Covid-19 in New York: ‘We knew the health system would be a frail match’ | Membership


Jessica Glenza, health reporter

When I pictured covering a crisis as a reporter, and I assumed one day I would, I did not imagine it would be from my kitchen table. But here I am. Stuck in a chilly apartment in Jersey City as we all, reporters included, attempt physical distancing.

When Covid-19 first struck New York, I would walk to a park near my apartment with a panoramic view of the city, look across the Hudson River, and remember people who were once part of my daily routine: the deli workers, the delivery men, the nurses and doctors.

And one day I woke up to hear Covid-19 had reached its grim hand across the water and taken hold of my own community. My city councilman, Michael Yun, died – his storefront served constituents just a few city blocks from my home.

Flowers, picture frames and memorial messages were stuck in the roll-down steel gate. His smile was still alive on the awning above the store. The shop was his magazine stand for decades before he became a politician.

From this kitchen table, I’ve talked to weeping emergency room doctors, angry nurses and stoic medical residents. I’ve interviewed experts in bioethics, palliative care, health insurance and hospital financing.

We all knew that America’s patchwork, for-profit health system would be a frail match against a vicious disease such as Covid-19. But constant calls for reform were often chalked up to politics, and change was always delayed.

Now, as a slow and bungled response from leaders in Washington DC continues to hamper any effort to recover, decades of poor health policy have been exposed.

Picture this: in 1975, the population of the US was 215 million people. Today, it is 328 million. In roughly that time, the US has lost 567,000 hospital beds, down from 1.4 million, because they were considered inefficient and unprofitable.

This was directly related to how people pay for healthcare. As the number of hospital beds fell, emergency departments also closed because they were the only part of the hospital required to treat patients who couldn’t pay. Which, it turns out, was a lot of people.

On average, the cost of healthcare per person between 1960 and 2015 has outpaced wage growth by roughly 2.4% each year, according to government economists. We’ve also managed to exclude 9% of the entire population, or roughly 28 million people, from health insurance entirely, with catastrophic potential for people’s finances.

Is it any wonder, then, that it is unaffordable for Americans to see the doctor? That, last year, half of Americans delayed or skipped care because of prohibitive costs? That, in turn, those untreated chronic conditions leave people vulnerable to Covid-19? And that the most vulnerable among us, both to Covid-19 and chronic health conditions, are the poor and people of colour?

These questions, of course, are rhetorical. Because even as this pandemic leaves us shocked and terrified, the 10,000 horrific deaths in New York City alone are the predictable consequence of a healthcare system that leaves so many people on the sidelines.

There are some other people I have talked to in this crisis: people with hope. Many emergency room doctors, nurses and researchers believe Americans may now see how urgent change is, and believe that maybe in disaster there is also opportunity.

Ed Pilkington, chief reporter

What does a reporter do when they are in lockdown and can’t get out of the house to report? How can you write the first draft of history when you’re not able to witness history in the making?

Well, one answer I have discovered, as a Guardian reporter barely able to leave our Brooklyn home (my wife, Jessica, has a brain tumour, so we are being extra careful to avoid infection), is that you join your son for one of his online college classes.

One evening, I was drawn into listening to a Zoom panel discussion at Georgetown University, where Felix is in his final year. One of the speakers was Ron Klain, who in 2014 was appointed by Barack Obama to be America’s Ebola tsar. He was asked what he thought of the way Donald Trump was handling coronavirus, and he replied: “The response will be studied for generations as a textbook example of a disastrous, failed effort.”

It was like a eureka moment for me. Suddenly everything that I had been hearing and reading – Trump’s downplaying of the crisis, his comparison of Covid-19 to flu, the botched federal effort over diagnostic testing – fell into place. We were living through a historic failure of leadership and governance.

That electric realisation set me on the path towards writing a series of pieces tracking Trump’s epic mishandling of the pandemic and its cost in American lives. I may not be able to leave the house, but with a little help from my son’s online classes I hope I have found a way to contribute to our understanding – and anger – about the disaster that’s unfolding here in the richest nation on Earth.

Park Avenue in Manhattan earlier this week.

Park Avenue in Manhattan earlier this week. Photograph: Sonia Moskowitz Gordon/ZUMA Wire/REX/Shutterstock

Amanda Holpuch, reporter

The first time I walked outside in New York City, once people were sheltering in place, I felt an eerie sense of familiarity. New York’s governor, Andrew Cuomo, was begging Donald Trump to send more ventilators to the city while the president was insisting the country would be back open by Easter. The mix of desolate streets, denial from the Trump White House and pleas from a political leader had happened two-and-a-half years earlier in Puerto Rico, after hurricanes Irma and Maria devastated the island. One big difference was that, in Puerto Rico, I woke up every day trying to get deeper into the island to understand the extent of destruction while phone and internet service were almost completely shut down. Now I’m stuck at home, depending on the phone and internet to let me know what is happening in the city I live in.

It makes a big difference, seeing people’s faces and interviewing them in person. I’ve been focused on the economic impact of the outbreak, so I do get a small taste of what that looks like when I walk past closed restaurants and shop at a grocery store where the city building inspectors are limiting how many people are inside. I’m really looking forward to interviewing people in person again.

I’m also deeply concerned that, a few months down the line, we’re going to see the same sort of denial from the White House that has followed Hurricane Maria – Trump still hasn’t acknowledged the actual death toll from the hurricanes.

Tom McCarthy, national affairs correspondent

I’ve been working exclusively from my kitchen table, so all news collection has happened on the phone, by text or online. The challenge is to tell a national story while operating from this island. But working to our advantage, I’ve found, is a real sense of urgency on the part of sources – experts in public health and emergency response. They want to get the message out: we need tests, we need contact tracing, we need equipment, we need leadership, and we need a plan. One public health expert whom I met on the phone last month texts me multiple times overnight; I awake to his links. Then home-schooling for my two daughters begins, with its own set of challenges.

Ironically, physical distancing has offered windows into the lives of sources across the country that otherwise would never appear. Before, you had a sense of which sources were likely to know what and which analysts could speak most effectively in a public-facing way. Now you know who has a dog and who yells at their kids, and whose kids yell at the dog. It’s been cheering, that part of it.

Nina Lakhani, environmental justice reporter

I was a freelancer for seven years before starting full time with the Guardian last October, and so have perhaps found working from home a bit easier than others. Still, staying indoors while the world outside unravels and people suffer so terribly goes against my instincts as a journalist and human being. We’ve all had to adapt.

It’s been almost three months since the WHO declared a public health emergency, so what have we learnt? It’s undeniable that coronavirus is not an equalizer, far from it, the communities suffering the worst Covid-19 outcomes in the US are low income households, people of colour and Native Americans – who by no coincidence are the folks most likely to live in polluted neighbourhoods, without access to clean, running water, adequate nutritious food, and green spaces.

These environmental inequalities fuel all sorts of health disparities, and Covid-19 has proven to be no different.

What’s also clear from my reporting on water shutoffs and food banks, is that mass layoffs in a country with virtually no safety nets, means millions of Americans will now need emergency food aid and help paying extortionate water bills.

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