THE DESPERATE HOURS

An urgent account of how Covid-19 created nearly insurmountable challenges to a famed hospital system.

In a book based on more than 200 interviews conducted over 18 months, Vanity Fair writer at large Brenner creates a tense, stirring picture of the impact of Covid-19 on New York-Presbyterian Hospital’s campuses in New York City, Westchester County, and the Hudson Valley. In the first months of the pandemic, the city’s “most elite hospital system” faced frustration and uncertainty. Little was known about the disease’s cause, treatment, and prognosis; hospitals faced a stunning lack of supplies; doctors and nurses were overwhelmed and grief-stricken by deaths they could not prevent; and they were constantly undermined by decisions at the federal, state, and city levels. The CDC’s “antediluvian” structures made the agency unable “to quickly gather, process, and interpret data,” and states were forced to compete for supplies. When FEMA sent ventilators, they turned out to be old and broken. By mid-March, the hospital had 90,000 masks on hand, a number it needed each day. In its search for protective gear, the hospital found a “profiteering and counterfeit market” allowed to flourish because of a lack of federal leadership. Tests, when they could be found, were unreliable, but the CDC and the Trump administration refused to authorize the import of reliable tests from outside the U.S. As late as June, with cases in New York City soaring, doctors and nurses were unable to get tests for themselves; even when available, processing them “was chaos.” Brenner reveals, as well, the conflicts between staff and “their corporate masters,” who punished health providers if they spoke out about the hospital’s challenges and failures. The author’s probing investigation includes animated profiles of a large cast of characters, creating a palpable sense of trauma, pain, and vulnerability in what one cardiologist characterized as nothing less than war. The casualties, Brenner shows, encompassed far more than the patients who died.

A potent cautionary tale for pandemic preparedness.