New York’s Ongoing Blackout: Hospitals in Lower Manhattan

ProPublica Staff

New Yorl, NY, United States (ProPublica) – by Charles Ornstein

Long after power is restored from Sandy, the effect of another more-precarious outage is still taking shape: Some of the largest hospitals in lower Manhattan remain shuttered. Other hospitals are scrambling to fill the gap, and concern is rising that the patchwork system can’t last for long.

NYU Langone Medical Center and Bellevue Hospital, the flagship of the city’s public hospital system, were forced to evacuate due to loss of electricity and damage from Sandy. The Manhattan Veterans Affairs Medical Center evacuated patients before the storm and has not reopened.

There is no firm timetable on the hospitals’ return. A spokesman for the city agency that runs Bellevue said that the hospital will likely be out for at least several weeks. NYU’s outpatient clinics have reopened but the hospital itself remains closed.

“This is not a tenable situation,” said Bellevue’s director of emergency medicine, Dr. Lewis Goldfrank, who holds a similar title at NYU. “There’s just too many people. You can’t dump this level of patients out on the open market.”

Bellevue’s emergency room treated more than 100,000 patients last year, and its physicians and outpatient clinics handled more than a half million patient visits, according to state Department of Health data. It is also a large provider of psychiatric services and a hub for treating patients in police custody.

Beyond the huge daily patient load it handles, Bellevue is also a key piece of the city’s crisis response system as the only high-level trauma center near the lower section of Manhattan. Trauma centers handle the most serious cases, including victims of gunshots, stabbings, auto accidents, falls and terrorist attacks.

Now, the nearest Level One trauma centers for residents of lower Manhattan aren’t all that close: New York Presbyterian/Weill Cornell Medical Center is on the Upper East Side at East 68th Street and St. Luke’s/Roosevelt Hospital is on the Upper West Side.

Officials say there’s no reason to think that, for now, trauma victims in lower Manhattan will be any worse off than those in other parts of the city. The response speed is still acceptable, they say. And if a trauma victim is in an immediately life-threatening situation, such as a traumatic cardiac arrest, ambulances bring them to the closest hospital, regardless of whether it’s a trauma center.

But the fear is that there won’t be enough surge capacity at other hospitals if there is a major disaster, or that overworked staff at other hospitals will grow fatigued under the load and patient care could suffer.

“All systems can work at above capacity for some time without significant detriment,” wrote Dr. Ronald Simon, director of trauma at Bellevue, in an email to ProPublica.

“But, with time, people will tire, over-worked systems will fail, and patients will suffer,” wrote Simon, who is also chairman of the state health department’s regional trauma advisory committee. “No question in my mind that the current status of care in Manhattan is not sustainable for any length of time.”

The longer Bellevue and the others are closed, the more worrisome it becomes.

It “leaves a whole blank spot in the lower part of Manhattan,” said Dr. Amesh Adalja, an associate of the Center for Biosecurity of the University of Pittsburgh Medical Center.

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Below is a map of Level One trauma centers in New York City. Click on an icon for more information.

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