Coronavirus: Eighty per cent of New York ventilator patients die

Reports from emergency rooms in New York have caused some doctors to speculate that ventilators may be making things worse.

A ventilator and other hospital equipment is seen in an emergency field hospital to aid in the COVID-19 pandemic in New York’s Central Park on March 30.

Eight in ten coronavirus patients placed on ventilators in New York City have died, according to officials.

New York state has recorded more confirmed cases of COVID-19 than any country other than America itself. The tally rose by 10,000 in 24 hours to 159,937, ahead of Spain and Italy, which at different times have reported the most infections in the world. The US, which now holds the position, had 454,615 confirmed cases yesterday and the national death toll was 16,074.

Reports from emergency rooms in New York have caused some doctors to speculate that ventilators might exacerbate the lung damage in some patients. It has also led to suggestions that Bipap machines, which supply oxygen via a mask rather than through a tube inserted down the throat, could give patients a better chance of survival.

“New York has been sharing everything,” said Elizabeth Clayborne, an assistant professor at Maryland University and an emergency room doctor at Prince George’s Hospital Center. “New York was reporting 80 per cent of people on ventilators were dying, in New Orleans the numbers were 60 per cent, it was doing better,” she said. This had given rise to “a lot of theories that have not been proved yet”, she added.

A Bronx-Lebanon Hospital Center employee next to a shelf with a body on April 9.

Using a Bipap machine seemed to carry a greater risk of spreading an infection, she said. “Initially, no one wanted to do Bipap, because of the greater risk of aerosolised particles,” she said. However, it was now being tried as an initial measure, she said.

The 80 per cent figure came from state and city officials. A small study in the Chinese city of Wuhan showed a worse survival rate: three in twenty two.

Andrew Cuomo, the governor of New York, said that the death toll in the state, where at least 7,067 people have died of the virus, had risen by a record 799 in a day. The rate of hospital admissions, however, appeared to have slowed and was up by 1 per cent from a day earlier. Mr Cuomo said this was a hopeful sign — “if it continues and if we continue the flattening of the curve”.

Craig Smith, chairman of the surgery department at Columbia University Irving Medical Center in Manhattan, told colleagues that “the governor, the mayor and all the rest of us are holding our breath in hope NYC is peaking”.

Mr Cuomo had called for 30,000 ventilators and lamented that the federal government had sent a small fraction of the number. “You pick the 26,000 people who are going to die,” he said. He has acknowledged that critically ill patients who were on ventilators for more than a week had poor rates of survival. Intubated, and placed in a medically induced coma, many remained there for “seven days, ten days, 15 days and they’re passing away”, he said.

Doctors at Elmhurst Hospital in Queens, the first and hardest hit of New York’s hospitals, found that moving patients helped to improve their blood flow and oxygen levels. Many physicians now report that placing patients on their stomachs has proved helpful. Some have also tried giving patients a mixture of oxygen and nitric oxide.

Joseph Habboushe, an emergency medicine doctor in Manhattan, said that “if we’re able to make them better without intubating them, they are more likely to have a better outcome - we think”. Though he added that these findings did not necessarily detract from the need for ventilators, which do not cure patients but may keep them alive while their lungs heal.

The Times