March 1, 2020, marked the first confirmed case of COVID-19 in New York City. It was not long before the disease had reached epidemic proportions. As cases surged, NYC Health + Hospitals (NYC H+H)—the United States’ oldest and largest municipal health care delivery system—began providing care to many, many patients fighting for their lives. Soon, it became clear that our community represented, essentially, the very epicenter of the epicenter of this terrible outbreak. NYC H+H has a rich history of responding to a wide range of infectious disease outbreaks, but the impacts of COVID-19 have exceeded all modern-day epidemics, emerging as the worst public health crisis in a century.
At its most fundamental, our challenge has been a race against time to open more hospital beds, onboard more staff, procure more equipment and supplies, develop new systems, and above all, save lives. Just as fast as these resources were brought online, the ongoing surge in demand consumed them, effectively testing every facet of our health care system, from postacute care to ambulatory care to (most intensely) our 11 acute care hospitals. COVID-19 created patient loads well beyond the system’s baseline capacities, especially in intensive care units (ICUs). From March through May of 2020, NYC H+H admitted 10,437 patients with confirmed or suspected COVID-19, including more than 2,000 patients to the ICU.
This post serves as the introduction to a series of articles describing how our system grappled with this unprecedented crisis. Our hope is that our early experiences may offer useful lessons for those facing the pandemic’s ongoing and future threats—health system leaders, policy makers, elected officials, researchers, patients, caregivers, and clinicians, among many others.