We are all in this together: individuals — families, communities, states, and countries — racing against the clock to flatten the curve. The pandemic has certainly picked up speed since my column last week. One week ago, The New York Times reported that there were “more than 15,000 confirmed cases of the coronavirus in the state of New York.”  Today, Tuesday,  that number is more than 67,000. More than half the cases, just over 38,000, are in New York City. The number of deaths in the state as of midnight on March 30th was 1,218, up 253 from the day before — the largest one day increase in deaths since the outbreak began. The number of deaths in NYC rose to over 900.

After New York’s Governor Cuomo issued an executive order on March 20th mandating that 100% of the workforce stay home, excluding essential services, I closed my office and created a virtual medical practice in less than a week. Two full-time staff members manage schedules and assist with clinical co-ordination.  The staff and I put in ten-hour days helping people here in the epicenter of the pandemic and those far from home find medical care or find answers to complex questions in still murky medical areas. I did lots of listening last week.  I heard that everyone wanted to do the right thing but many are understandably anxious about what this abrupt change in how we suddenly have to conduct our lives now will mean.  Will it be like this for two weeks?  Two months?  Six months? Over and over I expressed the certainty that there is little certainty at this time . . . just the certainty that the welfare of the community must come before individual plans. Everyone heard this and everyone understood that we are all in this together.

Hospitals in NYC are about to be overwhelmed with an influx of patients entering through the Emergency Departments this week, even though the peak of COVID-19 infections is not predicted to occur for another ten days.  Due to extraordinary efforts by the Armed Forces, the National Guard, FEMA, and nonprofit organizations, more than 2,000 additional hospital beds were created in the past few days that will provide care for those who are ill but presumably not infected with the Coronavirus.  The USNS Comfort sailed into NY Harbor with 1,000 beds for the care of the sick who do not have known COVID-19 infections. The Javits Center has been turned into a hospital for non-COVID-19 patients by the National Guard and FEMA and opens on Tuesday with 1,000 beds to start with. A small field hospital was set up in two days in Central Park by a nonprofit, Samaritan’s Purse, working in conjunction with FEMA, and will be operational on Tuesday morning.  Everyone who moved so quickly to aid the suffering in our city knew that we are all in this together.

I know many of the dedicated physicians and nurses currently working in direct clinical care areas in Emergency Departments and throughout the hospitals. I have friends and family members who are spending long shifts in the ICU divisions of our medical system where there are desperately ill patients and concerns that there will not be enough personal protective equipment (PPE) to protect them from infection. I hear from everyone that scarce supplies of PPE are of paramount concern for the safety of our healthcare workers. Governor Cuomo asked doctors and nurses and other health care providers to volunteer in NYC hospitals. I may be asked to join the ranks of full-time employees of the hospitals in NYC during this crisis. I know that we are all in this together.

In order to prepare in case I find myself on active hospital duty, I called Gigi Burris, a brilliant young milliner, on Sunday morning (follow @gigiburris  on Instagram). I asked her if she could create a prototype of PPE for me that would decrease my exposure to the coronavirus.  I suggested that she think of a way to cover my head and face.  Perhaps the face-covering part could have a horizontal opening across for my eyes and another horizontal opening for my mouth? This form of PPE would need to be washable and I would have to be able to remove it safely at the end of a shift without contaminating my face. I could wear a simple surgical mask over this face cover.

Gigi worked all day Sunday and Monday using material she had on hand and four helmet/face covers with masks will arrive tomorrow by FedEx.  These PPE prototypes were created from recycled clean workout clothing, sewn using her grandmother’s sewing machine.  Gigi’s mom suggested that a removable neoprene pad found in sports bras and bathing suits could be used as a face mask.  Elastic from old workout pants or newly ordered from Amazon can be sewn to the sides to hold the mask in place over the head. “In this together,” she said when I expressed my gratitude for the creation of protective facial gear. 

 

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Finally, I must reinforce this: each individual must know the rules and follow them. Stay at home unless there is a crucial need to be out. Practice social distancing when out of the home. Assume that everyone you meet has the virus and respond accordingly. Shop infrequently and with care to avoid infection with the coronavirus on shopping carts, freezer handles, shelves, produce and cardboard boxes that have been handled by many, some of whom will have been shedding the coronavirus. Wash your hands after touching anything when you are out of your home or use hand sanitizer frequently when outside performing needed chores. Follow the rules. Follow the rules. If we all do our part, we may be able to flatten the curve and decrease the numbers hospitalized and the numbers of those who will die in the COVID-19 pandemic. If we can do this, we may be able to prevent the unthinkable: an overwhelmed hospital system in NYC that can no longer care for all of the critically ill.  

 

Give what you can to those who have little. Give everything you have to keep us safe.

                                                       IN IT TOGETHER.

Dr. Pat