Coronavirus rages on, putting strain on U.S. doctors, nurses

By Gabriella Borter and Nick Brown

NEW YORK (Reuters) – U.S. doctors and nurses on the front lines of the coronavirus outbreak came under increasing stress on Friday as the number of cases skyrocketed and hospital staff were forced to ration care for an overwhelming number of patients.

The United States surpassed two grim milestones on Thursday. The death toll soared past 1,000, reaching 1,261 by the end of the day, and the total number of infections topped 85,000, exceeding the national totals of China and Italy to make the United States the world leader in confirmed cases.

Worldwide, confirmed cases rose above 550,000 and deaths 25,000, the Johns Hopkins University & Medicine Coronavirus Resource Center reported on Friday.

“This is past a movie plot. Nobody could ever think of this, or be totally prepared for this. You’re going to have to wing it on the fly,” said Eric Neibart, infectious disease specialist and clinical assistant professor at Mount Sinai Hospital in New York. “The scale is unbelievable.”

After days of wrangling, the U.S. Congress may soon respond with a $2.2 trillion relief package, reinforcing an extraordinary array of economic measures that the U.S. Federal Reserve rolled out on Monday.

Leaders of the U.S. House of Representatives said they expected to pass the measure on Friday, sending the bill to President Donald Trump, who has promised to sign it.

In addition to aiding hospitals in hot spots such as New York and New Orleans, the package will bring welcome relief to businesses and unemployed workers. With much of the country on lockdown, a record 3.3 million Americans filed jobless claims last week, nearly five times the previous record set during the recession of 1982.

The counties surrounding Chicago and Detroit were also emerging as areas of concern, said Deborah Birx, coordinator of the White House Coronavirus Task Force.

One emergency room doctor in Michigan said he was using one paper face mask for an entire shift due to a shortage and that his hospital would soon run out of ventilators, the machines needed by sufferers of COVID-19, the respiratory disease caused by the virus, to help them breathe.

The doctor, Rob Davidson, urged Trump to use his executive authority to procure more test kits and ventilators.

“We have hospital systems here in the Detroit area in Michigan who are getting to the end of their supply of ventilators and have to start telling families that they can’t save their loved ones because they don’t have enough equipment,” Davidson said in a video he posted on Twitter.

New York Governor Andrew Cuomo has said any realistic scenario about the unfolding outbreak would overwhelm the healthcare system. His state, which has become the epicenter of the U.S. outbreak with more than 37,000 cases and 385 deaths, is scrambling to create more sick beds.

It is looking to convert hotel rooms, office space and other venues into healthcare centers, while setting up a convention center as a temporary hospital. Some hospitals are scrambling to convert cafeterias and atriums into hospital rooms to house intensive care patients.

Mount Sinai hospital had 215 inpatients with COVID-19 as of Thursday.

“The fear is next week we’ll have 400,” Neibart said, expecting a shortage of doctors and nurses.

In lighter moments, Neibart said he and his colleagues joke about claiming their own makeshift spots, for when they inevitably fall ill with the virus, although he said they routinely check on one another’s well being.

COVID-19 claimed the life of Kious Kelly, a Mount Sinai nurse manager whose death has led to an outpouring of remembrances from former colleagues.

“I remember him running crazy, checking on us and making sure we were OK,” Diana Torres, a nurse at Mount Sinai, told Reuters. “He would deliver our messages to administration if we weren’t happy. He wanted good things for us.”

Torres and other colleagues have also infused their tributes with angry messages about the shortage of personal protective equipment (PPE).

“It seems like we are fighting the government, (the hospital) administration and the virus,” Torres said. “We can tackle one, but not all at once.”

The New York Police Department also announced the first coronavirus death among its ranks on Thursday. Custodial Assistant Dennis Dickson was a 14-year veteran, NYPD said.

The Department of Veterans Affairs may be asked to help in New York, even as it struggles to provide enough staffing and equipment for armed forces veterans.

Maria Lobifaro, a New York intensive care unit (ICU) nurse treating veterans with COVID-19, said staff normally change masks after every patient interaction. Now, they are getting one N95 mask to use for an entire 12-hour shift.

The ratio of patients to nurses in the ICU is usually two-to-one. As of Monday it was four-to-one, she said.

“Right now we can barely handle the veterans that we have,” Lobifaro said.

