I Don’t Miss Covid

It’s been a long time since I saw a Covid patient in the ER, and I couldn’t be happier

I’m an emergency room doctor in New York City, and I haven’t seen a Covid-19 patient in weeks. It feels great having my old job back.

In March 2020, Covid flooded our ERs. At first, it was just a dribble — one or two Covid patients per day. But within a week, the virus had taken over every body in every bed. Every shift in the emergency room brought an endless stream of patients, one after another, all struggling to breathe and in desperate need of oxygen.

The swiftness of Covid’s arrival in our emergency rooms took us by surprise even though we knew it was coming. On the front lines, we watched the virus take our patients, uncertain at first how to best treat this new disease. And once it found its way into our hospitals, Covid infected our friends and colleagues, taking many of them from us forever.

Covid permanently scarred a generation of health care workers. That’s why I’m so ecstatic to see it go.

Our job in the emergency room feels just like it used to for the first time since the virus surged into our hospitals.

I haven’t seen a Covid patient in my last five shifts in the emergency room. Not one person struggling to breathe because of this virus. Not one person coughing incessantly or needing immediate stabilization, high-flow oxygen, and intensive care.

This is the way it’s supposed to be. This is exactly how I like it.

To be honest, our job wasn’t easy before the pandemic. Working in the ER has always been stressful. We see sick patients every shift. And sadly, we sometimes see our patients die. But the onslaught of Covid brought a different kind of heart-wrenching chaos.

My last shift in the ER was extremely busy. I started the day by pulling a large winged insect out of someone’s ear (to the patient’s immense relief). I ended the day treating a young man who had been thrown from his motorcycle.

Throughout my shift, I saw a wide range of ailments: knee and ankle sprains, a pregnant woman with a migraine, an elderly lady who couldn’t urinate, quite a few people with abdominal pain and vomiting, an elderly man worried he might have a sexually transmitted infection, a woman with facial cellulitis, and a young guy with a kidney stone writhing in pain.

But I saw exactly zero Covid patients. And I couldn’t be happier about that.

When the pandemic first hit, many of our “regular” patients stayed away from the emergency room, fearful they might contract Covid while seeking care. As a result, ER visits dropped 42% in April 2020 compared to the same period a year prior. Emergency visits remained low throughout the pandemic, leaving my colleagues to worry that patients were delaying emergency care. But the Covid vaccine rollout is hopefully changing that.

With over 300 million doses administered in the U.S., more than half the eligible U.S. population is fully vaccinated against Covid. As a result, cases have plunged dramatically all across the country. We now average under 14,000 new cases a day, the lowest toll since the early days of the pandemic. Covid hospitalizations and deaths have dropped as well. Our job in the emergency room feels just like it used to for the first time since the virus surged into our hospitals.

We know Covid isn’t over, of course. Globally the pandemic still rages, largely due to vaccine hoarding by wealthy countries. And even here in New York City, I’ll likely see another Covid case soon. But it will almost certainly be a mild one. And when I do see a severe case, I’m far better prepared to treat it given how much my colleagues and I learned about the virus in the past year.

Covid will reemerge this fall and winter, that’s for sure. When it does, it will likely overwhelmingly impact the unvaccinated.

But unlike the outset of the pandemic when our emergency rooms treated almost exclusively Covid patients, future Covid cases will be mixed in with what ERs are used to managing: abdominal pains, heart attacks, and strokes. And Covid won’t ever take over our ERs again like it did. When front-line providers like myself see this virus again, we’ll have the benefit of being vaccinated against it, a luxury we didn’t have when we first crossed paths last year.

Early in the pandemic, I took to Twitter to describe what a “normal” day on the Covid front lines looked like. I didn’t realize how desperate many were for any information about this new and rapidly spreading disease. What I hastily wrote after a long shift in the ER immediately went viral, was shared by President Barack Obama on Twitter and became an award-winning animated video that’s been viewed over 25 million times. It touched a nerve because people wanted to know what was happening as Covid took over the emergency rooms of America.

If I documented the ins and outs of my regular ER shifts today, it wouldn’t generate anywhere close to the same interest or views. Abdominal pain, knee sprains, and migraines just aren’t as interesting or mysterious as Covid.

And that’s great. This is exactly how we like it.

NYC ER doctor | Ebola Survivor | Director of Global Health in Emergency Medicine at Columbia University | Public Health Professor | Doctors Without Borders BoD

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