Good morning. Today's Vitals is a deep-dive on health care workers and the coronavirus.
It's also a record length: 2,010 words, or an 8-minute read.
Photo Illustration: Sarah Grillo/Axios. Photos: Angela Weiss/AFP via Getty Images, Bruce Bennett/Getty Images, and Europa Press News/Europa Press via Getty Images
Health care workers are at an especially high risk of catching the coronavirus, because of their prolonged exposure to patients who have it. Making matters worse, the U.S. doesn't have enough of the protective equipment, like masks and gloves, that keeps them safe.
And yet these workers, with loved ones of their own, keep showing up at hospitals across the country, knowing that more Americans than they can possibly care for are depending on them.
Between the lines: The coronavirus is expected to create a demand for hospital care that far exceeds what the system was built to handle.
Two nurses in New York City died earlier this month, the New York Times reported last week, and health care workers said they were afraid more would follow.
Shortages of masks, gloves, face shields and other protective equipment have led providers to reuse supplies and improvise with makeshift alternatives.
Beyond their own health, workers have to worry about spreading a highly contagious disease to their loved ones.
The bottom line: "Each morning, on the way to work, I wonder if I'll be healthy enough to return tomorrow," Dhruv Khullar, a doctor in New York City, writes in the New Yorker.
Paramedics transport a patient wearing a face mask to the emergency room entrance of the Wyckoff Heights Medical Center in Brooklyn, New York, on April 2. Photo: Angela Weiss/AFP via Getty Images
The looming shortage of ventilators doesn't just impact the coronavirus patients who will need one to breathe. It also creates harrowing decisions for the health care workers who may have to decide which patients get them and which ones don't.
Between the lines: Today's doctors generally have no comparable experience to draw on for making these kinds of decisions, although accredited hospitals are supposed to have some mechanism for doing so, per NPR.
By the numbers: When the coronavirus is at its peak around the middle of the month, U.S. hospitals will be about 25,000 ventilators short of expected demand, according to one estimate, the Wall Street Journal reports.
The bottom line: If the numbers bear out, health care workers will still likely have to make horrible decisions about who receives a ventilator and who doesn't — decisions that mean life or death for patients.
Case in point: NYU Langone Health told emergency room doctors last month that they have "sole discretion" to place patients on ventilators, and that the hospital supports withholding "futile intubations," WSJ writes.
What to watch: New York City could run out of ventilators by Tuesday or Wednesday, Mayor Bill de Blasio said yesterday, per WSJ.
U.S. Surgeon General Jerome Adams said on "Fox News Sunday" that the next week will be "the hardest and the saddest week of most Americans' lives" — calling it our "our Pearl Harbor moment, our 9/11 moment" — as the projected death toll from the coronavirus pandemic surges.
Vice President Mike Pence told a news briefing Sunday hydroxychloroquine will be used in a 3,000-person study at Henry Ford Hospital in Detroit to test the effectiveness of the anti-malarial drug in treating novel coronavirus patients.
The White House coronavirus task force had its biggest fight yet on Saturday, pitting economic adviser Peter Navarro against infectious disease expert Anthony Fauci, Axios' Jonathan Swan scoops. At issue: How enthusiastically should the White House tout the prospects of an antimalarial drug to fight COVID-19?
New York Gov. Andrew Cuomo said in a press conference on Sunday that New York is struggling to maintain medical supplies while combating the novel coronavirus — operating "literally" on a "day-to-day" basis.
Louisiana Gov. John Bel Edwards said on CNN's "State of the Union" Sunday that coronavirus modeling projects his state will run out of ventilators on April 9 and hospital beds on April 11.
Companies are scrambling to reorganize operations and add protections for employees after a surge of public protests by workers who are fearful of contracting the coronavirus on the job, Axios' Joann Muller reports.
The federal government will cover the costs of coronavirus treatment for the uninsured, Health and Human Services Secretary Alex Azar said at a White House briefing Friday.
