Covid-19 Series, Entry #1

window (2)

This is the view from my office.  It’s been my view for almost seven years now.   I was pretty lucky to get an office with a window when I was only a fellow (this must have been a clerical mistake) and this has been my home base ever since.  Looking out my window I can see the medical intensive care units, a couple of general medical units and the blood and marrow transplant (BMT) unit.   I can see helicopters taking off and landing and I can see the shadows of doctors and nurses moving about the units.

I took this picture on Friday (3/13/2020) before I left for the weekend.  Our team has already started to plan for catastrophe, but many questions loom.   Will our team need to see patient’s with Covid-19 in person, or will we be able to manage end of life care by consulting with the primary physicians?  Will there be enough personal protective equipment (PPE) for us to use?  Does our entire team need to continue seeing patients in the hospital or should we work on a skeleton crew to mitigate transmission?  Is it still okay to go into areas of the hospital where patient’s are severely immunocompromised, or might we unknowingly be carrying the virus?  How do I reduce my risk of contracting Covid-19 and bringing it home to my family?  Will I need to stay at the hospital until the virus slows down?  Will I have to start managing critically ill patients if we have a shortage of physicians?  Will my team have to participate in decisions about how to ration ventilators?  If patients are dying of Covid-19, will their families even be able to come to the hospital to be with them?  Or will they have to remain isolated to die alone?  The list goes on….

I took this picture with a knot in my stomach.  The “normalcy” of the past seven years will likely be replaced with chaos and death in the coming weeks.  I pray that I am being overly dramatic, but stories from Italy and Seattle suggest otherwise.  News just broke that the number of cases in New York increased by 80% in the past 24 hours, 18% of those patients requiring hospitalization.  A handful of Emergency Medicine physicians are critically ill with Covid-19.

I am scared, but what brings me hope is the way the medical community has stepped up to disseminate information for the good of our patients and communities.  Online forums have popped up on social media where leading intensivists, infection specialists and epidemiologists have shared their expertise and experience in real time.  Doctors from China and Italy are sharing trends and interventions that seem to be helpful, as well as risk factors for poorer outcomes.  Be assured that the medical community is committed to doing whatever we can to fight this pandemic.

Please help us by restricting any non-essential activity.  For our family, that means only leaving the house to go grocery shopping and to play outside (in our yard, not at a playground).  My kids will not see their grandparents or friends until this is over.  I know it feels excessive, but, to borrow a line from Aladdin, “Desperate times call for desperate measures.”

Be safe and healthy, my friends.

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