[VIDEO INTERVIEW] COVID-19: Conversations from the Front Lines: Doctor in NYC


Students:
as you train to be future doctors and healthcare workers, we thought you might like to know what it’s like working as a doctor on the front lines of COVID-19. In a personal interview between Marlee Liberman, RN and a doctor in NY, we explore what it looks like inside the hospitals during this pandemic. We are so proud of the doctors, nurses, health care professionals, and support workers at this time, as well as the students who are preparing so hard to get into the field.

Note this interview was recorded March 25, 2020 and will give you a glimpse of what it was like on the front lines in the early weeks of the pandemic. For the latest news from New York and other areas hard hit across the country, please check your local news sources.

What’s in this interview:

0:55 when is the next big COVID-19 surge expected
1:47 young people and their virus risk
2:30 asymptomatic issues (loss of smell and taste?)
3:09 Mild symptoms and what to look for
4:21 Are doctors scared?
5:08 Doctors, self-quarantine and contact with the outside world
6:05 Cruise ship study about building immunity
7:00 Understanding 2nd and 3rd waves of the virus
8:57 Conflicting social restrictions in different areas
10:00 Is panic pushing people into the hospitals?
11:10 Mental health and social isolation
12:21 Myths about the coronavirus
13:07 Hoarding unproven drugs and the risks
14:13 What everyone can do to help your healthcare providers

Doctor:
Yeah, ICUs are all full and the floors are starting to fill up. New York City’s getting hit a little bit worse this week.

Marlee:
Yeah. Yeah. How has it been, in the progression of everything that’s been happening, how has this week and last week compared to the last couple of months?

Doctor:
So the area I’m in was much worse four weeks ago, but it’s leveled out in the last week. But, we anticipate another big surge coming in in the next 10 days.

Marlee:
How come? Why is that?

Doctor:
Because full restrictions really haven’t been followed, and we think people have been moving around a little bit and spreading it. And it usually takes about 10 to 14 days for people to get sick enough where they will go to the ER and that’s going to happen right around next week (first week of April) for us.

Marlee:
What was surprising for you with this whole thing? Was anything shocking? Because I know there’s a lot of thinking misinformation is out there about what this actually is. Because I remember when this was first, when we first started seeing it, it was a lot of like, “Oh, it’s just kind of like a bad flu,” or “Young people can’t get it really bad.”

Doctor:
That one, that one, that last one. Well, young people do fine. I think they’re death rate is pretty low. But they do get quite sick. They do get in the hospital. They do end up in the ICU. They do end up on the ventilator. But young people that also have high viral load exposure, like healthcare professionals or a principal died in Brooklyn who was 36. And I think she was probably around lots of kids and lots of people. So when you’re exposed repeatedly, and I think as a young person you socialize more, so you’re just around more people that might be infected. So that may be why young people have worse outcomes or are getting sick.

Marlee:
And what about the asymptomatic people? When people say, “Oh, some people are asymptomatic and they have it,” what does that mean?

Doctor:
That means you have it, are not feeling bad at all, think you feel great, and are walking around infecting everyone around you.

Marlee:
Does it eventually hit you, or can some people just be carriers of it and just continually not have any symptoms the whole time?

Doctor:
Both. So a lot of people that don’t have classic symptoms, one symptom they have talked about a lot is a loss of smell and taste.

Marlee:
Oh, wow.

Doctor:
Yeah.

Marlee:
Okay. And what are some milder symptoms that people might be thinking, “Oh, this is just allergies,” or “I’m just tired or something.”

Doctor:
Runny nose. Some people have a postnasal drip when they wake up in the morning, and the back of the throat is a bit sore. Sore throat, a little bit of a cough. Every time I cough now I panic.

Marlee:
Wow, wow. How are you guys protecting yourselves? Because now we’re saying that there’s so many things about not having enough PPE and not everyone is … we’re going to be running out of equipment for the healthcare providers.

Doctor:
I think that’ll happen. It’s happening in some cases, especially city hospitals and places that are not well funded. My department is really good. They’ve been taking care of us. They’ve been stocking-up in advance. So we’re doing much better, I think, compared to the average hospital. But even that, I think, will drop off as the real … because most people are expecting the peak in New York City to be in two weeks, and it’s already really bad. So I think in the next two weeks supplies will really dwindle. I’ve bought myself two full-on gas masks, basically, just in case, because if supplies run out, I want to protect myself.

Marlee:
Yeah. How does it feel going to work every day? Are you scared? Are you stressed? What’s going on in your world as you’re walking into the hospital every day?

