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How New York, California And Washington Are Dealing With COVID-19

NOEL KING, HOST:

At around 1:30 this morning, lawmakers reached a deal on a $2 trillion spending package. It's intended to help the U.S. economy, which is shuttering because of the coronavirus. It still has to be voted on, but for people who've been affected, it will likely feel like some good news, also some good news for places that have been hit hard, like New York City. More than 15,000 people there have tested positive, and that number is growing. In California, there are fewer cases, but the state is getting ready. And in Washington state, where the U.S. first saw this virus, the death rate is slowing, but health care workers there are still worried.

This morning we have Leila Fadel in Los Angeles, Martin Kaste in Seattle, and I'm going to start with Rebecca Hersher who is in Baltimore at the moment, but she has been covering what's going on in New York state. Becky, you've been talking to people at New York's hospitals. What are they telling you about the conditions there?

REBECCA HERSHER, BYLINE: Most of the hospitals in New York say that they have limited supplies. So we're talking about masks, gowns, face shields, gloves, hand sanitizer - basic stuff that you need to safely treat COVID-19 patients. Most of the hospitals I've spoken to have about one to two weeks of supplies. That may sound like a lot, but it's not. They're doing rationing, locking up supplies to make sure that people don't take more than they need.

And then there's also the issue of beds. There are not enough beds in New York City to accommodate the surge that is expected. There are probably about half as many beds or fewer than what's probably needed in the next couple of weeks. So FEMA and the National Guard are setting up a thousand-bed hospital in the convention center in Manhattan, same thing in college dormitories. But they're racing the clock, honestly, because right now that curve of new cases, it's very steep in New York City.

KING: And that must be very worrying for doctors and nurses in New York. What are they telling you about their specific concerns?

HERSHER: I'm hearing a mixture of bravery and, frankly, fear. People are concerned. I talked to the head of critical care at a Bronx hospital. She said more than half of the people in her beds have COVID-19 right now. You can imagine that's pretty scary. We're pretty early in this spike in New York City in cases. And that also takes a psychological toll. Hospitals have set up call-in psychiatric services for their employees to help them deal with the stress.

One longtime doctor at a hospital in New York City - he's in his 60s - he has asthma. He'll almost certainly be treating COVID-19 patients in the coming weeks. He said he woke up a few nights ago in a cold sweat because he realized he hadn't updated his will.

KING: Extraordinary stories. Leila Fadel in Los Angeles, California has fewer cases, but are doctors there looking at a place like New York and saying, oh, gosh, this is what's coming our way?

LEILA FADEL, BYLINE: Absolutely. So here it's this anxious buildup to get ready in time for whenever the wave hits, and doctors believe it's coming soon. I spoke to doctors across the state; they're saying they're in this calm before the storm, and they're watching New York and trying to learn and prepare. Individual doctors are calling colleagues in more hard-hit areas to get tips and tricks for when their hospitals are slammed with lots of really sick patients.

One doctor I spoke to had just finished watching a video from a colleague in China showing how to make a do-it-yourself negative air pressure room in an emergency with a plastic bag. And in the last couple days, ER doctors say more and more critical cases are showing up at the emergency room. The Los Angeles mayor, Eric Garcetti, warned last night that the peak is going to be bad, and the city will likely see the numbers New York is seeing in six to 12 days. So far, though, the most deaths in the state are in Santa Clara County in Northern California.

KING: So if California is predicting New York's numbers, does preparation in California mirror what we're seeing in New York?

FADEL: Right. But they hope they have the benefit of time here, a little bit more time. California Governor Gavin Newsom, remember, was one of the first in the country to issue a stay-at-home order. Based on projections, the hospitals will have great needs. This is a state of about 40 million people, and Newsom says they need 50,000 additional hospital beds.

So they're depending on the hospitals to create most of those, and then the rest they're trying to build between field hospitals. The U.S. Navy hospital ship's scheduled to arrive in Los Angeles on Friday. Offline hospitals, the states bringing back online in Northern and Southern California, as well as other efforts. So far, FEMA has come through with two of those eight mobile hospitals, one being built in Southern California on a fairgrounds and another in Santa Clara, up north, where, like I said, they've seen the most deaths. But beds really don't do anything if you don't have the staff.

I spoke to Dr. Scott Robertson (ph), the division chief medical officer for a group of hospitals in the central coast of California. And he says they've doubled ICU beds in anticipation and feel like they have an adequate supply of personal protective gear. But that, of course, depends on the number of patients they get. But here's what he said about staffing.

SCOTT ROBERTSON: If you're really running double your capacity day in and day out, the staff is going to get tired. There's going to be some staff that get sick. And so it is a concern in terms of will you be able to manage intensive care units at this volume for a prolonged period of time.

KING: All right, so the worry right now is in California. Martin Kaste, you're in Washington state, where hospitals have been preparing for a while because that's where we saw the early cases. How are they doing in Washington?

MARTIN KASTE, BYLINE: Yeah, they really got something of a head start because of kind of the horror of seeing that sudden group of deaths coming out of the Life Care nursing home in Kirkland a couple of weeks ago. And since then, hospitals here have really just been very serious about clearing out room in their systems for these incoming patients.

So they've been canceling - you know, any kind of procedure that can be postponed, they have. They've been keeping general patients away from clinics and hospitals by having their doctors shift to telemedicine - it's been remarkable seeing how all of a sudden almost everything is now telemedicine if it can be - and preparing special wards for the COVID-19 patients coming in.

So the upshot is some of the hospitals I've talked to here say they could probably stretch now to about double their normal capacity if necessary. At the moment, that's not necessary. They're not full, but they do say - see those COVID-19 cases coming in, and it's sort of a tide rising ominously.

KING: Martin, Washington state has also been pushing the whole social distancing thing longer than most states in the country, most areas of the country. Is there evidence that it's working?

KASTE: Well, I was talking to Cassie Sauer about this yesterday. She's the head of the Washington State Hospital Association here and talks to hospitals all day, and she also talks to the state. And I asked her if she's detected a hint of optimism when she's talking to state officials, and here's how she put that.

CASSIE SAUER: We had a big call with the state with all the hospital leaders on Sunday, and they did talk about - the data was encouraging, is probably too strong a word; not as terrifying (laughter) maybe is a better way to put it.

KASTE: One reason she said it was maybe a little less terrifying now than before is, you know, if you look at the actual total number of COVID-19 deaths here - they're still mounting; they're still growing - but the increase is less steep than it was at first, certainly not like what we're probably seeing in New York now or will be seeing. But it's way too early to say that social distancing has worked yet.

One thing that's important to point out here is this - the region is really moving fast towards a more methodical way of figuring out how widespread the infection is. They're starting a new process now in the Seattle area to get a cross section of tests of people whether or not they have symptoms, just to see where the infection is on a more sort of updated, maybe even real-time basis. And once that happens, we might have a much better sense of just where this infection is.

KING: OK. NPR's Martin Kaste in Washington state, Rebecca Hersher in Baltimore, Md., and Leila Fadel in Los Angeles. Thank you, guys, so much.

KASTE: You're welcome.

FADEL: You're welcome. Transcript provided by NPR, Copyright NPR.