When the first COVID-19 cases appeared in Detroit, there was a broad but nonspecific panic, and emergency departments across southeastern Michigan were flooded with coughing people who were more worried than ill. In the past week, that flood has abated; the patients who are coming in now are sicker, and often in immediate need of oxygen. Most visitors to hospitals have been banned and many departments emptied of patients, and so physicians report a spooky juxtaposition between the crisis atmosphere of the expanded I.C.U.s and the bureaucratic calm of the rest of the building. “I used to occasionally do employee rounds on the midnight shift, and you would see these usually busy, wide hallways, your main thoroughfares, just empty, and it would always be such a strange feeling,” Bob Riney, the chief operating officer of Henry Ford Health System, told me. “And now you see that in the middle of the day.”
The coronavirus pandemic has had a way of turning even the most prestigious hospitals into community-health operations. Henry Ford Hospital, in downtown Detroit, one of the largest teaching hospitals in the country, is building a unit for forty-eight skilled-nursing-facility residents who no longer require hospitalization for covid-19 but whose facilities refuse to take them back. Rana Awdish, who runs the hospital’s pulmonary-hypertension program and practices critical-care medicine, normally spends her days seeing patients who travel to her clinic from across the Midwest. But, since the first coronavirus patients arrived, about three weeks ago, the helicopters and ambulances that transfer patients have stopped almost entirely. The patients filling the covid-19 units are coming from Detroit.
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