An inside look at Elmhurst Hospital as told by
the director of the emergency department
BY JENNA BAGCAL
Since the end of last
month, Elmhurst Hospital
has been the center of the
COVID-19 crisis in Queens,
admitting about 200 patients
who tested positive for the virus
as of March 30.
Elmhurst’s Emergency
Department Director, Dr.
Stuart Kessler, described the
experience as “challenging”
and added that “no hospital
in the country was prepared”
to deal with a pandemic of
these proportions.
Kessler praised the hospital
and its healthcare staff,
including attending physicians,
residents, mid-level
practitioners and nurses and
said in the past, they have
trained for “disaster and
mass casualties.”
“It’s a totally different
experience. I’ve been doing
emergency medicine for more
than 20 years and none of
us could have imagined what
we’re seeing,” said Kessler.
“I still sometimes have a
hard a time getting my head
around the fact of what we’re
seeing today. It’s something
very different than anything
we’ve ever thought would
happen or could happen.”
Making adjustments
According to Kessler, the
early parts of March brought
“huge volumes of patients
that we never expected to
see.” The doctor estimated
that during that time,
Elmhurst admitted more
than double the patients that
would come on any other given
day.
“It started with a few patients
that I don’t think anyone
would recognize would
likely turn out to be patients
infected with coronavirus.
We then gradually saw a huge
increase in our volume of patients
that were coming to
the emergency department,”
he said.
The dramatic increase in
patients required the staff at
Elmhurst to make changes
in the way they staffed their
employees and in treating
patients diagnosed with the
virus.
“We had to figure out who
of all those patients was really
sick and who needed the
most intense care or who
People wait in line to be tested for coronavirus disease (COVID-19) while wearing protective gear outside Elmhurst Hospital Center on
March 25, 2020. REUTERS/Stefan Jeremiah
could get a medical screening
exam, be given good discharge
instructions and told
that they could go home fairly
rapidly after a thorough
evaluation,” Kessler said.
According to Kessler, the
issue wasn’t the amount of
patients admitted to the hospital
but rather their acuity,
or severity of their illness.
The doctor said that over the
past few weeks, Elmhurst
saw an increase in those patients
who became seriously
ill from COVID-19.
“Now, it wasn’t so much
that there was a huge volume
of patients walking in, there
was just a large number of
really sick patients. We’ve intubated
more patients in two
or three days than we would
in two or three months,” Kessler
said.
To offer an alternative to
going inside the hospital for
testing, Elmhurst set up an
outdoor tent next to the emergency
department.
“Some people were just
coming to the emergency
department because they
wanted to get tested. So we
were able to give them an option
that didn’t require them
to come to the emergency
department, they had the
option, if they chose, to get
tested,” said Kessler.
TIMESLEDGER | QNS.4 COM | APRIL 10-APRIL 16, 2020
A need for more
supplies
Prior to the COVID-19
outbreak, Kessler said that
Elmhurst had enough resources,
including ventilators,
for “any day of the
week.”
“But when people began
to realize what the need
was, it was something that
was sort of extraordinary.
It required us to work really
hard to try and get the
resources we needed,” Kessler
said. “So, I’m sure there
was some concern on everybody’s
part about how many
patients are going to come in
tomorrow that need to be intubated
and put on vents and
can we get enough vents to
manage all the patients that
need them.”
What he and other hospital
staff try to do is to manage
their needs on a daily basis
and determine if they’ll
have enough resources to
last for the next two to five
days and beyond that.
“We’ve managed to keep
up and that’s great. So the
fear is just, will we be able
to keep up today and will
we have enough for tomorrow,”
he said. “We’re always
concerned and we’re always
looking to get more because
we know if we have enough
today, that doesn’t necessarily
mean we’ll have enough
tomorrow. We always have
to be looking to get more tomorrow
and more the next
day and more the next day.”
Fortunately, the doctor
said that leadership, including
Vice President of NYC
Health + Hospitals Israel
Rocha Jr., hospital administrators
and the government
have provided “great support”
in providing enough
supplies for Elmhurst’s
needs.
So far, Kessler said that
they have not run out of supplies
and added that a lot of
people have “stepped up” to
donate PPE to the hospital.
“I think in hospitals that
haven’t experienced this yet,
they’re gonna go through
the same kind of learning
experience that we have as
to what’s the extent of PPE
how should you wear it, how
much do you need, how often
do you need to change it.
Those are all things we’re
learning as we go,” said Kessler.
Healthcare heroes
In terms of handling a
health situation that no one
could have prepared for, Kessler
said that the whole hospital
and the emergency department
has “done a great
job,” volunteering for extra
shifts, coming in when they
are not scheduled to work
and going above and beyond
their normal roles.
“They’ve stepped up in
amazing ways, they’re doing
things that they’ve never
imagined they would have
to do. In our department and
throughout the hospital but
everybody in the ED has just
been more than I could have
ever asked for,” said Kessler.
“There’s been no one that’s
said no to any request or
requirements, they’ve all in
fact volunteered to do more.
They’ve all spent time learning
how to best treat these
patients.
“Everybody in my department
knows how to work a
vent, they know the different
types of vents and they
know how to use them in a
very short period of time,”
Kessler continued. “We have
a really strong residency program
and our nurses and
everybody have stepped up
in exceptional ways.”
Reach reporter Jenna
Bagcal by e-mail at jbagcal@
qns.com or by phone at (718)
260-2583.
/qns.com