ER doctor | Ebola Survivor | Public Health & Humanitarian Response | Historical Foundations of Public Health Policy & Practice
@Brown_SPH
| Emmy Award Winner 🏆
As COVID19 surges across the US, it’s hard to describe the situation inside hospitals for healthcare providers & patients.
We made this video depicting 1 day in the ER to show the painful reality & to remind us why we must remain vigilant. Please watch.
As an ER doc, I can 100% tell you that after cardiac arrest, CPR and defibrillation (AED), there is no way any provider will say Damar Hamlin is ‘okay’ anytime soon.
Cancel the game
@NFL
. Let people be together.
Thank you everyone for your incredible messages of support and encouragement.♥️
Many of you asked what it was like in the ER right now. I want to share a bit with you. Please RT:
A Day in the Life of an ER Doc - A Brief Dispatch from the
#COVID19
Frontline:
Finally home after 13 hours in the ER. Today >90% of my patients were confirmed or likely
#COVID19
. Many really sick, some in their 30s like me. The sirens on otherwise empty NYC streets are unending & haunting. I’m tired. But really honored to be back in the ER in the morning.
Instead of praise or special ceremonies or free tickets, healthcare workers would actually just prefer if y’all stopped hosting superspreader events that gave us more work.
A vaccine won’t help any of the patients with COVID19 in my ER right now. It won’t help those that’ll come tomorrow either. Or the day after.
The pandemic is worsening everyday. What’ll get us through the next few months is vigilance. And masks. And distancing. And patience.
You might hear people saying it isn't real. It is.
You might hear people saying it isn't bad. It is.
You might hear people saying it can't take you down. It can.
I survived Ebola. I fear
#COVID
ー19.
Do your part. Stay home. Stay safe.
And every day I'll come to work for you
Just worked 12 hours in the ER on a busy Monday and didn’t have a single Covid patient. Not one.
This ain’t over. But it’s a helluva lot better than even just a few weeks ago.
I just left an ER shift, and it hit me.
Healthcare providers will be respected for tirelessly working to save lives, not accused of falsifying diagnoses or profiteering off a horrible pandemic.
We will have a partner working with us, not against us.
It already feels so good.
More Americans died of COVID19 today than died on 9/11.
After that horrendous attack, we restructured our way of life & accepted limits on our freedoms to combat the threat of terrorism.
9/11 was one day. COVID is everyday.
Be a patriot. Wear a mask. Help us end this pandemic.
Dear
@realDonaldTrump
,
I know you’re preoccupied with overturning the election, but I’m just leaving the ER and wanted to remind you there’s a worsening pandemic out here and we’d appreciate some assistance or if you’d hand this off to the incoming team that’d be great.
Thanks.
You know why we intubated people for Covid in March 2020?
Because otherwise they were going to die. Full. Stop.
I remember a patient rolling in with an oxygen saturation of 42%, breathing twice as fast as normal,struggling on a face mask with oxygen all the way up.
What to do?
If you think cable news anchors staying up a few nights in a row during an election is selfless and amazing, wait til you find out what night shift nurses do.
If you could see a
#COVID19
patient struggling to breathe like we do in the ER, you’d immediately understand why we’re so worried and why it’s safest to cancel your in-person family meetups over the holidays.
Next year will be safer and we’d like all of you to be there for it.
For everyone dismissing
#COVID19
as “just the flu” or dismissively saying “99.99% survive”, tell me the last time we stationed freezer trucks outside hospitals all over the country to serve as overflow morgues.
I’ve seen a lot of Covid in the ER recently.
With so many people getting infected recently, some folks may wonder what’s the point of getting vaccinated at all?
And is there really any value to a booster dose if I’ve had two Pfizer/Moderna or a shot of J&J?
My observations: 🧵
Tomorrow I’ll get vaccinated against
#COVID19
! You know what I’m gonna do right after?
I’m gonna wear a mask, always. I’ll take the exact same precautions that have kept me safe for months in the ER & in public. Im going to act as if Im not vaccinated. But will be grateful I am.
Questions for Trump’s medical team:
1. When was last negative test?
2. What labs were abnormal?
3. Does he have COVID pneumonia?
4. Is he on antibiotics?
5. Mental status exam results?
6. Fever? If not, what antipyretic is he on and how often?
7. Did you sign off on the joyride?
When I wrote these words, I didn’t know if anyone would read them. I certainly didn’t think this would happen.
I wrote them for my patients, my colleagues & myself.
Please watch this. Please share this.
This has been our reality. We can’t go back here.
Today I was promoted to Associate Professor at Columbia University’s medical and public health schools.
I’m guessing it doesn’t mean much to people outside academia, and frankly I’m not exactly sure how it changes things, but it’s just real nice to have any good news in 2020!
