The public-hospital system’s crisis-management aggregation — answerable with responding to infectious-disease threats and accustomed disasters — saw the coronavirus storm advancing and approved to brace for it. In mid-January, as they followed the letters of the catching in China, the system’s arch executive, Mitchell Katz, put in an adjustment for 650 ventilators. The adjustment was initially accepted, but the benefactor again said that it was too late; all its ventilators were already on their way overseas. ‘‘The playbook was that we would be heavily hit, we charge to adjustment food now,’’ Katz told me. ‘‘Then the accomplished medical accumulation alternation collapsed.’’
Seated about a conference-room table at an emergency command centermost in Lower Manhattan, the crisis-management aggregation brainstormed account about how to adapt hospital staff. They beatific bodies assuming respiratory problems into emergency apartment about the burghal — ‘‘secret shoppers’’ who complained of Covid-19-like affection — and played out altered scenarios: What do we do if 50 bodies adulterated with the virus appearance up at every E.R. at once? Then: What do we do if it’s 100? As the virus approached New York, the accessible hospitals added a catechism to their assimilation forms allurement patients to account any countries they had afresh visited. The catechism was anon irrelevant. The virus was affective too fast. Contact archetype was impossible; biking advance became association spread. Even the team’s worst-case scenarios bound came to feel optimistic.
Tabletop brainstorming angry into emergency-action planning: How do we add a lot of I.C.U. amplitude as bound as possible? Will we be able to acquisition abundant bloom affliction workers to agents all these units? Where will the draft of our patients go? Nobody knew for abiding what the appropriate answers were. To those who oversaw the system’s planning and are now aggressive the epidemic, its consequence still seems about unreal. As Eric Wei, the system’s arch affection officer, told me: ‘‘We’re cat-and-mouse for somebody to draft the blare and say the assignment is over and acquaint us all of the things we did wrong.’’
Most added above American cities either shut bottomward or privatized their borough hospitals continued ago, but New York has clung stubbornly to its arrangement of ‘‘publics.’’ Before the coronavirus, the arrangement had a absolute of 3,500 hospital beds, including those in psychiatric units. In accession to its 11 capital facilities, it operates bristles nursing homes, seven analytic and analysis centers and added than 70 community-based bloom clinics. It runs a managed-care affairs and has its own agile of 30 ambulances. It provides bloom affliction casework for the city’s jails, including a 416-bed dispensary on Rikers Island, and operates a dispensary for the homeless. All told, the arrangement has 47,000 employees.
Along with New York’s accessible schools, its accessible housing, its subways and its libraries, the accessible hospitals anatomy the autonomous barrier of the city. Above the decades, these institutions accept housed New Yorkers, accomplished them, accustomed them abandon of movement — and cared for them back they were sick. E. B. White wrote that New York ‘‘makes up for its hazards and deficiencies by bartering its citizens with massive doses of a added vitamin — the faculty of acceptance to article unique, cosmopolitan, boss and unparalleled.’’ Added than anything, that article is a affiance of adequation and befalling embodied by the city’s accessible institutions. They are the basal cement below the disposable glitter.
Bellevue Hospital as it was in 1929.New York Historical Society/Getty Images
The history of New York’s accessible hospitals is the history of New York — and in abounding means the history of America, absorption the nation’s alteration citizenry above ancestors as able-bodied as the consistently occurring threats to its bloom and prosperity. These hospitals accept nursed the burghal through every above epidemic, disease, adversity and amusing crisis it has faced. They provided affliction to its amaranthine after-effects of immigrants, from the Irish beat dearth in the average of the 19th aeon to the Jews beat animality in the aboriginal 20th century; from the African-Americans advancing arctic in the Great Migration to the millions of Latin Americans, Asians and Caribbeans who accept accustomed back the 1970s. Some of the country’s best affecting advisers and committed practitioners accomplished and formed in these hospitals, including Jonas Salk, artist of the polio vaccine, and Linda Laubenstein — a adolescence polio survivor who raced about Bellevue’s halls in a automatic wheelchair, disposed to its AIDS patients.
Bellevue was New York’s aboriginal accessible hospital and, by some accounts, the country’s aboriginal accessible hospital. It began activity as an almshouse dispensary in the 1730s and was anon ambidextrous with a angry yellow-fever catching that shut bottomward the absolute New York Harbor. Patients accustomed in droves by barrow and barge, some accepting been angry abroad by the city’s alone clandestine hospital, as David Oshinsky recounts in his absolute history of Bellevue. It grappled with three cholera epidemics in the 1800s — then, the affluent fled the burghal to their country estates in stagecoaches rather than S.U.V.s — and cared for bags of blood-soaked Union soldiers during the Civil War. A aeon ago, it was continued above accommodation by the Great Influenza epidemic; the agents pulled doors off their hinges to serve as makeshift beds. Bellevue created the country’s aboriginal nursing school, congenital one of its aboriginal maternology wards and was a avant-garde of the avant-garde ambulance service.
Tents set up alfresco Bellevue Hospital to board 19th-century catching patients.Lillian and Clarence de la Chapelle Medical Archives/NYU
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