While not confined to her home, the feeling of isolation is still very real to this intensive care doctor.
After a 12-hour shift in a Queens hospital without enough beds to treat the crush of patients the facility is seeing because of the COVID-19 crisis, she comes home to an empty apartment. She doesn’t have to worry about infecting her husband or son — they are based on the West Coast.
Her duties at the hospital are done. No one is asking her to decide whether to intubate a patient. There are no families asking about their loved ones. There are no death certificates to sign.
When she’s alone, it all comes out.
Tears and frustrations. Images of those that have passed away. The crushing reality of the crisis, not only at her hospital, but throughout the city and the world.
“At the hospital, I’m so busy,” the doctor said during a phone interview on Thursday, her first day off for almost a week. She did not want to be identified, or name the hospital where she works as not to compromise herself, colleagues or patients. “I don’t have time to think. I just have time to work to save lives.”
In tears, she struggled to continue.
“When I come home to rest, I cannot control myself. I start to think about what’s going on,” the doctor said. “I’m so tired. It’s so hard and I’m so overwhelmed.”
‘We have no choice’
Health-care workers throughout the city are battling the worst public health crisis in a century.
Worldwide cases of the coronavirus topped 1 million this week, with close to 55,000 fatalities, MarketWatch reported Friday. The U.S. alone has reported close to 250,000 cases and more than 6,000 deaths.
The virus had claimed 2,935 lives in New York state as of Friday afternoon, according to Gov. Andrew Cuomo. That’s up from 2,373 reported on Thursday, the highest increase in a 24-hour period since the crisis began.
Overall, 102,863 cases have been reported in the state, according to Cuomo. New York City residents account for more than 57,000 of the cases.
There have been more than 1,500 deaths as of Thursday evening, according to city data. Queens has the highest number of sick individuals, with 16,819 confirmed cases. Brooklyn has 13,290, the second-highest number, and there are 9,343 confirmed cases in the Bronx, 7,398 in Manhattan, and 2,822 in Staten Island.
The Queens doctor, who has been practicing for three years, said she followed the outbreak in Wuhan, China, earlier this year, reading about patients collapsing and dying in line while waiting for care. When the first cases were confirmed at her hospital in mid-March, she thought she had some idea of what lay ahead.
But the experience has been harrowing, and there’s no end in sight. She said she and her colleagues cannot keep up with the onslaught of COVID-19 patients arriving daily.
The hospital is creating a third intensive care unit, which should be open by the beginning of next week. But it’s not enough.
“We still cannot provide for all the patients coming,” she said.
About a third of patients are being transferred to other area hospitals because of the lack of space, she said.
“The Queens population is huge,” she explained. “And we haven’t reached the peak yet; we’re still climbing. I don’t know when we’re going to reach it.”
The borough is also extremely densely populated, the doctor added, which can increase the speed of the virus’ spread.
“It’s not like Long Island or California or Texas where there’s more space,” she noted. “And you’ll see in apartments a lot of elderly people.”
That means hard conversations.
“We have to push the palliative care team to talk to families and find out their goals,” she said. “That may be do not resuscitate or do not intubate.”
Although her hospital does have enough ventilators for the time being, patients who end up in the ICU are intubated for an average of 14 days. Such a slow turnover of beds adds to the space issues.
Doctors have to look at a patient’s likelihood of survival as they consider treatment.
“We have no choice,” the doctor said, her voice breaking. “We have so many young patients, and we have to save lives.”
One of the challenges of the virus is the many ways symptoms manifest.
Patients can present with flu-like symptoms, as well as gastrointestinal complaints or neurological issues that resemble a stroke or seizure.
“Then after five days or a week, they go into respiratory distress and can’t breathe,” she said. “It’s all a challenge…it affects patients from top to bottom. All the organs.”
Initially, doctors did not realize the array of ways the virus could present, so were not always treating patients correctly. Now, doctors understand these conditions could be COVID related.
Nurses in the ICU are treating three or four patients each, up from one or two on a normal shift. These patients need constant attention. Nurses monitor ventilators, administer medications, check vital signs and more to keep patients alive.
“I can’t imagine them taking any more,” the doctor said.
She said the ICU has developed a treatment protocol that includes a combination of drugs and supplements that boost immunity, such as vitamin C, zinc and thiamine, or vitamin B₁.
But the science is still evolving, the doctor noted, with new treatments being developed around the world.
“We still don’t know the full picture of this virus,” she said.
A dedicated team
At work, the young doctor tries to stay positive.
“I don’t want to be negative with my colleagues,” she explained. “I try to smile and not give in to the pressure.”
They don’t talk about what’s happening, she added. They don’t have time. She keeps it from her family, as well. She doesn’t want them to worry.
Also, she needs the break.
“When I FaceTime with them, I am very relaxed,” she said. “We just talk about what they are doing.”
But she has difficulty sleeping.
“All the images come to my brain, and I start to think about what I saw at the hospital,” she said.
The outlook is grim for the next month, she said.
“I want things to get better and better, but I haven’t seen that yet,” the doctor explained. “April will be the worst month. At the end of April, things will start to get better. In May, things will be a lot better, I hope.”
In the meantime, she and her colleagues remain dedicated, even though they are overwhelmed.
She said: “All the doctors, physician’s assistants and nurses are a team. We are not giving up.”
Health-care providers willing to share their stories should write to pete.catapano@dowjones.com