“All Our ERs Are Now ICUs”: A NYC Doctor’s Perspective on the Latest COVID-19 Developments

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When I last spoke to New York City ER doctor Dara Kass, she had just received a COVID-19 diagnosis. Two and a half weeks later, she is back at work. I spoke to her the day after her first shift back in the ER. Though her initial perception of the crisis proved to be quite astute, she was nonetheless changed and humbled by what she had seen after just one day back on the job. (She had continued to see patients via telemedicine while she was recovering.)

Firstly, how are you and where are you? When we last spoke your children had moved out of your house and you and your husband were occupying separate rooms in your house.

I’m staying at the Four Seasons in Manhattan, in a room that has been converted to house doctors during the crisis. My kids have come back to our house in Brooklyn, so I moved in here before I started work so that we would all be safe. I’m so grateful that this is available, but as soon as I think it’s safe, I want to go home.

What was your first shift back in the ER like?

On Thursday, before I came to the hotel, I donated blood at Mount Sinai for a study on the viability of plasma donation. About two hours into my shift, I got a call saying that my antibody levels indicate that I’m likely immune. This was a huge relief. I had gone to work hoping to maintain a level of care for noncritical patients—to help with arm pain or abdominal pain, the normal things that bring people to the ER. But as soon as I got those results, I went to my colleagues who were more involved in critical care of COVID patients, and I said, “Please let me help you.” During my downtime, I walked around the COVID patients to check their oxygen levels and hold their hands. There’s a sense of comfort that comes when a doctor is able to take a few extra minutes and provide a little physical touch, and I feel so fortunate to have this gift of the antibodies that allows me to take that time.

Since I got this news, I’ve also put in the paperwork to work at Downstate [Medical Center]—where I did my residency—one of the hospitals that has been designated as one of the COVID-only facilities.

Have a lot of your colleagues had their antibody levels tested? I imagine many of them have had COVID by now.

A lot of health-care workers want to be tested for antibodies, but most health-care workers are not tested for the virus if they are not obviously sick, if they are healthy enough to stay out of the hospital. There is a dramatic under-testing of health-care workers, and this seems like a major lost opportunity. If a health-care worker know she’s immune, she could not only donate plasma that could save lives, she would have a very powerful piece of information that could dramatically impact how she’s able to do her job.

We’ve been told that we may be about to see the peak of the crisis in New York City in the coming days. Can you tell me a little more about what you anticipate this week?

Across New York City, we are seeing a continuous onslaught of critically ill patients. All our ER departments are now ICUs. When you walk into any ER in New York City, you hear the noises of an ICU, which are not the noises of the ER. You hear the ventilators; you hear the sirens; you hear the pumps. You see people responding quickly to changes in clinical status. We have just seen so many more people in the ER, and so many more health-care workers. It’s been amazing to see people from the OR or the noncritical clinics helping to deliver frontline care. There has been a total flattening of hierarchy. I’ve seen attending surgeons with 40 years of experience pushing people to get tests or delivering oxygen tanks. The teamwork has been overwhelming as we all fight together against this invisible enemy.

Have you experienced the shortage of medical supplies that we’ve heard so much about?

I have only worked one day in one ER, but so far I have had what I’ve needed to treat my patients. I am mostly not taking care of critically ill patients, so I am still able to make decisions like that, for now. I have medical-professional friends all over the city and all over the country, and most of them are still able to make decisions based on quality of care—for now. I have watched people step up in many different ways to make this possible.

And how are you handling the pressures of the crisis personally?

I’m doing better than I expected, though I don’t want to speak for anyone else. So far, I’ve been able to deliver care deliberately and with intention, and that’s all any health-care worker can ask for at the moment—to deliver to their patients the chance to fight a disease that is literally suffocating. I still cry when I have to call family members to tell them that their loved one has passed away. That’s always hard, and it should always be hard. You don’t want to stop crying when you make those calls; that’s part of being human. You have to be present to deliver that kind of information, and I worry about a point where we may be too overwhelmed to make those kinds of calls with the respect they deserve.

And how about your family?

My husband is really proud of all of us. It’s very hard to be away from my kids, but they are busy with school and I want them to be busy. I think they’re not really getting the magnitude of this moment, and I’m okay with that. I’m okay with them just knowing that I had to move out to keep us all safe. I feel like everyone I know is in a similar position; we’ve all just suspended normal life.

Since we last spoke there have been all kinds of efforts to help medical professionals, from making and wearing the right kind of mask to meal donations. What’s one way we can help that people may not know of yet?

Headbands! No one wants their hair exposed, but the surgical caps are hard to keep on your head. I could use some headbands that are a good three inches thick. I would love to figure out how to get health-care workers headbands that are cloth and that we can wash and reuse. We will still put the caps on top of them, but then at least our flyaways will be protected.

Is there anything that gives you a dose of optimism at the moment? Today we got the news that the number of deaths on Sunday and Monday in New York had remained relatively flat.

This is a horrific virus that is killing people at a rate we have not seen before, and I am not ready to let down any of my guard. I appreciate people wanting to look for the light. For me that is going to be when there’s a decent number of health-care workers who are immune, when there is a sufficient number of ventilators and enough protective equipment, and there are better models to predict who is going to be coming in for care.

The idea of flattening the curve is not about ending the virus, it’s about being able to stay ahead of it. It’s about being able to hold steady. It’s about things not getting worse. This is not going away. My light at the end of the tunnel is the idea that we will be able to handle this for as long as the virus is out there.

Read more from Vogue’s coronavirus coverage:

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