Doctor:
I’m pretty scared when I walk in, but then I just tell myself to not think about it. Because if you think about it and you just realize that you’re in a building full of people that have this, and that it (the virus) can survive up to three days. And then you realize the entire building probably is covered in it. The elevator’s probably covered in it. Everything is covered in it. So what’s the point of even wearing gloves and masks, but then you can just wallow in a hole of anxiety, which is not productive either. So I just… wear my mask, wash my hands, and that’s really all I can do.

Marlee:
And then when you go home, are you around people? Are you around your family?

Doctor:
No, thankfully I live alone. But even then, I’ve cut off physical contact with my family because I don’t want to get my mom or dad sick. They’re older. They’re high risk for a bad outcome. So I told my mom, “Don’t expect to see me, maybe until summer.”

Marlee:
Wow. How long do you think, I know that obviously it’s really hard to predict with this, but how long do you think, based on what you’re saying, how long do you think this is going to be happening to this extent?

Doctor:
That’s a tough question. There’s a lot of variables at play. I think the ultimate thing we’re waiting on is a vaccine or antiviral treatment. Whenever that comes, that’ll be the real drop. In between, I think we’re going to have little waves. But then this new data came out in the last 48 hours where they did a study of the cruise ship in Japan that was anchored off for a month while they tested everyone. And it’s a really good experiment, because basically a cruise ship is a closed system. No one leaves and no one goes out or in.

Doctor:
And what they found, which was really interesting, I’ll just cut through all the numbers, but there’s a strong suggestion that a lot of people that were asymptomatic develop immunity really fast on the cruise ship. Which is good, because what that means is if you were to open up the cruise ship and let more people in with infections, they wouldn’t reinfect everyone in the cruise ship. They’d only affect a few people. The rest of the people would be immune. If that holds for society at large, I think, I’m really hoping that holds true, but what that will mean is the second and third waves won’t be that bad.

Marlee:
And what do you mean by … Can you talk a little bit about the second and third wave, for people that don’t understand what that means? What is the whole idea around it?

Doctor:
So basically, they’re locking everyone down in Tel Aviv. So no one will get the disease, but then the disease doesn’t go away. It’s still in some people, in some pockets, you don’t really know. And in the moment they let you back on the subway again, the few people that are still carrying will infect other people. But those people were never infected in the first place because they were home. So they never developed immunity.

Doctor:
So those people will get sick again. And then there’ll be a massive spike in cases. And then the authorities and Tel Aviv will have to shut everyone down again. And then everyone will go back home and try to preserve it for the health system. And then a few weeks later we’ll come back out, only to repeat this cycle. And the problem with that is that you have repeated waves of infection because no one’s developing immunity. And I think in rich societies like America, Israel, and Northern Europe, the authorities can afford to pay people and help them survive the economic damage of going home over and over again. But in other countries, you’re not going to have that.

Doctor:
So I think that’s going to be a huge test for the next two months, worldwide is what do you do with these people? So I think they might just let it go and let people develop immunity and pay the price. I think that’s an approach that some countries will take, so I don’t know.

Marlee:
And with you guys, I know it’s interesting because with us we’re a small country. Everyone is following the regulations and the rules and everything. And they know with the States, every state is kind of taking a different approach to it. Everyone is at different levels. When I look at my family in the Southwest, they’re kind of at the stage where we were three weeks ago. And even then, people aren’t really taking it seriously. So I know every state is different. How are you feeling about that? I guess, what’s your opinion on that? What do you feel the restrictions are versus what people are listening to, what needs to be happening, that kind of thing?

Doctor:
Yeah, I think that’s a major problem. I think it’s going to reflect pretty poorly on the American political system, especially compared to something pretty unified like China. Because if you shut down New York, and then everyone in Florida is still partying on the beach at spring break, then it really doesn’t matter if you shut down New York because it’ll come back. I think that’s going to be an evolving challenge.

Doctor:
But I guess the good news is that if it hits New York first, we will be the first to develop immunity, so hopefully it doesn’t come back. But if the virus mutates, which it has a high chance of doing, then maybe all bets are off. So there’s lots of variables, and people really have to just pay attention. But there’s politics involved. Different groups have different agendas as far as activity, economics versus public health, how much you want to spend. So it becomes kind of a complex issue.

Marlee:
Yeah, definitely.

Doctor:
It’s tough.

Marlee:
Yeah. I think there’s probably so much panic there now, are people coming in with milder symptoms, and are you able to look at those people versus the people that are in really, really critical condition?

Doctor:
I’m not in the ER, so I can’t answer that. But what I do know is that they literally have a giant room, like an entire center, just for if they think you have COVID-19. So I think anyone who has a cough and a fever just goes there. Whether you have the flu or seasonal allergies or something, you just go to this room.

