Epilogue

Pandemic

The corona virus pandemic began to unfold as this Case Study was being finalized.  New York City had become the world epicenter of the virus outbreak.   Though Brooklyn was not the hardest hit borough in the City, on  April 7, 2020, the day this Epilogue was written, the death toll  in Brooklyn had reached 946 people.  Each day, for weeks, that number would likely be revised upwards.   Within Brooklyn, Central Brooklyn was a COVID-19 hotspot.112

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In Central Brooklyn, Brookdale Hospital, part of the One Brooklyn Health system, began seeing Covid-19 patients in early March, 2020. By the end of the month, more than 100 of its patients had tested positive for the virus, and 78 additional patients were awaiting test results. The ICU was at capacity, patients lined the halls and the morgue overflowed.  A refrigerated truck parked outside the hospital handled the overflow from the morgue.  With capacity for only 300 patients at one time, to manage the COVID-19 surge, Brookdale had reopened floors that had been closed for years  It also converted its pediatric emergency department into a Covid-19 isolation area, separated from other wings of the hospital by walls made of plastic sheeting hung with duct tape.

And like many other hospitals in the New York City area, it struggled with resource shortages--masks, gloves, gowns, ventilators and medical space. Hospital staff had begun seeking ways to repurpose older, disused ventilators and adapting anesthesia machines to use as ventilators.  A “medical war zone, “ said Dr. Arabia Mollette, a Brookdale emergency department doctor,  said, "[e]very day I come, what I see on a daily basis, is pain, despair, suffering and health care disparities."113

Although many cities and states did not keep COVID-19 morbidity and mortality rates by race, early findings suggested that the virus was sickening and killing African Americans at disproportionate rates.114  These disparities are not hard to explain given racialized SDOH and the greater likelihood that African Americans are employed in service jobs that do not afford workers the luxury of staying home to observe social distancing.115

Before the outbreak, New York State had 53,000 hospital beds and 3,000 intensive care unit beds, nowhere near the 110,000 hospital beds (and 37,200 ICU beds) that potentially would be needed at the peak of the outbreak.  After years of hospital closures and bed reductions aimed at making NYC hospitals more financially sustainable, as the COVID-19 crisis loomed, the City faced the daunting task of finding tens of thousands of new beds.116

The DSRIP-funded plan to transform the One Brooklyn Health system (Interfaith, Kingsbrook Jewish and Brookdale Hospitals) by expanding preventative and primary care, would have eliminated dozens of urgently needed hospital beds.  As of this writing, those plans have been put on hold.  Instead, two unutilized floors at Brookdale Hospital were to be reopened to deal with the anticipated surge of COVID-19  patients.  And, according to One Brooklyn Health CEO, LaRay Brown, efforts to convert Kingsbrook Hospital, into a post-acute care and rehabilitation campus have been paused.

In response to these developments, CCB and Coalition leaders, working through CAAW and East Brooklyn Call to Action (“EBC2A”), are taking decisive action.  CCB has invested in a special $3 million Strong Communities Fund to accelerate support and capacity building for CBOs and community projects serving the neediest Brooklynites affected by COVID.   It is seeking to double the fund with a 1:1 philanthropic match for a total budget of $6 million.

Even as the virus takes its devastating toll, finding ways to connect in spite of social distancing measures, communities across NYC are rallying to honor healthcare workers each night at 7 pm with ovations from balconies, terraces and fire escapes, honking horns and banging pots.117  CAAW and EBC2A are working to create online civic infrastructure to continue weaving the fabric of local engagement and supporting the mobilization they painstakingly cultivated in Central Brooklyn over many years.  Building on the success of Wellness Empowerment Brooklyn PAR, and partnering with Local 1199’s Childcare Benefit Fund, MIT CoLab and others, they hope to engage a new cohort of young people to capture stories of  the pandemic from frontline workers and community members fighting the virus.

They plan to bridge social distance with an impactful virtual public square where community, labor, and other stakeholders can come together.  Efforts over the next few months will engage and mobilize community and labor, gather stories from the front lines, raise awareness and forge a platform for civic engagement that will culminate in a Zoom Virtual Town Hall.  In so doing, they seek to launch a model of mobilization and e-Democracy that will promote equity and justice during the immediate COVID crisis, and provide the means to shape the recovery process that follows.

Chapters
Introduction
1. An Epidemic of Hospital Closures
2. Crisis at Interfaith
3. Time to Mobilize: Forming the Coalition to Save Interfaith
4. Protest and Resolution
5. Medicaid Reform
6. Research-Based Action
7. Participatory Action Research as a Tool for Change
8. Healthcare System Reform: Cross-Sector Collaboration
9. Reinventing Interfaith
10. Focus on Health Equity
11. Creating Healthier Communities: Leveraging Community Assets
12. Community Planning for Healthier Communities
13. Making Health a Shared Value: Building Civic Infrastructure
14. Building a Culture of Health: Outcomes
15. Planning for the Future
16. Sustaining Transformation in the Face of Challenge
About the Report
Epilogue
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