@USATODAY
reporters are working to identify every single person in a photo of the White House Rose Garden event where many were exposed to COVID-19:
Can you help? Get in touch using this form:
Today I was asked to pick up our son early because of another exposure at daycare.
Tonight I just walked by a bar with dozens of unmasked people and a large live band in a tiny tiny space.
We need to get our damn priorities straight.
We were too late to stop this virus. Full stop. But we can slow it's spread. The virus can't infect those it never meets. Stay inside. Social distancing is the only thing that will save us now. I don't care as much about the economic impact as I do about our ability to save lives
Hi Chuck, ER doc here,
We’re not lying. It’s actually really horrible to see people die from COVID19.
And it’s not about the election. It’s actually still about the dying thing. And it’s preventable.
ps the economy only comes back when we manage COVID.
pss I’m also sick of it
The most outrageous lies are the ones about Covid 19. Everyone is lying. The CDC, Media, Democrats, our Doctors, not all but most ,that we are told to trust. I think it's all about the election and keeping the economy from coming back, which is about the election. I'm sick of it.
There's really no way to describe what we're seeing.
Our new reality is unreal.
The people and places we've known so long & so well have been transformed.
Our ERs are ICUs.
Everything looks, sounds and feels different.
Just one week and it's a whole different world.
THREAD
Leaving a tough shift in the ER. I’ve had to do it many times before, but it’s impossible to describe how sad and horrible it feels to tell someone their son has died. Or to hear his young daughter across the country, wailing, as you standby, feeling helpless. Hold em close.
So no matter your political affiliation, or thoughts on masks, or where you live in this country, as an ER doctor you’d trust with your life if you rolled into my emergency room at 3am, I promise you that you’d rather face the oncoming Omicron wave vaccinated.
Please be safe. ❤️
I’m spending Thanksgiving indoors with a lot of new people!!!
Because I’ll be working in the ER.
Even then - with PPE and COVID testing - the risk won’t be zero.
If you don’t need to travel, please don’t. There’s just no foolproof way to make holiday family meetups zero-risk.
I treated many really sick Covid-19 patients today.
All wanted to get vaccinated but didn’t know how to navigate appointments, transportation. Might sound easy, but for many, it’s not.
Expanding eligibility doesn’t always mean accessibility, especially for the most vulnerable.
It’s 4am. Most of the city is sleeping. I just saw an unstable COVID patient in the same room I saw my first COVID patient ~9 months ago. The same room I treated a colleague really sick with COVID. We all want this pandemic to end. Especially all of us working on the frontline.
Pfizer made $37 billion off its Covid vaccine last year, more than the GDP of 120 countries.
Moderna founders made Forbes’ list of richest people.
Yet only 10% of people in low-income countries have been vaccinated.
And Covax—the global dose-sharing initiative—is out of money.
I followed all public health guidance and infected no one.
You’ve unnecessarily exposed numerous people over the last few days, your administration is refusing to do contact tracing, and there’s an outbreak in the White House because of your dangerous disregard of public health.
She screams it over the phone:
“Please don’t let him die, he’s 92 and the only person I have left!”.
My shift is over but I go to check on him.
He’s in a corner in the ER.
He’s on oxygen. Breathing rapidly.
Oxygen saturation dropping fast.
But he looks up and smiles at me.
Today I was vaccinated against COVID19! After witnessing the havoc this virus wreaked on our community, I was ecstatic to be vaccinated. A true scientific miracle.
I got vaccinated for my patients, my colleagues, and for the new baby joining our family any day now!
#IGotTheShot
For months, me & my colleagues at Columbia University’s medical center have treated thousands of
#COVID19
patients.
Every one with dignity. Never disgracefully.
I wrote about their sacrifice here. I still choke up when I read it.
We are not disgraceful.
"Columbia is a liberal, disgraceful institution" -- Trump to Sharyl Attkisson on Columbia University study that found 30,000 lives could've been saved had his federal government recommended social distancing measures just one week earlier
I had Ebola and was treated with convalescent plasma. It was before we had good data on it. And it actually made me worse.
Convalescent plasma has an incredible history & works for many diseases.
But it didn’t for Ebola. And might not for Covid.
Only good science can tell us.
Four years ago today, I walked into the apocalypse.
Crossing the line in the ER felt like entering a whole other world.
Frenetic alarms.
Patients strewn about, struggling to breathe.
Too few staff. Too many deaths.
Covid was everything.
It had completely taken over our ER
It’s not an attack on Fauci. It’s an attack on science. On public health. On everything we should be doing to combat this pandemic.
It’s the reason we have more cases than any other country.
It’s the reason we have more deaths than any other country.
It’s why we’ve failed.
I just did a BBC interview. The host said that in the U.K. you can just walk into a pharmacy and pick up free tests.