U.K. Prime Minister Boris Johnson has been admitted to the hospital for tests as a "precautionary step" as his coronavirus symptoms have continued to persist 10 days after testing positive, according to a Downing Street spokesperson.
In a rare televised address on Sunday, Queen Elizabeth II urged the U.K. to respond to the coronavirus pandemic with the "self-discipline" and "resolve" that have defined the British people in moments of crisis.
Irish Prime Minister Leo Varadkar has rejoined Ireland's medical registry to work one shift a week for the Health Service Executive, which is responsible for providing health and personal social services to everyone living in the country, the Irish Times reports.
Pope Francis called on listeners in his Palm Sunday sermon — on the first day of Holy Week — to "reach out to those who are suffering and those most in need" during the coronavirus pandemic, Reuters reports.
Illustration: Aïda Amer/Axios
The health care system cut 42,500 jobs in March as the coronavirus epidemic forced providers to delay an array of non-urgent procedures and doctor visits, according to new data from the Bureau of Labor Statistics.
The big picture: Almost all of the lost jobs came in medical offices and other outpatient settings, but many people who are fighting the coronavirus in hospitals are seeing cutbacks, too, Axios' Bob Herman reports.
Driving the news: 96% of the axed health care jobs in March are on the outpatient side. Those are places like dentists' offices, physicians' clinics, speech therapy and vision centers. Hospitals did not net any job losses, according to BLS.
Yes, but: Hospital workers, including clinicians who could be treating coronavirus patients, have not been immune to furloughs and layoffs.
Go deeper: Health care's hiring boom may not help the coronavirus outbreak, since most new jobs are administrative.
In response to the overwhelming demand for coronavirus care, the medical workforce has rapidly swelled and morphed to expand its critical care capacity as much as possible.
Details: Retired providers have jumped back into the workforce, medical students are preparing to help, and providers whose specialties are on pause are shifting into roles that are drastically different from those they're used to.
Yes, but: This redeployment isn't always voluntary, the New York Times reports.
What they're saying: The care of some coronavirus patients at NewYork-Presbyterian "was being provided by a redeployed cardiac anesthesiologist and a redeployed cardiac surgeon, both close colleagues of mine," wrote Craig Smith,
chair of Columbia's Department of Surgery, in his daily update on Saturday.
A home care worker drives to her client in March. Photo: Lane Turner/Boston Globe via Getty Images
The coronavirus has made life even more difficult for the 5 million aides and workers who care for the frail populations living at home and in nursing homes, Bob reports.
Why it matters: These low-paid workers face the conundrum of seeing patients and increasing risk of exposure and spread, or staying away at the expense of their income and patients who rely on that care.
By the numbers: Home health workers, nursing home assistants and other therapists and orderlies hover around poverty and are predominantly women and people of color, according to PHI, a research group that studies this group of care workers.
The big picture: It is almost impossible for workers to bathe, feed and otherwise care for their patients while social distancing, and a reliable source of masks or other protective gear for them is not guaranteed.
The bottom line: "There's no doubt that we're being sort of forgotten in all this, and I fear that mentality is going to eventually come back and punish us," Joe Russell, executive director of the Ohio Council for Home Care and Hospice, told the Washington Post.
State and local governments are working to help medical workers and emergency responders fighting against the coronavirus outbreak who no longer have child care and day care centers for their children, AP reports.
By the numbers: 4.6 million health care workers are parents of children under the age of 14, according to the Center for American Progress.
Some state governors have allowed some child care centers to stay open for essential workers like employees in health care, Axios' Marisa Fernandez writes.
Other institutions and fellow nurses and doctors have created networks to take care of their colleagues' children in states with no other options.
Photo: Bill Tompkins/Getty Images
So many of you shared your personal stories about the health care workers you know, and I enjoyed reading every one of them. Thank you again. I wish I had room to share them all.
A small sampling:
To all the health care workers out there — thank you. We couldn't do this without you.