nearly half of all covid patients in some major cities were admitted for another condition. >> it is possible for somebody to come in with a broken arm or hand and become a covid positive case. >> exactly >> the u.s. and russia hours away from high stakes talks as vladimir putin sends more troops into kazakhstan to help contain protests there. happening right now tennis star novak djokovic in court. will he be allowed to leave isolation in australia to play? real life super hero a police officer and former airman's new mission. >> this is nbc "nightly news" with kate snow >> good evening. a terrifying scene in new york city this morning. one of the worst fires in the city's recent history. the fire commissioner says it started with a malfunctioning space heater in the bedroom of an apartment. the door to the apartment was left open allowing smoke to spread to every floor of the high rise building where many residents are immigrant families there were dramatic rescues but also many trapped in stairwells. authorities are saying 19 people perished among them, nine children many more are injured and now homeless we begin tonight with kathy park >> reporter: the five-alarm fire ripped through this bronx high rise just before 11:00 a.m. flames shooting out windows on the second and third floors this woman was making breakfast when it all started >> i just heard people screaming, help, help, help >> reporter: the smoke spreading quickly to all floors throughout the 19-story building with more than 100 apartments. >> this smoke extended the entire height of the building members found victims on every floor in stairwells and were taking them out in cardiac and respiratory arrest >> reporter: the emergency response was massive. roughly 200 firefighters, some pulling residents down ladders. others tending to the injured. >> i looked out my window and saw the flames coming out of the window. >> reporter: new york city's mayor eric adams calling it one of the worst fires in the city's history. >> the impact of this fire is going to really bring a level of just pain and despair in our city. the numbers are horrific >> reporter: dozens were injured and transferred to five different city hospitals. it is the second fire with major fatalities in a week. just days ago, 12 perished in this fire in a philadelphia row house. the lengthy investigation is getting under way. a painful and horrific day for a community now in mourning. >> we'll be here for this community to help them navigate through this during the tragedy, we are going to be here for each other >> kathy joins us live from the bronx what can you tell us about the smoke alarms were they working? >> reporter: well, kate, officials say there are smoke alarms throughout the building in fact, a resident heard an alarm, saw the smoke, then called for help right away. but tonight still so many questions on what went wrong kate >> kathy park, thank you. the mayor of new york acknowledging that fire came as the nation is battling covid as well. this week could prove to be one of the most challenging yet. one estimate says 5 million people could be home sick in the coming days possibly crippling critical services now hospitals overwhelmed with patients are struggling to find the staff to care for them sam brock has more >> reporter: the omicron variant may be spreading at the speed of light but its grip on american workers is slowing down critical services >> we have over 500 employees throughout baptist health that have come down with covid. >> reporter: at baptist health in miami some urgent care centers have been closed to reposition strained staff >> is this purely a function of not enough people is that why you're making these choices >> yes we have plenty of equipment, plenty of medications. it is a staff issue. >> reporter: the crunch prompting change in california >> it's major disaster waiting to happen. >> reporter: the hyperinfectious variant leading to new state rules. health care workers who test positive and are asymptomatic may return to work immediately without isolation and without testing. that switch incensing the california nurses' association >> i think it is very calloused and putting our patients and ourselves in grave danger >> reporter: the toll of sick outs on the transportation sector is also getting worse. portland, atlanta, washington, d.c. have all pulled back on routes with d.c.'s heavily used transit authority shifting week day bus service to a weekend schedule to ensure customers have a more reliable schedule. experts say the ripple effect is enormous. >> the fact the transportation system is so disrupted is really a very significant hardship on the broader economy because all parts of the economy rely on that transportation network to get us to work, to school. >> reporter: parents and students are suffering under the weight of sick outs, too. philadelphia is shifting nearly four dozen schools to remote learning amid staffing shortages and evaluating others on a case by case basis as the state of georgia just loosened quarantine protocols for teachers with more stores posting signs like these temporarily closed millions of workers are expected to call out next week because of covid >> sam joins me now from south florida sam, it really sounds like the reach of this goes well beyond hospitals and schools. >> reporter: kate, there are supermarkets with empty shelves because there aren't people there to stock them pharmacies like walgreens that are issuing apologies to customers for longer than usual wait times. the sick outs right now are well beyond where we were during delta's peak >> thank you hospitals clearly are under strain one of the measures, though, of just how serious this wave has been is the number of covid hospitalizations but tonight there are growing calls to re-evaluate what is classified as a covid hospitalization with some doctors saying the numbers don't reflect reality. >> reporter: tonight as more hospitals report spiking cases of covid-19, confusion is mounting over what should actually count as a covid hospitalization. right now anyone at the hospital who ends up testing positive for covid is counted by the cdc in cities like new york recent numbers show over half of those counted as hospitalized with covid were there for something else. >> they might be having a stroke or heart attack and end up being positive just because of the community spread right now. >> reporter: at los angeles county hospitals two-third of covid patients were admitted for other causes same in the bay area so it is possible for somebody to come in with a broken arm or broken hand and become a covid positive case efrjts actually. as of tuesday we had 40 adults hospitalized under the designation of covid positive. but only 12 were hospitalized for covid illness. >> reporter: this e.r. dr. jean noble says before the vaccines most of those testing positive in the hospitals were in need of critical covid care. >> my job went from patients coming in in respiratory distress worrying would we have enough ventilators to now in january of 2022 the majority of people who come in with covid i discharge home really quickly. >> reporter: she says today most severe cases are among the unvaccinated while the high hospitalization counts among children in the bay area appear to paint a much more dire picture than they're seeing in the emergency rooms. >> we had 19 kids hospitalized for covid but only six were in house, were admitted patients because of covid. >> reporter: in marin county, california out of the 20 listed as covid hospitalizations last week ten were admitted for