To handle the rapidly-spreading outbreak, the hospital, which borders Bedford-Stuyvesant, Bushwick and East Williamsburg, had to make major modifications to meet the demands of patients, according to Dr. Edward Fishkin, Woodhull’s chief medical officer.
From staffing and equipment to the number of intensive care beds, Woodhull had to adjust quickly. Normally, Fishkin said, the emergency room would only have three or four patients on ventilators. During the pandemic, up to 25 patients required ventilators.
“To procure the equipment and get new space in a hospital takes months,” he said. “We were able to do magic in days. It was remarkable.”
Because Woodhull is part of the Health+Hospitals system, there was “a lot of sharing going on” between the city’s hospitals, Fishkin said. Woodhull borrowed some materials from the Bronx and Bellevue. Elmhurst Hospital, which became an epicenter of the virus, was also receiving equipment.
Fishkin said there was a conference call every morning to get each hospital what it needed, whether it was personal protective equipment (PPE), ventilators or medication.
There was also a “tremendous burn rate” with the supplies. Normally, for one patient in isolation for tuberculosis or other airborne diseases, the hospital will go through 25 PPEs in one day.
“When you have 200 patients in isolation, you’re talking about thousands of them per day,” he said. “They just weren’t available.”
The lack of PPE, especially early on, resulted in hospitals restricting who gets N-95 masks. Health care workers also had to wear PPE more than one day at a time.
Woodhull Hospital also made “incredible changes” to its facility. Fishkin said they had to quintuple the number of ICU beds. Within four days, the hospital added 40 rooms for ICU patients, recovery rooms, and converted medical and pediatric units into intensive care rooms.
The hospital also needed isolation rooms for staff to put on and take off their PPE constantly.
As for staffing, the Health+Hospitals system contracted with agencies and even the military to provide additional doctors and nurses, Fishkin said.
The International Medical Corps, which goes all over the world into war zones and after famines and floods, walked through the city’s hospitals. According to Fishkin, they had “never seen anything like this.”
Emergency rooms were packed with over 200 patients who had COVID-19, he said. At any given moment, 25 to 30 patients were on ventilators.
“I’ve been in this business for over 30 years,” Fishkin said. “I’ve never seen anything like this.”
During the peak of the outbreak, the Brooklyn hospital’s clinic and operating rooms were empty. But inside the ICU and medical units, there was a “beehive of activity.”
“Patients were desperately ill,” he added. “We were trying everything possible.”
Given the unprecedented nature and scale of the pandemic, Fishkin said he’s never been as proud to be part of a public hospital as he was during this crisis. He praised health care workers who were on the frontlines battling the virus.
“They knew they were going into an environment where they could contract this and die,” he said. “They put patients first and took care of them.”
The situation was “very hard” on nurses and doctors, Fishkin said. The hospital had to put into place a post-traumatic stress disorder (PTSD) team. They also had wellness rooms where staff could take a break from work.
Although the staff did not want to get their kids or families infected, they still came to work everyday, Fishkin said.
“It was very challenging,” he said.
Now that it appears the worst of the outbreak is over, Fishkin said the hospital learned “a phenomenal amount,” especially about the importance of good data and communication. He stressed that the public still had to maintain social distancing, wear face coverings and wash their hands or use hand sanitizer.
Woodhull also added a lot of critical care and medical beds. He noted that they have more non-COVID-19 patients now, but the hospital is still maintaining 30 percent extra capacity for ICU beds.
“We’re watching the prevalence everyday as we get ready to do surgeries and clinic visits again,” Fishkin said.
The hospital also has extra ventilators, and the supply chain has improved. But Fishkin noted that there are still some weak links, such as the reliance on pharmaceutical companies to get medicine. He also said the hospital has to be prepared for the upcoming hurricane season.
Woodhull’s chief medical officer said the community was “fantastic” in supporting the hospital. Community members donated food, groceries and other items that helped the staff during the peak of the crisis.
But Fishkin also sensed a lot of fear and nervousness from the community during the pandemic. One particular barrier was restricting visitation, which made it difficult for families with loved ones who were battling the virus.
The hospital had a team call every family at least once a day. The staff also hosted FaceTime calls with the patient's family members.
Despite the obstacles, Fishkin said he felt all of the public hospitals met the challenge of the pandemic. Patients received really good care within the confines of a new disease, he said.
“It was a tremendously rapid proliferation of patients that stressed all the systems to the max,” he said. “In the context of the tools and knowledge and resources we had, we did a very good job.”
Woodhull has changed some procedures in light of COVID-19. Everyone gets their temperatures checked in the hospital, Fishkin said. Any patient who undergoes surgery will also have a COVID-19 test.
The hospital is also doing more telehealth visits, which has been well received.
“I think this will change the practice of medicine in a better way,” Fishkin said.
Another silver lining is that the outbreak shed light on the value of having a primary care physician.
Fishkin noted that for generations now, people have been using urgent care centers and emergency rooms. Those patients don’t get the screening and prevention they would normally get with a primary care doctor.
“People really see the value now of having a relationship with a primary care doctor who can address all their needs,” he said.