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COVID Crisis Post 11: This is Fucking Scary.



This is so depressing.

I will be working overnight from 7pm-7am on the COVID-19 ICU floors, functioning as an ICU attending for those patients. I volunteered for this role, and many of my colleagues have also volunteered for various roles, of taking care of the sickest patients in our hospital.

Please, wish us luck.

I'm getting this post out early because I'm sure I will be working nonstop and will need to be putting 100% of my focus on my patients and keeping myself safe.

I would be lying if I said I wasn't a bit anxious about it all.

Things just keep looking bleaker and bleaker, and the more I read and experience, the more depressing all of this gets.

Makeshift morgues are being built around the city outside of hospitals consisting of tents and refrigerated truck trailers to store the dead bodies of COVID-19 patients because hospitals just won't have enough space to store them. And many of the dead will not be able to have the type of funeral service they deserve.

Just typing that made me nauseous. What the fuck.

Many of the sickest patients in the city's hospitals, with the majority in the ICU, are slowly dying with some inevitably going into cardiac arrest. And do you want to know what the early data shows on resuscitation of those patients who do go into cardiac arrest?

Pretty much none of those patients survive. And those healthcare workers charged to take care of these patients are massively at risk of exposure should they attempt resuscitation. This is real: multiple hospitals around the country are looking into enacting protocols where ALL patients who are COVID-19+ are DNR (do not resuscitate) - overruling the wishes of a family who want everything possible to be done to save their loved one.

We need to put the safety of many over the life of one.

This shouldn't be happening here, in the US. This is insane. But with limitations on PPE to keep healthcare workers as safe and healthy as possible and people STILL NOT PRACTICING SOCIAL DISTANCING, it logically makes sense. But logic doesn't eliminate the nauseating feeling I get from all of this.

Most of these patients don't die immediately. Their health usually declines over many days. This gives the caring physician and team time to discuss the grim situation with family members so they can CHOOSE to make their family member DNR, where they get to make that choice and be at peace with it.

Versus the hospitals making that choice because, well, they no longer feel they have any other choice.

We CANNOT just rush in to help these patients should their heart stop like we normally would do, as we all have done multiple times in the past. We need to ensure we are wearing full PPE before we enter. We CANNOT risk a group of us getting sick to try and resuscitate someone who has almost no chance of being resuscitated.

Our safety HAS to take priority because we CANNOT afford to get sick and risk our lives and the lives of our future patients as a result.

It's clear our State, and especially here in NYC, needs a shit ton of help.

We are in desperate need for reinforcements as I mentioned a couple of days ago. Some hospitals are more fortunate than others in terms of resources. Some, as shown in this video, are not so fortunate and its sickening: https://vp.nyt.com/…/85711_1_dispatch-elmhurst_…/master.m3u8

We are short on so many resources, healthcare workers being a big one. But fortunately, so many of you have heeded the call to arms.

Yesterday, Governor Cuomo stated he had received 40k (!!!) healthcare volunteers, some retired, some furloughed, for New York's Surge Healthcare Force, ranging from physicians to CRNAs to NPs to PAs to RNs to many others, PLUS 6k (!!!) mental health professionals who would all work for free to assist us during this crisis.

And NYU received 69 volunteers from their medical school who chose to graduate early and join the front lines. I implore ALL of my healthcare colleagues to help protect these babies whose first role as newly-minted doctors is literally jumping into the fire and potentially risking their lives.

Idealism is clearly not dead in medicine.

We need to make sure we protect ALL of these volunteers. We need to ensure they are all getting adequate PPE. We also need other resources, such as vents and more hospital beds, to ensure we can maximally utilize this extra workforce.

PLEASE EVERYONE: if you have any way of procuring PPE, PLEASE SEND THEM TO US. And to all of you who have contributed in some way to help us during this crisis, I'm sure I speak for EVERYONE working here in New York when I say:

Thank you. And please pray for us.

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