As New York Health System Struggles, USNS Comfort Helps Few Patients

USNS Comfort arrives in NYC, March 30 (USN)

Published Apr 3, 2020 2:25 PM by The Maritime Executive

The hospital ship USNS Comfort arrived at a pier in Manhattan early this week in order to provide support for the region's hospitals, which are struggling to accommodate thousands of COVID-19 patients. However, Comfort has orders to restrict how patients may be admitted, just as she did in 2017 during her relief mission to Puerto Rico. Once again, shoreside hospital administrators say that these restrictions have effectively kept Comfort out of the fight: on Thursday morning, four days after her arrival, there were only three non-COVID patients on board the 1,000-bed hospital ship. The number rose to 20 people by the end of the day.

The restrictions on admission are intended to keep COVID-19 patients off of the vessel, reserving Comfort's services for individuals who need other kinds of emergency care. Officials note that Comfort is a military hospital ship, and her layout is designed for handling large numbers of wounded soldiers, not for containing an epidemic. Before Comfort set sail from Norfolk, Pentagon spokesperson Jonathan Rath Hoffman pointed out that she is not built like a normal hospital. “You have litters that are stacked floor to the ceiling with individuals, you have open-bay rooms because they're intended for trauma and for dealing with people who have suffered some sort of trauma, not for an infectious disease environment. There are some beds for that, but it's a much smaller number," he said. 

Under the protocol set up at the time of Comfort's arrival, potential patients had to be taken to a shoreside hospital, evaluated, tested for COVID-19, determined to be virus-free and then transported to the ship. Northwell Health CEO Michael Dowling, who runs New York's largest hospital system, told the New York Times that with these restrictions in place, the Comfort's contribution to the city's health crisis is “a joke.” 

In 2017, Comfort also used a strict hospital referral policy during the first three weeks of her relief mission to Puerto Rico: she stayed out at sea and accepted about 10 people per day by helicopter from shoreside medical facilities. Following criticism, she berthed in San Juan and accepted about 90 patients per day using walk-in screening and admission at the pier.  As in that deployment, the federal response team has now changed course and will allow Comfort to accept patients on-site in Manhattan with a basic health screening to detect symptomatic COVID-19 cases. 

"Screening for care on the USNS Comfort will be modified and will now occur pier-side in an effort to reduce the backlog at some of the nearby New York hospitals. The screening effort for the USNS Comfort will no longer require a negative [COVID-19] test, but each patient will still be screened by temperature and a short questionnaire," said the Pentagon in a statement Friday. 

Hospital administrators in New York City are asking for Comfort to accept coronavirus patients as well. New York's hospital system is overrun with COVID-19 patients, and state officials warn that they will run out of an adequate number of ventilators to treat critically-ill cases by next week. This treatment shortfall has implications for the fatality rate, which is already high: as of Friday, New York State has lost 2,935 people to the virus, a larger number than the state lost in the 9/11 terror attacks. With 100,000 confirmed cases and about 10,000 more per day, the count is expected to climb. 

New York City Council Health Committee Chair Mark Levine has called for Comfort to help out with recovering coronavirus patients in order to relieve the burden on shoreside facilities. "Hospitals need to be able to discharge COVID-19 patients who are no longer critical, but currently, there is nowhere for these recovering patients to be discharged to. These patients stay on for much longer than normal patients and they are taking up hospital capacity that is needed for incoming patients," Levine said in a statement Friday. "There are still huge numbers of recovering patients that can and need to be rotated out to a lower level of care. We need the beds on the Comfort . . . to serve as surge beds for these COVID-19 patients coming out of ICU."