covid out of the 20 cases reported to the cdc as covid-19 hospitalizations, three of them were women that were asymptomatic that were delivering babies? >> that's right. if we don't understand the distinction between the people who might be in icu on a ventilator truly there because of covid-19 we might over estimate the burden of omicron. >> reporter: now doctors are calling on the cdc to specify how patients who test positive should actually be counted. >> we have simply been reporting patients who test positive for covid in one big bucket and those numbers go to the cdc. that's what we've really got to change >> it is fascinating but given everything you just said, there are still hospitals very much overwhelmed, right? >> absolutely. the experts we talked to said there is still a significant crisis still happening within hospitals but so much of that crisis has more to do with the staffing shortage and health care workers testing positive for omicron than it does with the severity of the disease. >> interesting thank you. u.s. diplomats are just hours away from beginning high stakes talks with russia with the threat of a russian invasion of ukraine looming. the biden administration warning russia of massive consequences if they go through with it monica alba is at the white house. >> reporter: ukraine on edge tonight. ahead of major talks between the u.s. and russia >> we're going to listen to russia's concerns they're going to have to listen to our concerns. >> reporter: planning for dialogue and diplomacy but ready to respond with massive economic consequences if russia invades ukraine. >> we're about to test the proposition about which path president putin is prepared to take. >> reporter: high stakes discussions kicking off in brussels and vienna this week though no major breakthroughs are expected. >> if we're actually going to see progress we have to see deescalation. >> reporter: the u.s. vowing to slap unprecedented sanctions on russia if it further escalates the situation with the ukraine. >> we are prepared to deal very resolutely with russia if it chooses confrontation, aggression. >> reporter: so far president putin has demanded the u.s. pull troops out of eastern europe and rule out expanding nato to include ukraine. but neither are being considered according to the biden administration what could shift washington is prepared to discuss the possibility of scaling back military exercises and missile deployment in the region, but only if agreed upon by moscow as well. >> monica is with us putin has also sent military troops to another former soviet union republic today. >> russia was invited by kazakhstan to deploy an estimated 2500 troops to help authorities reassert control in the country's biggest cities following days of sometimes violent protests against its leadership at least 160 people have been killed this week in the unrest kate >> all right monica alba at the white house for us still ahead tonight, right now novak djokovic's lawyers are pleading his case in an australian court will the world's top tennis star be allowed in the country to play also the daring rescue that saved dozens when the sheet of ice they were on began to float away. t you just ride the wave? 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>> my stress level i would say is pretty high. >> reporter: her mother has learned to keep a close watch over both allegra and her twin brother alexander. >> i worry 24/7 how they both will navigate school, life, everything emotionally. worried. >> reporter: and john also a senior now says there is a growing possibility his school will go back to remote any day now. does that create anxiety for you, stress >> it definitely creates anxiety. it feels like the same as it was last year. that sort of uncertainty you don't know what next week is going to hold anymore. >> reporter: there is overwhelming data that remote learning has taken a harsh toll on children's academic and mental health. the uncertainty of the pandemic over all has been incredibly stressful for kids probably important to really check in with kids and understand what it is that they're experiencing that might be stressful. >> reporter: whatever comes, both john and allegra say they are better prepared. did you learn coping skills last year >> i would say definitely, yes. i was breaking down, crying, very upset when i needed to get the work done. i took a deep breath and did the best i could. >> it is really important to make sure you can adapt and plan flexibility into your schedules. >> reporter: lessons learned in the age of covid. helping these students stay on course nbc news >> i relate so much to allegra's mom. when we come back, to the rescue. one police officer's alter ego to help kids when they need it most you downloaded the td ameritrade mobile app so you can quickly check the markets? 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>> well, about four and a half years ago, just wanted to do a little something more, and i remember seeing somebody dressed as spider-man visiting sick kids in hospitals and i thought, man what an awesome idea thanks to my wife pushing me and motivating me to get the captain america shield we saw one day in the mall everything else is history. >> reporter: the super hero going above and beyond to help kids at community events, in the hospital, and others with special needs. like 6-year-old michael murphy, who was born with a rare condition that makes it hard for him to eat, breathe, and hear >> first day of kindergarten >> officer douglas and other first responders showed up to make his first day of school a little less scary. >> when they arrived at the school captain america got out and was giving high fives to the kids. it was unforgettable >> reporter: for michael's mom britney officer douglas has been a life tyne. >> when your kid has differences you just want them to be accepted >> reporter: what do you hope to bring to these kids >> i want to bring a certain level of joy, compassion, just general positivity. >> reporter: positivity and joy for kids like 12-year-old alex who has autism. officer douglas showed up to be part of his birthday parade. and when it came time for alex to get a covid shot mom elvia says he stepped in once again. >> i called officer douglas and i said alex is a little bit scared can you walk him through it he said sure give me a couple minutes. officer douglas has taken on this role because alex wants to grow up one day and save the world >> wants to be a super hero. >> yes. >> reporter: small gestures with big impact that officer douglas says he is hoping will catch on. >> if i make contact with one person that changes one person's life then mission accomplished if they do that to somebody else then there is no going back from that. >> reporter: officer douglas told me he has a mandalorian costume on the way for his future super hero missions one last note tonight my digital series "the drink" tells the stories of people at the top of their game and the latest is my conversation with actor ian summerhalder of the vampire diaries and opens up for the first time about how he almost lost everything after a financial decision that is at nbcnews.com/the drink or get it on the nbc nightly news podcast i'm kate snow. for all of us here at nbc news, stay safe and have a great night. >> announcer: nbc sports, home of the olympic games, the premier league, the pga tour, prime time's number one show, "sunday night football," and super bowl lxi, only on nbc. las vegas. the high stakes capital of america. what a setting to decide the last couple of playoff spots.