Pandemic Reflections

‘It Won’t Be Okay for a While’ — Reflecting on a Year of Covid-19

I’m an ER doctor treating Covid-19 in New York City. This is what I wish I knew a year ago.

In New York City, the first case of Covid-19 was confirmed on March 1, 2020. Today, on the one year anniversary, I wrote myself a letter. This is what I wish I could have told myself at the start of the pandemic.

Get ready. Sleep more. Spend extra time with the family. Cherish every minute. Things are about to get weird. It won’t be okay for a while.

As a doctor in the emergency room, the next year will test every part of you. This pandemic will strip your energy. It will eat away time from your family. Make you afraid when you come home and your toddler runs toward you before you shower the virus away. You won’t see your friends. Some of your colleagues will die, casualties of the virus they fought against.

I know right now you think you’re ready. Yeah, you’ve done similar things before. Don’t let that fool you.

You saw people die every day in the Ebola treatment center in West Africa and survived a 19-day battle with the disease yourself. You made it through that; you’ll make it through this.

The images out of China are scary and unsettling—health care workers getting infected and dying. The quarantines in Italy are undoubtedly jarring as well. The coming weeks will only be worse. You’ll see pictures from Iran, bodies piling up. This virus doesn’t play. Learn everything you can. Be prepared.

On February 29, 2020, Seattle reports the first Covid-19 death in the U.S. The next day, March 1, the first confirmed Covid-19 case in New York City is announced. You’ve been waiting. Later you’ll learn there were already thousands of cases circulating undetected.

You’re about to get hit with a tidal wave of patients. They won’t stop streaming in, each one sicker than the last. So take a minute now and breathe.

You’ll see your first Covid patient in just a few days. He’ll be the only Covid patient in your emergency room.

In a few weeks, Covid will have consumed every one of your patients.

Even though you felt the onslaught coming, its swiftness will surprise you. One shift and it will change completely. Every patient will be the same. Cough, fever, shortness of breath. Can’t breathe.

You’ve never seen a patient with an oxygen saturation so low and still conscious. Right away you’ll recognize that this disease is very different.

In the chaos, don’t forget to stop and drink water. I know you won’t feel comfortable taking off the mask, but you should. Remember the cramps after an hour in the hot mask and gown treating Ebola patients in Guinea? It’s like that. So step out, take off your mask, and drink up.

You’ll learn a lot in those first few days. Coughing comes from everywhere. You won’t know how to best help them. No matter what you do, so many will die.

Treatment protocols will change by the hour. Check in with friends around the city. What are they doing? Try to act faster than the virus can move.

At first, you may think Covid is the great equalizer. You’ll see it take down and humble so many. But as time wears on, it will become clearer: The impact of this pandemic will fall disproportionately on communities of color.

One day, more of your patients will die in a shift than they ever did during Ebola in West Africa. You’ll feel helpless. Please keep going.

The next day, you’ll walk through the doors of the ambulance bay, the ER spread out in front of you. All you see is the apocalypse. Everyone on a breathing machine. Monitors are the only sound you hear, so many monitors, all running their own rhythm.

You’ll see a woman, struggling to breathe and gasping for oxygen, watching as her mom dies across the ER.

A man is brought in, short of breath. You’ll get his wife on FaceTime. This is the last time they’ll talk. Ever. You will have seen this enough to know that by now. You hold the phone up to his face. You hold his hand.

You’ll keep wondering when the onslaught ends. A few more weeks? Or months? Your colleagues will call you crying. You’ll watch your friends struggle to breathe in the same spaces that seem haunted by now.

A year later, and you will still see the faces and hear the sobs of family members. Those that couldn’t come into the treatment area with their dad. Those that are at home, powerless, confused, and scared. The phone will drop from their hands. There is no closure over a cellular connection.

You will see your colleagues do amazing things. Every day. The drive, the commitment, the courage. It wears on them, their faces bruised and blistered. Their souls are heavy with sadness. But every day they come to work, suit up, walk in, and transcend the chaos.

At some point, the wave will ebb. You will feel it. And when the virus moves on, a city stunned, saddened, and broken will be left in its wake.

You’ll try to warn people and politicians in the rest of the country, but so many won’t listen. Just like New York didn’t listen. Sometimes we only learn when we learn the hard way. Pandemics are like that.

It will be different a year from now. There will be a reason for hope. And your whole family will still be here. You are lucky. Continue to be grateful, every day. There are more than half a million empty chairs in houses all across this country.

Before the year is out, you’ll be vaccinated against the disease that demanded so much of your life. When you go to work a year from now, you’ll still treat really sick Covid-19 patients. But you won’t fear becoming one yourself.

That may not sound like much. But trust me, after the year you’ll have, you can’t imagine how comforting that will be.

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

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store