SARATOGA SPRINGS — For Dr. R. Jamie Green, there’s a simple way to explain the process of getting a temporary hospital up and running in a matter of weeks during a global pandemic.
“The big line was, ‘We’re building a helicopter while we fly it,’” Green said.
Before the COVID-19 outbreak struck New York in mass numbers, Green was going about his business running his dental practice in Saratoga Springs. When the virus hit, Green changed hats rapidly. With his practice closed, Green was called into duty with the New York Army National Guard, where he’s a colonel and commander of the National Guard’s Medical Command.
In late March, Green’s role evolved again. With New York City’s hospital system creaking under the stress of the pandemic, Gov. Andrew Cuomo announced that the Jacob K. Javits Center in Manhattan would be turned into a temporary hospital by the National Guard and the Federal Emergency Management Agency to deal with overflow patients.
Green, who had run a field hospital in Iraq when he was called into active service in 2006 and 2007, was sent to the city as the National Guard’s medical liaison, “just to help coordinate what this is supposed to look like, because really, it’s never been done before.”
“They needed somebody with a medical background to go down there as well,” he said, “because they were going to be bringing in active-duty medical units to do the care on the floor. Not all guardsmen are medical people, obviously, and the people they had down there weren’t medical folks. They needed somebody to go down and help coordinate it.”
In less than two weeks, construction on the hospital was complete, and the massive convention center soon started receiving patients.
With all of the different federal, state and local authorities involved in getting things off the ground, Green headed to the city all but certain that a turf war between the various agencies would hamper the ambitious project.
He couldn’t have been any happier to find out how wrong he was.
“I was thinking, ‘This is going to be a nightmare, because everyone is going to want their piece and fight for their turf,’” Green said. “Nobody did that. Not a single person. In my whole time there I didn’t see anybody who was claiming territory or anything like that. Everybody pitched in and worked to make it happen. The reality is, when we all got on the ground, we all knew our parts. We just didn’t know what it would look like at the end, because nobody’s really done it before.”
As the project got underway, the biggest issue was that of scale. Green had run a field hospital before, but nothing like the size of the 1,000-bed temporary facility at the Javits Center.
Getting up to speed in the middle of a pandemic while dealing with an already chaotic New York City healthcare system wasn’t going to be easy.
“As a layperson, if I’m just sitting at home and say, ‘Oh, they’re going to build a hospital in the Javits Center,’ that sounds simple,” Green said. “But, if you go to any hospital, anywhere in the world, and just look around the building, the stuff that they have and the processes that they have and all of the stuff that goes into a hospital isn’t just putting beds on a floor. It’s getting stuff, getting communications, developing systems of treating patients, and how do you get them in and get them out. The process of making that work as a hospital is a totally different thing.
“We have this place, we have all these cubicles, we have these beds. Now, we have to put the equipment in them and we have to make this a working hospital — that, by the way, functions in the New York City system of referrals, and who goes where, and patient regulating, making sure that this person is tracked from here to here to here.”
Both the Javits Center and the medical ship USNS Comfort were initially intended to treat overflow, low-risk patients to provide a release valve for New York City hospitals that were projected to be overrun by COVID-19 cases.
Quickly, Green said, that purpose changed.
“The city didn’t need a place to put people who weren’t those low-acuity patients that really just needed basic care — they needed another hospital,” he said. “In short order, we went from being non-COVID, low-acuity patients to being a full-on COVID hospital.”
After initially seeing low numbers being admitted to the hospital, things rapidly got much busier as the Javits Center saw an influx of COVID-19 patients.
And a busy Javits Center meant that the city’s hospital system could begin to breathe a sigh of relief after the massive initial wave of coronavirus cases.
“We were getting fuller and fuller,” Green said, “and then we started to tail off and as the hospitals started getting control of the situation, it kind of slowed to us, too, to the point where it was like, ‘Hey, our job is done.’ For a spur of the moment thing, it really did work.”
The hospital served more than 1,100 patients before closing May 1.
While it’s closed, the hospital won’t be fully disassembled, meaning there’s a pop-up hospital “basically in storage” and ready to be reactivated if the need arises. The pandemic exposed a weakness in the U.S. healthcare system, Green said, and after this experience it will be better equipped to handle future problems.
“Now they know what it requires to man it, what it requires to supply it, what kind of pharmacy you need, what kind of supplies and equipment, what kind of space,” Green said. “All that stuff has now been recorded and will be useful if there’s, god forbid, a second bump in the disease or if something else comes along. It’s actually been a really good experience.”
After weeks of working 12 to 15 hours a day with few, if any, days off, Green returned home to the Capital Region last Wednesday.
Upon his return, he had some paperwork and medical evaluation to get out of the way, but with the red tape cleared up, Green has gone from a whirlwind of stress in Manhattan back to being a dentist without any patients to see.
“Now, I’m just kind of doing what everybody else has been doing for six weeks,” he said, “just kind of staying at home, doing nothing. It’s weird to be doing nothing.”
After his experiences in Manhattan, Green can look at reopening his dental practice and getting back to dealing with toothaches and cavities in a much different perspective.
“Every now and then, you get tired. It’s a long day, being a dentist,” he said. “But, now I know what a long day really is. I’ll be glad to get back to work.”
Reach Adam Shinder at [email protected] or @Adam_Shinder on Twitter.