Doctor:
Doctor:
I know they’re setting up massive centers just to send overflow, like the Jacob Javits Center in New York City. They’re just going to send everyone in New York who doesn’t have COVID, to the center to free up beds in the other hospitals for COVID.

Marlee:
Okay. How are you, and again this is just an opinion question, but because of everything that’s happening, not only because of the panic but also social isolation and just a change from people’s normal routines to completely a different world that we live in now, how are you thinking that this is going to play out with mental health and that kind of area that people might be suffering from; either complete panic or suicidal ideation or just loneliness? Where do you think this is going to come into play?

Doctor:
I think that’s a pretty silent epidemic that no one’s paying attention to. There’s going to be a lot of people that aren’t going to be able to leave their apartment to get their psych meds. I think loneliness and anxiety and depression are going to be massive. Not many people that live alone are going to be okay with this for weeks on end.

Doctor:
On top of that, there’s substance abuse issues. That’s actually why all states, in every news conference, whenever they say stuff is shut down, they always say the liquor stores are open. Because if the stores are closed, all the alcoholics are going to go into withdrawal, and a lot of them will die from that. So you actually can’t shut down the liquor stores. So all that stuff, I think, will start really showing up in the next week or so. But people, I don’t think, will take it seriously because everyone is afraid of the plague that’s going around. So it’ll be interesting to see how seriously that gets taken.

Marlee:
Yeah, okay. Are there any other myths that you’re hearing around this, that you’re hoping that people will just stop spreading? Or things that you’re seeing that you’d like to tell people that pay attention to?

Doctor:
I would definitely say social distancing does not mean that you go out to a park and sit six feet away from each other. It means you don’t go out of the apartment. And if you are at a store picking up food or drugs, then you stay six feet away. But you don’t have a party and pretend to stay six feet away, because that defeats the purpose. I’ve seen picnics of people where they are sitting three feet away and they’re like, “Oh, this is like six feet.” I’m like, “No, it’s not. This doesn’t count.”

Doctor:
And then the other thing is to avoid hoarding any of these drugs that are hitting the news. I think some politicians have been touting them as cures, for whatever reasons, and none of them are proven. The trials are … the data is pretty weak, and all these drugs have side effects. A lot of them cause heart arrhythmias. And there’s been reports of people taking them to prevent getting Corona and dying of heart problems.

Marlee:
Oh, my God. I know. I saw something about a fish tank additive or something like that.

Doctor:
Yeah, yeah. There’s so much stuff out there. And there’s one medication, which a lot of people with autoimmune diseases like arthritis or lupus use called Plaquenil, and it’s been getting hoarded in the last week. And now people with lupus don’t have meds for their treatment because other people are hoarding, hoping to use it. So this is like toilet paper but on another level, because you can cause actual harm to yourself if you take these drugs without a doctor’s prescription. And you’re going to cut off other people that have to be using this drug as well. We’re starting to see a lot of that in pharmacies that are starting to cut down. But that’s, I think, the new thing that’s starting to sweep that we’re really starting to get worried about.

Marlee:
What are some things that people can do to help you guys who are on the front lines, like healthcare providers? What is something that any of us can do to help?

Doctor:
Stay home. Don’t hoard, because I think hoarding is the ultimate problem because everyone’s going through a tough time, and then people that need food aren’t getting their food. People that need TP aren’t getting TP. People that need meds aren’t getting meds. And that’s going to cause social problems, and then long-term, that’ll get in the way of distributing other stuff. So I think just being orderly and staying home. We have enough stuff in countries like mine and yours to go around, and it’ll go around.

Doctor:
At the end of the day, the data says you likely will not die and you likely will not get it. You just have to keep that in mind. The odds of you getting it and getting sick are, those are the hard odds. And if you do get sick, we live in two countries which have good treatment, so we can have faith in that. It’s better than being someplace else. So there’s lots of things to look for that are positive. A lot of scary stuff out there, which is true, but there’s reasons not to lose hope.

Marlee:
That’s great. Awesome. Thank you so much. We really, really appreciate you talking with us.

Doctor:
Of course. Hope you guys stay healthy over there.

Marlee Liberman

Marlee Liberman, RN, Master Nursing Scholar

As a registered nurse, Marlee understands the struggles that nursing school throws at you – not to mention the overwhelming pressure preparing for the NCLEX®! Marlee brings a unique skill set and perspective to Picmonic with her previous degree in broadcast journalism, her creativity in video production, and her wandering nomad lifestyle. Her blend of talents provides her with the knack for simplifying complicated concepts and demystifying the world of nursing.

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