Two Upstate University Hospital doctors and a nurse are playing integral roles managing the emergency hospital for COVID-19 patients set up inside the Javits Center in New York City.

Emergency Medicine physician Christopher Tanski, MD, MSEd, is working as the chief medical officer and Director of Nursing Recruitment and Retention Rebecca Milczarski, MSN, RN, MBA, NEA-BC, is working as chief nursing officer at the Javits Center. Division Chief of Hospital Medicine Housam Hegazy, MD, MLS, SFHM, FACP, CHCQM, is also on site assisting his Upstate peers.

The New York State Department of Health sought assistance from Upstate in deploying doctors and nurses to manage the civilian side of operations at the Javits Center. The United States military and the U.S. Department of Health and Human Services established the field hospital there in late March to relieve overflowing hospitals in the New York City area. As the pandemic continues, the military will eventually transition management of the facility to civilian medical professionals. Tanski, Hegazy and Milczarski are tasked with managing the transition on behalf of the department of health.

Through a Zoom call on Tuesday evening, they described what it’s been like to work in a massive convention center-turned hospital at the epicenter of the coronavirus.

All three are based in the fourth-floor Command Center, which overlooks the 250,000-square-foot convention center floor that currently houses about 350 patients and can hold 500. They are all working 14- to 16-hour days and on their feet a lot. Milczarski said she’s walking about 20,000 steps (more than 10 miles) a day and Tanski said he attends near constant meetings.

Decisions that might normally take days or weeks now have to be made instantly, Tanski said. He described it as “1,000 decisions a day,” managing the stream of crises that arise when building a huge emergency hospital from scratch. “There’s tons of work to do,” he said. “We’re running a 350-bed hospital, which is larger than a lot of community hospitals.”

There are between 200 and 250 people working in the command center at a time. They are ordering supplies, developing protocols and recruiting staff alongside their counterparts from the Army, Navy, National Guard and United States Public Health Service.

“Everybody works really well together,” Milczarski said. “The days are really long. We’re all tired. We’re all stressed. But there’s an overwhelming sense of camaraderie that we’re all in this together.”

Despite not being directly involved with patient care, Tanski and Milczarski walk through the patient areas regularly. One hundred percent of the patients there are positive for COVID-19 and were transferred there from other hospitals. Most are not critically ill but require hospitalization. Tanski said they try to bring comfort to those they encounter by offering assistance to the bathroom or by waving hello. But you can’t see someone smile from behind a mask and they recognize that their full-body personal protective equipment is not exactly welcoming.

Patients are separated by walls made of white sheets and the rows and rows of “rooms” all look alike, Milczarski said. Many patients don’t speak English and none have much to do. There are no visitors and there is no television. Many spend time on their phones.

The constant flow of patients and the barrage of daily work make the days go by fast, they said. The Javits Center receives 50 to 100 new COVID-19-positive patients per day and is discharging between 60 and 70 per day. The facility does contain an ICU but if a patient get sicker while there, he or she is transferred to a nearby hospital, Tanski said.

The Javits Center is also working in tandem with the U.S.N.S. Comfort, a U.S. Navy hospital ship stationed about a mile away. Command Centers at both locations are in regular contact with each other, Tanski said.

Hegazy said his Upstate colleagues in Syracuse have been critical to his work at the Javits Center. He regularly consults them about establishing management protocols and treatment guidelines. He has been interviewing and screening new physicians and Milczarski has been recruiting and onboarding nurses who are willing to work there. 

The need for staff at the Javits Center is great. Doctors and nurses should commit to working there for at least a week and longer is appreciated; travel and housing are provided.

Interested medical professionals must submit an application through the New York State Department of Health website at: https://apps.health.ny.gov/pubpal/builder/survey/retired-health-professional. That process will allow for proper screening and management of staffing needs, Milczarski said.

Despite being about 250 miles from home, all three were quick to say they were thinking of their colleagues at Upstate and were proud of those now working at SUNY Stony Brook. Upstate Interim President Mantosh Dewan, MD, who has touched base with all three since they arrived, said their willingness to work at the heart of the pandemic was remarkable.  

“I am proud of and admire the courage, dedication, and generosity of these three amazing professionals,” Dewan said. “They bring an exceptional level of expertise and experience to their leadership roles at the Javits Center. It was humbling to see them leave at a moment’s notice to take over the running of a massive emergency hospital!

“Upstate has been privileged to provide medical leadership and to serve patients in our 17-county region. In this time of need, heroes like them inspire us and enable us to extend this across the state.”

At the end of their exhausting days, Tanski, Hegazy and Milczarski walk a few blocks east to their temporary home at a Courtyard Marriott. They pass shuttered restaurants and bars and say the usually bustling Big Apple is “eerily quiet.” After Facetiming with their families, sleep comes quickly. About six hours later, they rise and head back to the convention center to begin their work again.

“Having Dr. Hegazy and Rebecca here has been incredible,” Tanski said. “It’s not like we left a normal situation at home. The coronavirus is affecting every part of the world so I think we came down here thinking OK, we’re going to help but we worry what we left behind in Syracuse.

“I’m proud to work at Upstate. I miss being there but I’m certainly honored to represent Upstate here.”

On Wednesday, the New York State Governor’s Office asked Tanski to remain on as medical director until the Javits Center closes, to which he agreed. The others said they would continue to work there as long as was necessary.  

Once this is all over, Milczarski will celebrate Easter with her family. Tanski will move home from the hotel he was living in to be with his wife and two young children. And Hegazy was quick to say what he’s looking forward to most once this crisis is over. With a soaring wall of Javits Center glass behind him, Hegazy pulled away his mask to reveal a huge smile. “I can’t wait to see my daughter,” he said. “All of my kids, of course. I have three. But my daughter especially.”

She is just 18 months old. 

 

Caption: From left to right at the Javits Center in New York City are Upstate employees Rebecca Milczarski, MSN, RN, MBA, NEA-BC; Housam Hegazy, MD, MLS, SFHM, FACP, CHCQM; and Christopher Tanski, MD, MSEd.