New York City's public health system to convert all facilities into ICUs + 20 other updates from the 6 hardest hit states

Below are 21 updates from the six states hardest hit by the COVID-19 pandemic:

Editor's Note: This is not an exhaustive list of updates or health measures taken by the states.

New York (84,046 cases as of 7:25 a.m. CDT April 2)

1. In a media briefing April 2, New York Gov. Andrew Cuomo said that if the current rate of people coming into the hospital stays the same, the state will run out of ventilators in six days. The state is taking several measures to manage a potential ventilator shortage, including transporting ventilators to hospitals in need from facilities where they are unused, using anesthesia machine ventilators, allowing ventilator-sharing and converting bi-level positive airway pressure, or BiPAP, machines into ventilators.

New Hyde Park, N.Y.-based Northwell Health has developed a protocol to transform a BiPAP machine into a functional ventilator and is sharing it with other hospitals in the state. 

The state plans to conduct nightly surveys of all hospitals in the state to keep track of resource use and need, the governor said. 

2. Mr. Cuomo said April 2 that 21,000 healthcare workers have volunteered to come in from out of state to provide support for the state's response to the pandemic. Around 85,000 New York residents have joined the state's surge healthcare workforce. 

3. New York City's public hospital system will convert all of its facilities to intensive care units to accommodate the surge of coronavirus patients expected by the end of April, officials told The New York Times. The public health system expects to need an additional 65,000 hospital beds, as well as enough staff for them, by the end of the month, which is when the state is expected to reach peak patient volumes.

Patients without COVID-19 will be sent to temporary hospitals or to hotels that are being transformed into temporary healthcare facilities. The city has secured 10,000 beds from 20 hotels, officials told the Times.

4. New guidelines for emergency medical services personnel in New York City and Long Island state that cardiac arrest patients should not be brought into a hospital if they cannot be resuscitated in the field, according to ABC7 Eyewitness News. The guidelines state if EMS workers cannot resuscitate patients outside the hospital, they must not perform CPR and declare the cardiac arrest patient dead.

5. New York City-based Mount Sinai Health System launched a web-based app to capture symptoms and track the spread of COVID-19 in the city. The web app, now available by texting "COVID" to 64722, allows city residents to monitor their symptoms by first completing a survey about demographics, exposure and symptom history, followed by short daily surveys about their symptoms through text messages.

The data can help health officials identify clusters of outbreaks in specific communities and make informed decisions regarding resource allocation.

Read more about measures New York is taking here.

New Jersey (22,255 confirmed cases as of 7:25 a.m. CDT April 2)

1. New Jersey Gov. Phil Murphy responded to President Donald Trump's comments that the state "got off to a very late start" in addressing the coronavirus.

"I don't think that there's any state in America that was on this earlier than we were," apart from Washington, which experienced an early outbreak at a nursing facility, the governor said at a media briefing April 1.

"The facts don't support that. Period. Full stop," he added. "If the facts don't support something, I don't spend a whole lot of time worrying about it."

2. An executive order signed by the governor on April 1 authorized the state to temporarily reactivate the licenses of recently retired healthcare workers and provide temporary licenses to physicians licensed in foreign countries, reports Insider NJ.

Some healthcare workers will be temporarily permitted to perform services outside of their scope of practice, and broad civil immunity will be granted to workers and facilities offering their services in good faith to address the COVID-19 outbreak in the state.

3. The governor visited the Meadowlands Exposition Center in Secaucus, which is being transformed into a 250-bed field hospital, reports ABC7 NY. Set to open next week, Meadowlands is one of four such facilities in the state that will treat patients who don't have COVID-19 to ease the burden on emergency rooms.

California (9,907 confirmed cases as of 7:25 a.m. CDT April 2)

1. California Gov. Gavin Newsom said he is worried that fatigue with social-distancing guidelines and closures could unravel the state's efforts to combat COVID-19, CBS News reports. California was one of the first states to implement strict stay-at-home orders. 

"I worry that people say, 'You know what, we got this. Let's have that birthday party and let's mix some of the extended cousins together.' If we do that too soon, we're in trouble," the governor told CBS News.

2. In the last six days, the number of patients needing intensive care unit beds has quadrupled, the governor said, according to the Mercury News. The number of patients hospitalized has tripled in the same time period, he said.

"Those numbers represent our most urgent need in terms of keeping people alive and keeping people healthy and safe in the state of California," the governor said. "It is incumbent that we prepare for a surge in the number of hospitalizations and the number of ICU patients." 

Since the state started tracking cases, more than 40 percent of the patients who have been hospitalized with COVID-19  have needed to move into the ICU, the Mercury News reports. 