(Reporting by Gabriella Borter, Nick Brown and Maria Caspani in New York and Doina Chiacu in Washington; Writing by Daniel Trotta)

Trump-backed ‘conscience’ rule for healthcare workers voided by U.S. judge

Trump-backed ‘conscience’ rule for healthcare workers voided by U.S. judge
By Jonathan Stempel

NEW YORK (Reuters) – A federal judge on Wednesday voided a White House-backed rule that would have made it easier for doctors and nurses to avoid performing abortions on religious or moral grounds.

U.S. District Judge Paul Engelmayer in Manhattan said the so-called “conscience” rule was unconstitutionally coercive, by letting the U.S. Department of Health and Human Services (HHS) withhold billions of dollars of federal funding from healthcare providers unless they complied.

“Wherever the outermost line where persuasion gives way to coercion lies, the threat to pull all HHS funding here crosses it,” Engelmayer wrote in a 147-page decision.

The judge also said the rule conflicted with federal laws governing the obligations of employers to accommodate workers’ religious objections, and hospitals to provide emergency treatment to patients who could not afford it.

Engelmayer’s decision covered a lawsuit by New York state and 22 other states and municipalities, as well as two lawsuits by Planned Parenthood and other healthcare providers.

HHS and the U.S. Department of Justice did not immediately respond to requests for comment. The rule was scheduled to take effect on Nov. 22.

U.S. President Donald Trump, a Republican, has made expanding religious liberty a priority, and the conscience rule has drawn support from abortion opponents.

Neither the office of New York Attorney General Letitia James nor Planned Parenthood immediately responded to requests for comment.

The states and municipalities have said the rule could undermine their ability to provide effective healthcare, and upset their efforts to accommodate workers’ beliefs while ensuring that hospitals and other businesses treated patients effectively.

Opponents of the rule have also said it could deprive gay, transgender and other patients of needed healthcare because providers might be deemed less worthy of treatment.

HHS countered that the rule would help enforce “conscience protection” laws that have been on the books for decades.

Engelmayer said these provisions “recognize and protect undeniably important rights,” but the government’s rulemaking “was sufficiently shot through with glaring legal defects.”

The state and municipal plaintiffs are led by Democrats or often lean Democratic.

They also include New York City, Chicago and Washington, D.C.; the states of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin; and Cook County, Illinois.

The states’ case is New York et al v. U.S. Department of Health and Human Services et al, U.S. District Court, Southern District of New York, No. 19-04676.

(Reporting by Jonathan Stempel in New York; Editing by Chizu Nomiyama and Bill Berkrot)

Nearly 1000 killed in attacks on health workers in 2014-15

Candles are pictured outside the Medecins Sans Frontieres (MSF) headquarters in Geneva, Switzerland

By Stephanie Nebehay

GENEVA (Reuters) – Nearly 1,000 people were killed in attacks on health centers worldwide over the past two years, almost 40 percent of them in Syria, the World Health Organization (WHO) said on Thursday in its first report on the growing scourge.

The United Nations agency documented 594 attacks resulting in 959 deaths and 1,561 injuries in 19 countries with emergencies between January 2014 and December 2015.

Syria, torn by civil war since 2011, had the most attacks on hospitals, ambulances, patients and medical workers, accounting for 352 deaths. The Palestinian territories of Gaza and the West Bank, as well as Iraq, Pakistan and Libya, followed.

Some 62 percent of all attacks were deemed intentional and many led to disruption of public health services.

“This is not an isolated issue, it is not limited to war zones, it is not accidental. The majority of these are intentional,” Dr. Bruce Aylward, executive director of WHO’s emergency program, told a news briefing.

“It is also not stopping and it has real complications for what we are trying to do. It is getting more and more difficult to deploy people into these places, it is getting more and more difficult to keep them safe when they are there and it is getting more and more difficult to ensure they survive, let alone recover in crises.”

The casualty figures include 42 killed and 37 wounded in a U.S. air strike on a Medecins Sans Frontieres (Doctors Without Borders) hospital in Kunduz, Afghanistan last October.

A U.S. military report last month said that the incident did not amount to a war crime but was caused by human error, equipment failure and other factors, but MSF has called for an independent inquiry.

WHO said 53 percent of the attacks were perpetrated by states, 30 by armed groups and 17 percent remain unknown.

“One of the most important rules of war you is that you don’t attack health care facilities, health care providers, the sick, the disabled. So these attacks do represent gross violations of international humanitarian law,” said Rick Brennan, WHO director of emergency risk management and humanitarian response.

“Violations of international humanitarian law, if proven, can be considered war crimes and the perpetrators can be taken to the International Criminal Court,” he said.

(Reporting by Stephanie Nebehay; Editing by Mark Heinrich)