be treated and ambulances lined up outside with more, said Dr. James Neuendorf, Saint Joseph’s medical director.

(WARNING: DISTURBING CONTENT) The ER staff at Saint Joseph’s Medical Center in New York are in the battle of the their lives. COVID-19 has ravaged their community, but day in and day out the staff suits up with one goal _ to save lives.

Staff from other areas of the hospital was redeployed to manage patients and additional treatment areas were set up to augment the hospital’s 194 acute-care beds.

The adjustments meant “we were able to take care of a large number of patients — well over above our numbers that we normally see on a daily basis,” Neuendorf said.

More than 900 have died in Westchester, which had an early outbreak in neighboring New Rochelle in March before Yonkers became a hot spot. At Saint Joseph’s, coronavirus-related symptoms accounted for more than 85% of all admissions for a period of nearly four weeks from March 20 to April 19.

Officials at the hospital knew the pandemic was going to crush them, since COVID-19 has proved particularly punishing for the largely minority population that makes up a significant portion of southwest Yonkers.

One particular challenge is that large families frequently live together in small homes, making it difficult to isolate sick ones. And, Leno noted, there have been few effective therapies other than isolation.

“We’ve had many family members and groups, and we’ve even had people from the same family who have died within days of each other,” Leno said.

The community was hit so hard that a tent was erected outside the hospital on March 19 to accommodate the rush of people seeking to be tested. In the first few days, it was up, 150 to 175 people were examined each day to determine who should be tested, according to Catherine Hopkins, Saint Joseph’s director of school health and community relations.

Nurses and doctors perform CPR on a patient with COVID-19 who went into cardiac arrest Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y. The emergency room team successfully revived the patient. 

Even some in the area who may otherwise be reluctant to seek medical care, fearing the loss of pay or in some cases deportation, showed up after seeing the effects of the coronavirus.

“People are afraid,” Hopkins said. “They’re scared. Their relatives, their friends are dying.”

For most people, the coronavirus causes mild or moderate symptoms that clear up in two to three weeks. But for some, especially older adults and people with existing health problems, it can cause more severe illness and lead to death.

Beyond the unprecedented medical challenges, the outbreak caused financial hardships for the Catholic hospital that has served Yonkers since 1888. Beds and equipment had to be bought or rented to meet Gov. Andrew Cuomo’s mandate for hospitals to increase their capacity, and personal protective equipment had to be purchased at much higher costs than usual as normal suppliers ran out.

“There’s a lot of people gouging out there. A mask that cost 50 cents before are costing $7, $8 each. Gowns that would cost 50 cents as well, are $7 each. Protective shields that were $1.25, people looking for 25 bucks a pop,” said Frank Hagan, Saint Joseph’s chief financial officer. “So, cost is a significant issue.”

As is the morale of the staff, who fear for their own health, are juggling responsibilities when their colleagues are ill and are bombarded — even more than usual — with death and disease.

“It is tiring. It is stressful,” said chief nursing officer Margaret Cusumano, who has been back about three weeks after she had tested positive. “You’re watching people be sick. You’re watching people succumb to the disease. It weighs on you mentally, physically.”

Fewer patients are coming to Saint Joseph’s now. Though there’s still a steady stream of patients wearing masks being wheeled into the ER every day, the staff is optimistic that the worst is over. But there is also the fear that people will rush too quickly back to their lives — potentially triggering another flurry of infections.

“They hear we’re over the plateau and they think, ‘OK, it’s business as usual,’” Hopkins said. “It’s not. It can’t be.”

A nurse pulls a ventilator into an exam room where a patient with COVID-19 went into cardiac arrest Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y. The emergency room team successfully revived the patient
Dr. Anthony Leno, Director of Emergency Medicine St. Joseph’s Hospital, left, and Dr. James Neuendorf, Director of Medicine, right, look into an exam room where a patient with COVID-19 who went into cardiac arrest was revived, Monday, April 20, 2020, in Yonkers,
A nurse operates a ventilator for a patient with COVID-19 who went into cardiac arrest and was revived by staff, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers,
A nurse operates a ventilator for a patient with COVID-19 who went into cardiac arrest and was revived by staff, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y. 
Dr. Anthony Leno, Director of Emergency Medicine, pauses at the end of his shift after his staff revived a patient with COVID-19 who had gone into cardiac arrest, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y. 
John Ohnmacht, Radiology/Cardiology Administrator at St. Joseph’s Hospital, checks his personal protective equipment as he enters a COVID-19 triage and testing tent, Monday, April 20, 2020, in Yonkers, N.Y. (AP Photo/John Minchillo)
Catherine Hopkins, Director of Community Outreach and School Health at St. Joseph’s Hospital, performs a COVID-19 swab on a patient in their testing tent, Monday, April 20, 2020, in Yonkers, N.Y
Catherine Hopkins, Director of Community Outreach and School Health at St. Joseph’s Hospital, right, hands a batch of COVID-19 samples to an assistant in a testing tent, Monday, April 20, 2020, in Yonkers, N.Y.
Catherine Hopkins, Director of Community Outreach and School Health at St. Joseph’s Hospital, stands outside a COVID-19 triage and testing tent, Monday, April 20, 2020, in Yonkers, N.Y
A nurse speaks to resident physician Leslie Bottrell, left, from inside an Intensive Care Unit room to ask for supplies after suctioning the lungs of a COVID-19 patient, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y.
Emergency room doctors and nurses wear personal protective equipment while manning desks due to COVID-19 concerns at St. Joseph’s Hospital, Monday, April 20, 2020, in Yonkers, N.Y.
Emergency medical technicians transport a patient from a nursing home to an emergency room bed, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y.
A patient recently transported from a nursing home is attached to a ventilator in the emergency room, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y.
Emergency medical technicians load a patient into an ambulance as Dr. Anthony Leno, Director of Emergency Medicine, stands outside at the end of his shift, Monday, April 20, 2020, at St. Joseph’s Hospital in Yonkers, N.Y.
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