Will hospital ships help the US reduce epidemic hotspots?

Same as no?

According to the New York Times, as of April 2 (local time), the large white ship that officials had promised would bring help in times of trouble and hardship to a city teetering on the brink of collapse, remained silent, almost empty.

Local hospital leaders were furious when they learned that the ship's 1,000 beds were mostly unused, and that the 1,200 crew members were largely idle and had nothing to do.

According to officials, only three patients have been transferred to the hospital ship, even as hospitals in New York are struggling to find space for thousands of people testing positive for the new strain of Corona virus (Covid-19).

Similarly, on another US Navy hospital ship, the USNS Mercy, currently docked in Los Angeles, there are only 15 patients.

US President Donald Trump speaks at the farewell ceremony for the Comfort ship in Virginia on March 28. Photo: Getty

Contrary to the initial grandeur and expectations, the reality that is happening on America's "super ships" has left many experts in the medical field disappointed.

“If I’m being blunt, I think it’s a joke,” said Michael Dowling, head of Northwell Health, New York’s largest hospital system. “People can say, ‘Thank you for creating these wonderful places and opening up these cavernous halls.’ But we’re in a crisis here, we’re in a war zone.”

The ship, aptly named Comfort, was initially sent to New York to relieve the pressure on hospitals in the city while treating patients with diseases other than Covid-19.

Last week, President Donald Trump abruptly ended his nine-day self-quarantine at the White House to travel to Norfolk, Virginia, to personally see the ship off to New York, declaring that it would play a “vital role.”

So when the ship docked on March 30, it was greeted as one of the few bright moments amid a city shrouded in a pandemic gloom.

But life is not like a dream, the reality is quite different. A mess of military procedures and bureaucratic obstacles prevented the Comfort from accepting many patients.

In addition to strict rules that prevent people with the virus from coming on board, the Navy is also refusing to treat many other cases. Guidelines distributed to hospitals include a list of 49 medical conditions that would disqualify patients from being admitted to the ship.

Not only that, ambulances cannot directly transport patients to the Comfort hospital ship; they must first take patients to a hospital in the city, undergo a time-consuming assessment process — including virus testing — and then transport them again to the ship.

Beth Israel Hospital, Manhattan set up tents outside the building to treat Covid-19 patients. Photo: Reuters

"Some people can't finish eating, others can't find anything"

The delays and red tape have frustrated hospital leaders. Dowling said he has had to tear his hospitals apart, requisitioning any unused space, including lobbies and conference rooms, to turn into patient rooms.

His facilities are now treating 2,800 Covid-19 patients, up from 100 on March 20, with 25% of them in critical condition in intensive care units.

Hospitals across New York are overwhelmed. Patients are dying in hallways, unable to wait for one of the few ventilators available. Doctors and nurses are wearing the same protective gear over and over again, and are starting to get sick themselves. The death toll is so high that the city is running low on body bags.

Meanwhile, the number of non-coronavirus patients has not been as high. Because most New Yorkers have been self-isolating at home, fewer fatalities from car accidents, shootings, and workplace accidents have required emergency room visits than before.

Therefore, Mr. Dowling and many others believe that if the Comfort refuses to accept Covid-19 patients, very few patients will be transferred there. And given the serious spread of the disease in New York City, where as of April 2, nearly 50,000 positive cases have been recorded, it is useless to distinguish patients who have or do not have the virus.

The solution proposed by Dowling and others was to open the Comfort to Covid-19 patients. “It’s ridiculous,” he said. “If you’re not coming to help us take care of the people we need, then what’s the point of coming here?”

Medical staff transfer the body of a Covid-19 patient to a refrigerated truck in New York. Photo: AFP

In response to questions from reporters, citing Mr. Dowling’s criticism, the US Department of Defense reiterated President Trump’s statements about the Comfort ship during his daily press briefing. The White House boss only said that the ship did not accept patients infected with the Corona virus.

On the evening of April 2, New York Governor Andrew M. Cuomo reached an agreement with Mr. Trump to move Covid-19 patients to the Javits Convention Center, another field site operated by the US military, with a capacity of 2,500 beds.

“This morning, I asked President Trump to consider the request and the urgency of the matter, and the President has just informed me that he agrees with New York’s request,” Cuomo said in a statement. However, there was no mention of a similar move for the USNS Comfort.

Challenges with "super ship"

Captain Patrick Amersbach, the Comfort’s medical officer in command, said at a press conference that he was currently under orders to only accept patients who tested negative for the coronavirus. He added that if he received orders to accept Covid-19 patients, the ship could be repositioned to meet mission requirements.

Getting the hospital ship ready for use in a pandemic was challenging from the start. The Comfort was designed to operate in combat conditions, and its doctors were used to treating young, healthy service members wounded by gunshots and bombs.

Meanwhile, most of those hospitalized with Covid-19 are older and carry a new pathogen that even the world's leading medical researchers still don't fully understand.

The US Navy hospital ship Comfort docked at Pier 90 in Manhattan earlier this week. Photo: NYT

There is no denying that any outbreak on board could spread rapidly and render the ship inoperable. As a precaution, the ship’s crew was placed in self-quarantine for two weeks before departing for New York. They will remain on deck for the duration of their mission to the city.

In the past, the “supership” has struggled to fulfill its civilian missions. In 2017, after Hurricane Maria devastated Puerto Rico, the Comfort was sent to relieve the hospital load, but ended up treating only a few patients a day.

A military doctor who served on US Navy hospital ships said that the conditions on deck were suitable only for soldiers, and the cramped bunk beds, not modern hospital beds, were not ideal for treating civilians.

But he also added that although military medics are familiar with battlefield conditions, they are, after all, well-trained, and must be able to handle stressful situations during a pandemic if ordered to treat Covid-19 patients: “As military doctors, they will certainly do their best”./.