Inside the field hospital operation at NYC's Javits Center
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As the coronavirus continues to cripple New York – threatening to overwhelm the state's health care system the death toll continues to climb – one New York City cardiovascular surgeon is lamenting that efforts to help are being met with red tape and silence.
"We began making proposals to hospitals in different boroughs on Monday, March 23 – offering to donate space and provide services," Dr. Yan Katsnelson, founder of the USA Vein Clinics, Vascular and Fibroid Centers, told Fox News. "But there was resistance from hospital leadership due to legal uncertainties of how hospitals can treat patients at facilities they do not control by staff they do not employ. The hospitals we have contacted are currently focusing on increasing space generally within their own facilities."
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Dr. Yan Katsnelson, founder of the USA Vein Clinics, Vascular and Fibroid Centers in New York. (Provided)
Katsnelson declined to specifically name which hospitals the team approached, highlighting, "Hospitals are composed of people doing best they can under very difficult circumstances" and that "legal impediments" of the state and city cannot be impeded on them.
New York remains the U.S. epicenter of the virus – officially termed COVID-19 – with more than 130,000 verified cases and more than 4,758 lives lost.
But from Katsnelson's lens, his team "proposed creative solutions" in the form of utilizing well-equipped physician clinics across the city – yet the stress of the situation has enabled little time or resources for the status quo to be changed.
"Governor Cuomo has requested beds, personnel and supplies. He further stated one is not good enough; the state needs all three together," Katsnelson claimed. "We offered New York City hospitals, 600 beds, 100 people staff, and supplies (for free). We have sent our offer to governor email and answered his Tweet and there was no response. We give him exactly what he asked for, and nobody called us from the governor's office."
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Gov. Andrew Cuomo and New York City Mayor Bill de Blasio have in recent weeks desperately appealed for retired health care professionals to come out of retirement and offer their services in helping the beleaguered state and city fight the pandemic.
Moreover, the leaders have lamented the dire shortage of ventilators and other lifesaving personal protective equipment (PPE) needed for medical staff and for patients.
Medical personnel wearing personal protective equipment to protect from the new coronavirus remove a body from the Wyckoff Heights Medical Center to refrigerated containers parked outside, Thursday, April 2, 2020 in the Brooklyn borough of New York. (AP Photo/Mary Altaffer)
At a press conference on Sunday, Cuomo announced that – for the first time since the outbreak took hold more than a month ago – New York's death toll fell for the first time from 630 on Friday to 594 on Saturday.
The trend continued slightly as Cuomo announced Monday that 599 new deaths were reported in the state. The number of hospitalizations – and admissions into intensive care – had also fallen slightly after escalating with each passing day.
“While none of this is good news, the possible flattening of the curve is better than the increases that we had seen,” he said.
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However, experts warn it might only be a blip in the data the escalating body count remains jarring.
Katsnelson believes officials' and administrators' refusals to accept help is part of a larger issue afflicting America's health care system and that the key to lowering the morbidity rate is keeping the hospitals as unburdened as possible. The main obstacle, in his purview, is that the medical offices are not allowed to keep patients overnight. And not every office or doctor is credentialed with every insurance.
"Physician offices are currently are not allowed to observe and treat patients overnight, which can be a tremendous and immediate help to non-COVID patients and COVID patients in moderate condition to relieve hospitals," he explained. "Where this possible, hospitals would be relived from significant burdens to focus on patients with severe COVID disease. There many more beds in the medical offices than in the hospital. Probably 20 times more."
NYC clinics cannot treat patients for the coronavirus, despite fears of overwhelming the hospital system
The surgeon – who was working at USA Vein Clinics, USA Vascular and Fibroid Centers clinicians as an interventional cardiologist until the pandemic hit – also underscored that most patients around these offices already have Managed Medicaid, such as Healthfirst, UHC Community, Metroplus and similar insurance companies. He said the "credentialing process to allow doctors to accept those insurance is prolonged and, quite often, is not even possible because insurances do not accept new doctors if they fill that they have enough providers of this specialty."
"Medical offices such as ours need instant credentialing for Medicaid managed care patients to be able to see them upon arrival at our offices," he stressed. "This change is entirely within the state's control to make it possible. That will streamline access to care."
Katsnelson also pointed out that the vast majority of the rooms are private and have one bed per room, in a network spanning some 30 locations across the New York City metro area and across all five boroughs, making them ideal isolation pods for those battling with coronavirus.
"We have or otherwise can obtain all necessary equipment other than ventilators," he said.
In order to reduce the usual regulatory burdens, he noted, his team would suggest that the governor issue an executive order that will help them -- and other medical practices -- accomplish the same goal.
"What we are suggesting is one, to allow qualified medical practices to provide these critical resources, and two, ensure that Medicaid managed-care insurers will cover these services so that Medicaid patients have access and the practices can afford to provide the services," he said. "It's the inner workings that no one talks about. There are so many secrets in this industry. Patients can't get treatment outside of their network."
And it's a race against the clock.
In this Friday, March 27, 2020, photo provided by Office of Governor Andrew M. Cuomo, makeshift hospital rooms stretch out along the floor at the Jacob Javits Convention Center in New York. (Darren McGee/Office of Governor Andrew M. Cuomo via AP)
President Trump has cautioned the entire country to brace for the "toughest week ahead," with the death toll expected to soar by several thousands more.
As of Monday morning, coronavirus has infected more than 1.3 million people globally and claimed the lives of over 69,000 individuals. In the United States alone, at least 337,000 people have tested positive, and the pathogen has killed some 10,000.
Representatives for Cuomo and de Blasio did not immediately respond to a request for comment.
"Physician offices can place beds in their offices, and with the use of oxygen tanks and other tools can keep patients overnight in their facilities. Physician offices can provide tremendous additional access to patient beds and capacity for New Yorkers," Katsnelson added. "Every life counts, and we are trying to help."
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