I informed him that at-home tests in the US cost $8-$10 each—if you can find them—and I’m not sure but I think maybe his head exploded.
This ain’t normal people.
I’m sick of seeing people trying to relitigate 2020 through the eyes of 2023.
If you miraculously know everything now, why didn’t you tell us so then?
So over a million Americans didn’t have to die of Covid.
So we didn’t have to put ourselves at risk every time we went to work
Today this administration tried telling you we’re better off without the World Health Organization, that we have the ‘lowest Mortality Rate in the World’, and that it’s safe to reopen schools as a pandemic rages across the country.
I’m here to tell you that’s all bullshit.
BREAKING: Moments after stating “I learned a lot about COVID”, the President takes a joyride in an enclosed space with presumably
#COVID19
negative people, all while on experimental medications.
I’d love to chime in with some
#COVID19
updates but I’ve got multiple jobs and can’t sit around tweeting all day like I’m the President. I hope you’ll understand.
It’s November 4th. And today we had 103k new
#COVID19
cases. The highest ever and the first time over 100k.
52k are hospitalized. And 1,116 died.
This wasn’t a hoax. Or a fake-news plot. This is a public health crisis that you’ve mismanaged since day one.
ALL THE FAKE NEWS MEDIA WANTS TO TALK ABOUT IS COVID, COVID, COVID. ON NOVEMBER 4th, YOU WON’T BE HEARING SO MUCH ABOUT IT ANYMORE. WE ARE ROUNDING THE TURN!!!
My sickest patient was an elderly woman gasping for air.
She was resolute - no life support.
A colleague called a professional musician to play Bach on a phone by her bed.
Later I walked by. Her breathing labored. On oxygen. At peace. With a violin playing in the background.
There are thousands of people in a stadium for a sports event like we’re in country that’s managed covid instead of one still averaging 3,000 deaths a day.
Here the president falsely claims frontline healthcare workers are profiting by claiming false
#COVID19
diagnoses.
In reality, they are working nonstop, often without adequate PPE, because this administration failed.
To date, more than 1,700 have died.
I don’t care about the narrative you want to create, from the safety of where you stand now.
Do not try to reimagine the environment and the challenges so many of my colleagues felt on the frontlines, 3 years ago, when we knew almost nothing.
My colleagues died.
I’ve seen hundreds of
#COVID19
patients. Mark Meadows has seen none.
Please do not listen to these damn fools.
Nearly half of US adults have high blood pressure. Over 40% are obese. And nearly 10% have diabetes.
THE MAJORITY OF AMERICAN ADULTS HAVE SIGNIFICANT COMORBIDITIES!
Why does the US have more
#COVID19
cases and deaths than any other country in the world?
Because the people who signed off on this are the exact same people leading our pandemic response.
BREAKING: Moments after stating “I learned a lot about COVID”, the President takes a joyride in an enclosed space with presumably
#COVID19
negative people, all while on experimental medications.
Just leaving the ER.
It was a long day. And a stunning amount of Covid.
Today I worked in an area that was temporarily converted into a makeshift ICU during the first COVID wave.
Here’s what different from then.
And also what challenges we’re facing with this surge in NYC: 🧵
The ER was super busy today! Started the day pulling a huge insect out of someone’s ear. Ended it taking care of someone who was in an accident and thrown off their motorcycle.
BUT I didn’t see a single Covid patient. Not one.
This is how it’s supposed to be.
You get home. You strip in the hallway (it's ok, your neighbors know what you do). Everything in a bag. Your wife tries to keep your toddler away, but she hasn't seen you in days, so it's really hard. Run to the shower. Rinse it all away. Never happier. Time for family.
Here's your
#COVID19
update:
◽️Testing capacity is strained. Again.
◽️PPE in short supply throughout the country. Again.
◽️Today was another record high case count. Again.
◽️NOT ONE SINGLE STATE has a decreasing case count.
It's July, people. Not March.
This is abject failure.
119k Americans are hospitalized with
#COVID19
tonight.
I’m grateful for everyone who took care of our loved ones on this holiday.
To my colleagues - nurses, respiratory therapists, pharmacists, physicians, laboratory technicians, transporters - thank you for everything you do!
There was one clear takeaway from today’s POTUS
#COVID19
update:
The nation’s best medical professionals and the President himself chose an experimental medicine with very limited data for treatment over hydroxychloroquine.
I’m getting lots of messages from people freakin’ out about Delta, so let me reiterate:
If you are fully vaccinated against Covid, you are still much much much much much much much much much much much much safer than anyone who is unvaccinated.
So what's really going on here in NYC?
You're hearing conflicting information on who is tested, who is admitted, who goes home, and what's going on inside hospitals.
Let me shed some light. NYC ER docs are a small and collaborative community, so let me share the scoop:
THREAD
Hi, public health person here to help clarify:
So, this is NOT a ‘great update’.
