COVID Upate April 4: Spent the day talking to hospitals at ground 0. Learned about new problems that will emerge everywhere.

And on a program for vulnerable populations rolling out in NY that can be done everywhere.

Amazing stuff. In about an hour. Follow if interested. 1/
3 of the next major hot spots in are NYC, New Orleans & Detroit. I decided to talk to all 3 today— hospitals, Congresspeople, health commissioners. To figure out how to help and to send the early warning signals to everyone else.

It’s like talking to civilians fighting a war.2/
The NY Public hospitals have 3500 beds & are right in the middle of the war zone. I heard from the WH that they had the biggest challenge on vents & vents were sent there.

They in fact told me that vents r not their biggest problem. What he told me are not in the news as much.3/
Number one issue by far is labor: they are desperate for RNs, nurse practitioners & especially respiratory therapists.

So short in fact that they will fly people, put them up at a hotel, and pay them big sums. They also have sufficient PPE for people willing to do it. 3/
I don’t want to list what they would be paid here because shortages drive bidding wars, but I looked up starting salaries & the weekly payments are 6-8x traditional salaries. 4/
If anyone is interested here is an intake form: https://covid.nychealthandhospitals.org/Volunteer 

Or contact @AndrewSchwabDC at @USofCare

So I decided to call the American Nursing Association & the equivalent for Resp Therapists....5/
Andrew at the @USofCare team found them and got them both on the phone within the hour.

Here’s why: in MSP, Denver & other locations, nurses are getting furloughed & laid off as they eliminated elective procedures. 5/
Casual conversations indicate that these folks need money. And some would gladly go to NY.

To their credit, both organizations are putting out a call to find staff. 6/
I suggested that they organize a nurses and therapists brigade to go from place to place.

(I know I’m a great marketer.) 7/
Yes, there are staffing companies. And they are fully engaged in this. But we need greater reserves (and not clear we need to add profits to anyone).8/
The second issue is the lack of social services. I’m going to cover a great new program shortly but this covers everything from food to medications to social work. Every city should get ready. 9/
NY is also having real issues at the Javits Center. There are vents, staff & machines ready to go. But like the hospital ship, the rules are too tight & we have packed hospitals & empty field hospitals. 10/
Yes I let FEMA know although I’m sure they already did. Detroit having similar issues starting up its field hospitals. States start working on this now. 11/
The other issue was new to me and I can’t urge other cities enough to start focusing on this TODAY.

Reengineer rooms to pipe in Oxygen. The amount of oxygen to it takes to keep a COVID-19 patient alive is absolutely startling. 12/
Apparently 8 or more of those massive oxygen cylinders/day to keep someone alive.

I don’t know who the oxygen suppliers are & what kind of engineering is required to create walled oxygen rooms but look into it. 13/
Time out here: one thing I learned leading a major turnaround is until you go all the way through a complete cycle of something you don’t really know where the bottlenecks are. 14/
I wanted to talk to these 3 cities for the simple reason that today’s N-95 and ventilator problem tomorrow will be some other problem.

I wanted to learn what those problems are. 15/
Before I move on I have to mention something that one of the hospital leaders said. He said their no show rate had skyrocketed in COVID wings. I asked if it was because of PPE? No. Illness? No.

The answer...27/
“No one is supposed to see that much death.”

18/
Now I want to tell you about something that could be a game-changer.

The death rate will be disproportionate in low-income, older populations with chronic conditions.

So in New York, a group formed— The New York City Rapid Response Coalition to serve & save at risk people. 19/
They pulled 40 organizations together across NY to serve people & created a process & simple SMS based technology to reach out people to get them services. 20/
Who’s involved: hospitals, Medicaid plans, social service organizations, pharmacies, transportation companies, translators, telemedicine, & technology companies.

I did none of this work, but along with others agreed to serve on the board. The people who did this did it in weeks.
They did it without a penny. They are now approaching foundations now for funding. 21/
And @USofCare built a playbook following each step so this could be replicated in any city in America.

If we keep our seniors, sick & low-income neighbors safe, comfortable and well fed, we will dramatically kick down the death toll. We can do this.22/ https://bit.ly/3aDKYcp 
I’m going to say what I learned today:
-Help the hot spot cities while you can. They will help you.
-Prepare for all the bottlenecks that can come up. There are more than meet the eye.
-Protect the people who need it.
-If we #StayHome we can help the most.23/
A friend sent me this. Any opinions?
I’m guessing many of you may have lost someone close to you in the past few weeks. I did today. One of the first people I ever knew. Not from COVID-19 actually but for the second time in 10 days, it’s a loss without a funeral.

Strangely it makes the loss not seem as real. 24/
Governor @PhilMurphyNJ decided to fly all flags at half-staff until further notice. Look at the flag or whatever fills you wih hope or solace ahead. Phil is going to be on #inthebubble this week as he deals with massive tragedy. You can subscribe./end https://podcasts.apple.com/us/podcast/in-the-bubble-with-andy-slavitt/id1504128553
You can follow @ASlavitt.
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