The chief medical officer, Dr. Vasantha Kondamudi, later summed it up: Staff was short, medical residents were falling ill every day, and the number of patients with suspected or confirmed Covid-19 was ballooning in nearly every area of the hospital. Yet the crisis had not peaked.

Nurses and others from departments that had cut back on services, like elective surgery and outpatient clinics, were being trained and redeployed. “You’re working completely differently,” said Judy McLaughlin, senior vice president and chief nursing executive. But even that wasn’t enough: The hospital had requested more than 100 volunteer doctors and nurses from the city’s Medical Reserve Corps and was rapidly working to vet them.

After the call, Dr. Gasperino conferred in the hallway with the director of respiratory therapy. The hospital had 98 ventilators, many acquired in recent days, including small portable devices from the national stockpile. Employees were running simulations to practice how they might use each ventilator to treat two patients, a difficult and risky proposition. “We’re doing this because the alternative is death,” Dr. Gasperino said.

An alert sounded on the loudspeaker, interrupting the conversation: “Code blue, 6B. Code blue, 6B.”

The critical care team was designed to respond to emergencies anywhere in the hospital. Although he was supposed to be on his way home after an overnight shift, Dr. Gasperino joined more than than a dozen others pouring into the patient’s room.

“Covid?” someone asked.

“No, not Covid,” came the answer.

Young residents stood on either side of the man’s bed and took turns doing chest compressions. Nurses ran out of the room and back in with supplies. Dr. Gasperino threaded a catheter into a large vein to infuse medication into the patient’s body. The man’s pulse returned.

At about the same time, one of the pregnant patients was wheeled from the intensive care unit and into an operating room for a cesarean section. She was in her early 30s, and her baby was being delivered nearly two months early in an effort to save the mother’s life. Over the past day, doctors had ordered two doses of steroid medication to help the infant’s lungs mature.

During rounds earlier that morning, a resident presented the woman’s case. She had been put on a ventilator and sedated the previous evening. Dr. Rosenberg cursed under his breath: This disease was cruel.



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