‘Stabilizing’ at 20k new cases is a disaster.
21 states have upward trends in newly reported cases.
And 10 states are seeing highest daily average of new COVID19 cases.
This is an abject failure
Great update w/ the WH Coronavirus Task Force. Today less than 6% of Americans tested have the virus, cases have stabilized over the past 2 weeks, averaging 20K—down from 30K in April. Hospitalizations are declining & we’re working closely with states to Safely Reopen America.
Every patient I’ve seen with Covid that’s had a 3rd ‘booster’ dose has had mild symptoms.
By mild I mean mostly sore throat. Lots of sore throat. Also some fatigue, maybe some muscle pain.
No difficulty breathing. No shortness of breath.
All a little uncomfortable, but fine.
You reflect on the fact that it's really hard to understand how bad this is - and how bad its going to be - if all you see are empty streets.
Hospitals are nearing capacity. We are running out of ventilators. Ambulance sirens don't stop.
Nearly everyone you see today is the same. We assume everyone is
#COVID
ー19. We wear gowns, goggles, and masks at every encounter. All day. It's the only way to be safe. Where did all the heart attacks and appendicitis patients go? Its all COVID.
Remember this is about learning lessons to be better prepared for the next time, not about padding your Twitter followers.
I’m happy to talk about what I got wrong (a lot!).
But I will not allow others to undermine the real, sad, and horrible challenges we faced from day one.
I just watched a whole White House COVID-19 Response team briefing and never had the urge to shout or rage tweet.
Plus I love how nearly every media question started with 'thank you for doing this'.
Amazed at how much has changed in just a week.
You walk out and take off your mask. You feel naked and exposed. It's still raining, but you want to walk home. Feels safer than the subway or bus, plus you need to decompress.
The streets are empty. This feels nothing like what is happening inside. Maybe people don't know???
Given how many times I’ve had to say ‘No, that’s NOT at all what the new CDC guidelines say!’ in the last few hours, I’m guessing this ain’t gonna go well.
Before you leave, you wipe EVERYTHING down. Your phone. Your badge. Your wallet. Your coffee mug. All of it. Drown it in bleach. Everything in a bag. Take no chances.
Sure you got it all??? Wipe is down again. Can't be too careful.
For the rest of your shift, nearly every hour, you get paged:
Stat notification: Very sick patient, short of breath, fever. Oxygen 88%.
Stat notification: Low blood pressure, short of breath, low oxygen.
Stat notification: Low oxygen, can't breath. Fever.
All day...
Sometime in the afternoon you recognize you haven't drank any water. You're afraid to take off the mask. It's the only thing that protects you. Surely you can last a little longer - in West Africa during Ebola, you spent hours in a hot suit without water. One more patient...
And almost every single patient that I’ve taken care of that needed to be admitted for Covid has been unvaccinated.
Every one with profound shortness of breath. Every one whose oxygen dropped when they walked. Every one needing oxygen to breath regularly.
‘Don’t let it dominate your life’ you said!
210k Americans have died.
We held their hands & called their families over grainy video connections so they could see their last breaths.
Your lack of empathy is the single greatest threat to the American people.
You have failed us.
When your shift ends, you sign out to the oncoming team. It's all
#COVID
ー19. Over the past week, we've all learned the signs - low oxygen, lymphopenia, elevated D-dimer.
You share concerns of friends throughout the city without PPE. Hospitals running out of ventilators.
Wake up at 6:30am. Priority is making a big pot of coffee for the whole day, because the place by the hospital is closed. The Starbucks too. It's all closed.
On the walk, it feels like Sunday. No one is out. Might be the freezing rain. Or it's early. Regardless, that's good.
Everyone we see today was infected a week ago, or more. The numbers will undoubtedly skyrocket overnight, as they have every night the past few days. More will come to the ER. More will be stat notifications. More will be put on a ventilator.
Dear parents and teachers,
It’s not coronavirus that’s keeping our kids from safely going to school next month.
It’s this administration’s repeated failures over the last six months that is.
Yours in continued frustration,
Dejected doctor and dad
A healthy and beautiful baby boy joined our family earlier this morning!
Everyone is doing well and happy.
It’s an auspicious debut to a new year full of more promise, joy and good health than its predecessor! ❤️
Walk in for your 8am shift: Immediately struck by how the calm of the early morning city streets is immediately transformed. The bright fluorescent lights of the ER reflect off everyone's protective goggles. There is a cacophony of coughing. You stop. Mask up. Walk in.
You take signout from the previous team, but nearly every patient is the same, young & old:
Cough, shortness of breath, fever.
They are really worried about one patient. Very short of breath, on the maximum amount of oxygen we can give, but still breathing fast.