Musa Masala began with the idea of a group of medical professionals getting together with a group of climbing and trekking guides to make educational materials to help people stay safe in the outdoors. Today with COVID-19 infecting people around the world we seem to be in the middle of it. Our guides are all out of work with the closure of the spring climbing and trekking season in Nepal and our medical crew find themselves staring into the unknown with a tsunami of illness coming their way.
We will be sharing with you our eyewitness stories from our members who are now doing everything they can to protect the public, while trying not to infect themselves, their families and loved ones. It is exhausting and it is scary. Tatiana Havryliuk is an emergency physician in NYC and one of the founders of Musa Masala. Together with her colleagues she is fighting the pandemic that is spreading through her city. Read on about the challenges they are facing and how you can help. Keep in mind, she wrote this two days ago, the number of infected patients in NYC has doubled since then.
COVID-19: Report from the Frontlines, by Dr. Tatiana Havryliuk
COVID-19 is now rampant in NYC, the city that thrives on social gatherings (nightlife, restaurants, theaters, museums, etc.). Over 15,000 people already tested positive and this is just the beginning. In the last two weeks, my city has slowly turned into a ghost town. Schools, theaters, bars, music venues, museums and gyms are closed. Since March 22nd, all “nonessential” businesses are closed. Restaurants are open for pickup and delivery only, although many are completely shut down. Over 75% of people are working from home, so the subways, buses and train stations are nearly empty. Most grocery stores are missing toilet paper, hand sanitizers and canned and frozen food after frantic apocalypse-inspired shopping that occurred last week.
The good news is that New Yorkers are resilient. And it is NYC after all; you can always find things you need. My corner bodega still somehow has unlimited supply of TP. My favorite restaurants are still open for delivery. People are coming together to help each other with homeschooling, childcare, pet sitting, running errands, etc. Friends are checking in with one another from across the boroughs, the country and the world. Despite the social distancing, more human connections are being made.
From my own experience and accounts from my physician network in NYC, situations in the hospitals have been stressful and very fluid. We have been seeing a spike in patient visits due to COVID-19. Some people are sick, requiring admission to the hospital. Some are being placed on ventilators to help them breathe, while the majority get released back home on self-quarantine. It has been shocking to see younger patients developing acute respiratory distress syndrome (ARDS) and requiring breathing tubes and ventilatory support. We have now seen a few deaths from COVID-19 and are bracing for what’s to come.
Here are some of the biggest challenges we are facing now:
- Lack of isolation rooms in the emergency departments (ED). At baseline, the NYC EDs are cramped. We see huge volumes of patients in curtained-off beds, but more often in the chairs and hallways. Most EDs have 1-2 isolation rooms that are appropriate for patients being tested for COVID-19 who need contact and respiratory isolation. This pandemic has exacerbated the lack of space issue in NYC EDs. Many of us are struggling to create makeshift areas with portable air filters to cohort patients with viral illnesses, thus separating them from other patients to prevent spread of disease. In the cohorted areas, however, patients who have COVID-19 are mixed with patients who are still waiting for COVID-19 results, as only flimsy curtains separate them. This likely leads to inadvertent spread of disease in that group.
- “Boarding” of admitted patients with possible COVID-19 infection in the ED. “Boarding” refers to keeping admitted patients in the ED for extended periods of time due to lack of beds on the inpatient ward. This is an ongoing problem in NYC due to lack of space in the hospitals and also lack of social services for safe discharges. This is becoming more problematic now that we are faced with multiple patients who require isolation being boarded in an ED that is not equipped with proper isolation, thus potentially exposing the staff and other patients to the virus.
- Lack of personal protective equipment (PPE) for staff. There is a worldwide shortage of N95 masks, surgical masks and gowns. In most hospitals, PPE is under lock and key. Many of my physician friends do not have access to even surgical masks while providing care to patients, unless those patients have confirmed COVID-19. (The test can take up to 7 days to result.) The CDC has changed the guidelines from recommending more protective N95 masks and eye shields when taking care of patients with potential COVID-19, to wearing less protective surgical masks. There is an absurd stipulation in the latest document from CDC that bandanas and scarfs might be used as a “last resort.” Due to the shortage of N95 masks, we have been reusing them for days at a time, wearing them way beyond the recommended eight hours. The situation is worrisome, as we cannot afford healthcare providers getting sick in the midst of the pandemic.
- Exposures and sickness among healthcare providers and hospital staff. We are starting to see our colleagues succumb to the disease, likely in part to the above mentioned problems and also due to inadvertent exposures to patients with unrecognized COVID-19 infection. Our nurses, doctors, technologists and clerks are out on self-quarantine, leaving us with a skeleton crew. Many of us know someone who knows a healthcare professional who is in critical condition due to COVID-19. We are all a bit scared for the health of our colleagues and for our own. We also know that now more than ever we need to stay tough.
Things you can do help
- Stay at home! Social distancing is proven to work to stop the spread of disease. Even if you have no symptoms, you might still be a carrier of COVID-19 and can unknowingly spread it to others who might become critically ill from the virus.
- If you have flu-like symptoms—fever, mild shortness of breath and/or cough—DO NOT go to the hospital to get tested. Assume you have COVID-19 and self-isolate for two weeks. Only if you have more severe symptoms, seek medical care.
- Donate masks, gloves and gowns to hospitals. There is a critical shortage of PPE and healthcare workers on the frontlines need it most. You can also donate money for masks for NYC hospitals here.
- Use only legitimate sources to learn about COVID-19, such as cdc.gov and who.int. There is a lot of misinformation out there. (No, garlic is not going to eradicate COVID-19.)
- Volunteer to help seniors and those in need. Make sure you stay the recommended six-feet away if in-person interaction is required.
- Avoid any travel, including domestic and international. Given the low ticket prices, it is tempting to get on a flight these days. But it is not worth it if you might spread the disease to others or are not be able to return due to lockdown. Buy your tickets now to travel safely in the future, after the pandemic is resolved.
Stay safe and healthy out there!