Lessons from New York, an Epicenter of Corona Virus Pandemic – Take Immediate Measures for a potential rapid surge in infection

Description: Takahiro Yanagisawa Professor, Mount Sinai Medical University
Robert Yanagisawa, Professor, Icahn School of Medicine at Mount Sinai

Apr 03, 2020

 Robert Yanagisawa, President of the Japanese Medical Society of America (JMSA) who sees patients in New York, the world’s largest epidemic with COVID 19 infections, is a professor at Icahn School of Medicine at Mount Sinai. In an interview, he spoke of the current situation, and called for Japan’s urgent response. The questions and answers are as follows.

What is the medical response against COVID 19 in Mount Sinai Health System?
Our health system is comprised of eight hospitals with a total of 3000 beds, over 1700 patients are infected by COVID 19, and over 300 patients are in the intensive care units (ICU). The number of new COVID 19 patients on March 27 was 1,000, but it has increased 1.5 times in just three days. We have more than doubled hospital internal medicine teams taking care of these patients, working on 12-hour shifts.  As the number of patients is expected to continue to increase in the future, dedicated units have been increased throughout the hospital.
―Is medical equipment sufficient? Is the medical system at it’s limit?

Description: Physicians at Mount Sinai Medical University Hospital in New York treating acutely ill patients infected with the new coronavirus (courtesy of Mount Sinai Health System)
Physicians at Mount Sinai Health System in New York treating acutely ill patients infected with the new coronavirus (courtesy of Mount Sinai Health System)

 The ventilator is highly in demand, but 400 new units have been procured. Protective equipment such as masks and gowns are sufficient at present and all measures are in place to protect our healthcare workers. If the number of critically ill patients continue to increases rapidly, there is a risk of disrupting adequate medical care.  Only patients with moderate to severe cases with low oxygen saturation levels are hospitalized. All elective surgeries and procedures have been postponed to free up ICU beds.
– When do you expect to see the peak of infection?
Our prediction model suggests that the infection peaks in the coming weeks. Recently, the surge curve of the new COVID positive patients requiring hospital admission is less steep than when it started. Effective vaccine will not be available for long time and rate of infection has not hit it’s peak yet. Several clinical trials are under way in our medical university. Recently infected individuals have high titers of antibodies against the new corona virus, and trials have begun to extract and administer them to critically ill patients. Hopefully such therapeutic trials would offer a breakthrough.
-Japan is also concerned about infection resurge. What recommendations do you have as a healthcare professional in New York?
 New York was virtually unaffected until a month ago. CIVUD 19 is highly infectious and the situation changes dramatically. Large cities such as Tokyo have such an element. Precautionary measures must begin early. First of all, it is important to stay home and stop the spread. Also important, a crisis management plan for the spread of infection. It is necessary to have a realistic plan on how to increase the number of beds, and to secure personnel that can help manage medical facilities. It is imperative that a system be developed as soon as possible, such as reallocating medical personnel across country to the areas with high demand, reinstatement of medical staff who have recently retired or those who have left work after maternity leave.