3. Nursing homes in California may soon be ordered to accept COVID-19 patients and serve as overflow facilities for hospitals, according to The San Francisco Chronicle. The move is part of the state's efforts to boost bed capacity to care for the surge in COVID-19 patients. Nursing home experts have called the move a "death sentence" for vulnerable residents. 

4.  Los Angeles Mayor Eric Garcetti is urging the city's 4 million residents to wear masks in public, according to ABC News. He said that wearing a mask, even if it is a tuckedin bandana or a homemade cloth shield,will help the city combat the spread of the novel coronavirus. He is urging residents to avoid using medical-grade masks, such as N95 respirators or surgical masks, which are in short supply for frontline workers.

"I know this looks surreal," Mr. Garcetti said, according to ABC News. "We’re going to have to get used to seeing each other like this. This will be the look."

Michigan (9,315 confirmed cases as of 7:25 a.m. CDT April 2)

1. An April 2 executive order signed by Michigan Gov. Gretchen Whitmer suspended the remainder of the school year, as well as in-person K-12 instruction, reports Fox2 Detroit.

Teachers and school employees will be paid for the remainder of the school year. 

All standardized tests, including the SAT and M-STEP, will be canceled, and students will be able to sit the SAT and PSAT exams in October.

Remote learning guidelines are being developed, which will be available by April 3.

"There is no video chat or homework packet that can replace the value of a highly trained, experienced teacher working with students in a classroom," the governor said, according to Fox2 Detroit, "but we must continue to provide equitable educational opportunities for students during this public health crisis." 

2. On April 1, Ms. Whitmer declared a state of disaster due to the economic, educational and civic issues caused by the coronavirus in the state, reports Click On Detroit.

The legislation will enable the state to "respond more effectively to every facet of this crisis," the governor said.

The announcement came three weeks after the governor declared a state of emergency on March 10 to address the spread of COVID-19.

3. The governor also signed an executive order broadening the scope of healthcare workers who can treat patients diagnosed with the coronavirus, reports Fox 2 Detroit.

Signed March 29, the order relaxes the state's medical practice laws, temporarily permitting nurses and physician assistants to treat COVID-19 patients without the supervision of a licensed physician.

4. The University of Michigan in Ann Arbor is considering using its athletic campus as a field hospital, which could be operational by April 9 or April 10, reports Click On Detroit. 

The university's indoor track can provide up to 500 beds and would serve as a "step down" hospital for patients recovering from COVID-19, according to Keith Dickey, chief strategy officer of Ann Arbor-based Michigan Medicine.

Florida (7,773 confirmed cases as of 7:25 a.m. CDT April 2)

1. Florida Gov. Ron DeSantis issued a statewide stay-at-home order April 1, after resisting calls to lock down the state, according to The New York Times. Mr. DeSantis issued the order after the number of COVID-19 infections jumped by more than 1,000 March 31.

But the order includes several exceptions and does not close public beaches, despite the outrage directed last weekend at photos of crowded beaches in Florida posted on social media.

The order will go into effect April 3.

2. Miami-Dade County is opening a 250-bed field hospital on its fairgrounds, according to the Miami Herald. The facility will be used to care for patients with minor illnesses if other hospitals in the county are overwhelmed with critical COVID-19 cases. The county does not expect to use the facility, as projections show it will be able to manage the influx of coronavirus patients.

3. Mr. DeSantis has agreed to allow Florida residents to disembark the Zaandam cruise ship in the state. The ship reported nine passengers testing positive for the novel coronavirus and more than 200 with influenza-like symptoms, according to USA Today

The governor said the state will also allow Florida residents to leave the Rotterdam cruise ship, which is also seeking to dock in Florida. Asymptomatic passengers from the Zaandam ship were transferred to the Rotterdam last week.

Previously, the governor expressed reluctance to allow any of the passengers to disembark.

"My concern is that we have worked so hard to make sure we have adequate hospital space in the event of a COVID-19 surge, we wouldn't want those valuable beds to be taken because of the cruise ship(s)," he said, according to the report.

There are 24 Floridians on the Zaandam ship and 25 on the Rotterdam ship.

Read more about measures Florida is taking here.

Massachusetts (7,738 confirmed cases as of 7:25 a.m. CDT April 2)

1. Massachusetts Gov. Charlie Baker said April 1 that hotel rooms and home-sharing platforms like Airbnb can only be booked by healthcare workers who were displaced from their homes due to the COVID-19 pandemic, according to NBC Boston.

2. The Landry Arena, the sports center for Fitchburg (Mass.) State University, is being turned into a mortuary to prepare for an expected surge in COVID-19 deaths, reports.

More articles on public health:
Texas temporarily halts abortions amid COVID-19 pandemic
Coronavirus data surge freezes Washington state's disease-reporting system
62% of US clinicians said their facility can't handle coronavirus patient influx


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