I’ve had hard conversations this week. “Look me in the eye,” I said
to my neighbor Karen, who was spiraling to a dark place in her mind. “I
make this personal promise to you — I will not let your children die
from this disease.” I swallowed back a lump in my throat. Just the image
of one of our kids attached to a tube was jarring. Two weeks ago our
kids were having a pizza party and watching cartoons together, running
back and forth between our apartments. This was before #socialdistancing
was trending. Statistically, I still feel good about my promise to
Karen because children do not seem to be dying from Covid-19. There are
others to whom I cannot make similar promises.
A few days later, I
got a text from another friend. She has asthma. “I’m just saying this
because I need to say it to someone,” she wrote. She asked that if she
gets sick and has a poor prognosis, to play recordings of the voice of
Josie, her daughter. “I think it would bring me back,” she said. Josie
is my 4-year-old’s best friend.
Today, at the hospital where I
work, one of the largest in New York City, Covid-19 cases continue to
climb, and there’s movement to redeploy as many health care workers as
possible to the E.R.s, new “fever clinics” and I.C.U.s. It’s becoming an
all-healthy-hands-on-deck scenario.
The sky is falling. I’m not
afraid to say it. A few weeks from now you may call me an alarmist; and I
can live with that. Actually, I will keel over with happiness if I’m
proven wrong.
Alarmist is not a word anyone has ever used to
describe me before. I’m a board-certified surgeon and critical care
specialist who spent much of my training attending to traumas in the
emergency room and doing the rounds at Harvard hospitals’ intensive care
units. I’m now in my last four months of training as a pediatric
surgeon in New York City. Part of my job entails waking in the middle of
the night to rush to the children’s hospital to put babies on a form of
life support called ECMO, a service required when a child’s lungs are
failing even with maximum ventilator support. Scenarios that mimic
end-stage Covid-19 are part of my job. Panic is not in my vocabulary;
the emotion has been drilled out of me in nine years of training. This
is different.
We are living in a global public health crisis
moving at a speed and scale never witnessed by living generations. The
cracks in our medical and financial systems are being splayed open like a
gashing wound. No matter how this plays out, life will forever look a
little different for all of us.
On the front lines, patients are
lining up outside of our emergency rooms and clinics looking to us for
answers — but we have few. Only on Friday did coronavirus testing become
more readily available in New York, and the tests are still extremely
limited. Right next to my office in the hospital, a lab is being
repurposed with hopes of a capability to run 1,000 tests a day. But
today, and likely tomorrow, even M.D.s do not have straightforward
access to testing across the country. Furthermore, the guidelines and
criteria for testing are changing almost daily. Our health care system
is mired in situational uncertainty. The leadership of our hospital is
working tirelessly — but doctors on the ground are pessimistic about our
surge capacity.
Making my rounds at the children’s hospital
earlier this week, I saw that the boxes of gloves and other personal
protective equipment were dwindling. This is a crisis for our vulnerable
patients and health care workers alike. Protective equipment is only
one of the places where supplies are falling short. At our large,
4,000-bed New York City hospital, we have 500 ventilators and 250 on
backup reserve. If we are on track to match the scale of Covid-19
infections in Italy, then we are likely to run out of ventilators in New
York. The anti-viral “treatments” we have for Covid-19 are experimental
and many of them are hard to even get approved. Let me repeat. The sky
is falling.
I say this not to panic anyone but to mobilize you.
We need more equipment and we need it now. Specifically gloves, masks,
eye protection and more ventilators. We need our technology friends to
be making and testing prototypes to rig the ventilators that we do have
to support more than one patient at a time. We need our labs channeling
all of their efforts into combating this bug — that means vaccine
research and antiviral treatment research, quickly.
We need
hospitals to figure out how to nimbly and flexibly modify our existing
practices to adapt to this virus and do it fast. Doctors across the
globe are sharing information, protocols and strategies through social
media, because our common publishing channels are too slow. Physician
and surgeon mothers are coming together on Facebook groups to publish
advice to parents and the public, to amplify our outrage, and to
underscore the fear we feel for our most vulnerable patient populations,
as well as ourselves and our families.
Please flatten the curve
and stay at home, but please do not go into couch mode. Like everyone, I
have moments where imagining the worst possible Covid-19 scenario
steals my breath. But cowering in the dark places of our minds doesn’t
help. Rather than private panic, we need public-spirited action. Those
of us walking into the rooms of Covid-19-positive patients every day
need you and your minds, your networks, your creative solutions, and
your voices to be fighting for us. We might be the exhausted masked face
trying to resuscitate you when you show up on the doorstep of our
hospital. And when you do, I promise not to panic. I’ll use every ounce
of my expertise to keep you alive. Please, do the same for us.
Cornelia Griggs is a mother, writer and pediatric surgery fellow in New York. nytimecom