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The Navy hospital ship USNS Comfort chugged into New York City at 10 a.m. Monday on a mission to help alleviate the surge in patients during the coronavirus outbreak, but after days of being up and running, on Thursday morning officials said in a briefing that just three patients had been admitted to the facility. The Navy said later in the day Thursday that the number of transfers had risen to 20 patients. The aim of the thousand-bed vessel staffed by a 1,200-member crew was to take non-coronavirus-infected patients to allow the city’s hospitals to use their resources to assist those suffering from the virus. So far, it isn’t working. Officials say that a similar Navy hospital ship docked on the other side of the country in Los Angeles has seen a total of 15 patients.
What’s wrong? The process of admitting patients onto the Navy ship hospital in New York is cumbersome, in part, by design. In order to make the facility safe for non-coronavirus-infected patients, each patient must test negative for the virus before being allowed on board for treatment. That means ambulances cannot directly deliver patients to the hospital ship like they would to an emergency room at a normal hospital under normal conditions. Instead, patients first must be taken to an existing hospital for evaluation. Only then, if they test negative for the virus, can they be transported to the ship for treatment. There are a number of other hurdles, according to the New York Times, including 49 other medical conditions that prevent a patient from admission to the Comfort.
The effort to prevent the spread of the virus on the ship is a well-intentioned one, of course, because a single case could knock out its ability to safely serve patients for a protracted period. So it makes sense to be careful—but not to the point of incapacitation. Hospital officials expressed frustration and anger to the New York Times about the ineffectiveness of the ship. The head of New York’s largest hospital system referred to the situation as “a joke.” While other city hospitals are treating people in corridors and hallways, the non-coronavirus ship hospital is lagging, in part, because the entire city is largely sitting around at home, which has led to a dramatic drop in the other types of injuries that might require a trip to the emergency room.
Where does that leave us? The USNS Comfort could be repurposed to treat coronavirus patients, much like how the newly erected, military-operated facility at the Javits Convention Center in Manhattan has been repurposed. New York Gov. Andrew Cuomo asked President Donald Trump to change the mission of the site’s 2,500 hospital beds to treat coronavirus patients, and Trump agreed Thursday night. Navy officials say the Comfort could be refitted to function as a coronavirus unit but needs the go-ahead orders to do so. Misjudging the impact of a good-faith decision can and will happen during this crisis, and isn’t a justification for having not acted at all, but leadership at all levels needs to be nimble and humble enough to course-correct. As health systems teeter, time is of the essence.
The inability of both the Navy hospital ships to jump on the moving treadmill that is the coronavirus response should serve as a reminder that grand gestures, presidential proclamations (and tweets), and easy fixes are not what’s going to make the difference. Beating back the pandemic will be mundane, incremental, and unglamorous—just like the virus.
For more on the impact of the coronavirus, listen to this week’s What Next: TBD.