June 30, 2020 • 22 mins
An E.R. doctor describes an unsettling decrease in emergency room visits, and wonders just how many patients in need of urgent care are avoiding the hospital due to fears of COVID.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:07):
I'm Danny Shapiro, and this is the Way We Live Now.
Today is day one and twelve since we started seeing
endless ads for lounge wear and a fifty six of
this podcast. My guest today is someone I've wanted to
have on this podcast from the start, but at the
start a hundred and twelve days ago, he was well,
(00:27):
he was pretty busy, and he's still busy, but he
thankfully has enough time to catch up with us Today.
Here's Eric Salk, a physician whose specialty has long been
emergency medicine. Eric, thanks so much for joining me to
talk about the way we live now. Very excited to
(00:49):
be here. So I've started this podcast as a way
of reaching out to others so that we could still
gather during this time of social distancing and have windows
into each other's lives. So to that end, would you
describe for us where you are as we're having this conversation,
what you're looking at, like, what's out your window, anything
(01:10):
about your surroundings. So I am here in beautiful northwest Connecticut, um,
and in my home and just using my bedroom which
happens to have to be a little bit quieter, um,
but but it's a beautiful day and um, and surrounded
by natural beauty around here, which is which is one
(01:32):
of the great things about living in this corner of
the world. You and I are more or less neighbors,
and it's been such a stark contrast to look out
the window at all of this beauty, all that's natural beauty,
and to be, you know, so hyper conscious of what's
going on in the world around us. But you have
a bigger, way, bigger window on that than than I do,
(01:55):
which is really why I wanted to have you on
the show. So you've been an e R doctor for
a long time and you've seen a lot um When
did you realize that we were facing something huge and
unprecedented at least in our lifetimes. There were those early rumblings,
you know, in the earliest early part of this year. Um,
(02:17):
you know, after the sort of holidays, we we were
hearing about this outbreak in China, in the e R,
in the medical world. You know, we're hearing about the
same thing that everybody else was. You know, it started
to get a little more serious in sort of February,
and you know, alarm bells were going off and you know,
(02:39):
the react people's reaction was sort of all over the map.
Many people were becoming quite anxious, and others sort of
you know taking it into pride and minimizing and and
UM and I, you know, I was guilty of probably
both extremes at some at some point. And you know,
as the as the information was coming across. So when
(03:01):
COVID nineteen did arrive here, what was the beginning of
the pandemic like for you? What were your what were
your days like? Because of where we are, um sort
of not in in an epic center or a place
where people international travelers are coming going, we were we
were are Our wave hit a little bit later than
New York and Seattle, so we had time to get ready.
(03:24):
But in those weeks that we were getting ready, you know,
it was getting it was pretty anxious. We just had
sort of the level of anxiety. Of uncertainty is the
thing that I remember most. And stress levels were running high.
We were building out, you know, structures in the parking
lot in order to you know, handle potential hordes of people,
(03:45):
um and trying to you know, sort through and sequester
those who were less thick and more sick, and we
were figuring out plans to you know, how to expand
our i CU capabilities, and how to redeploy staff and
close down certain services like the services and stuff. So
a lot of that was going on. As the cases
started to show up, you know, we had to start
(04:07):
getting serious about personal predictive equipment and isolation and and
and figure out routines for testing. And as that progressed, um,
it was a sort of a wild ride. Information changed,
you know, the new information came out daily, and this
was happening so quickly that that the usual sort of
(04:30):
way that we digest scientific information and studies, you know,
it was irrelevant. We you know, we were using social media,
web conferences and blogs of critical care medicine people and
emergency medicine people sort of sharing anecdotal information and early
studies and some of those, you know, the ways that
(04:51):
we approached patients in those early days, you know, using
the best information we had, you know, and the experience
it's you know, we were learning from from China, from
Italy was appropriate for the moment, but as things unfolded
it we ended up turning things upside down. And the
way that we were you know, managing patients in subsequent weeks,
(05:13):
it was vastly different, you know, and hopefully we were
getting better every day, but it was you know, it
was challenging. It was also very exciting. I mean, it's
never in the twenty five plus years that I've been
at this did we have something changing unfolding that quickly.
And the need to sort of synthesize and digest information
as it as it came through and you know, work
(05:33):
together with colleagues and compare notes and you know, that
part of it was exciting at the same time as
as it was anxiety for book. That's so interesting because
I would imagine that somebody, somebody who goes into emergency
medicine up for that kind of daily, you know, minute
(05:54):
by minute challenge of meeting the moment whatever it is. Yeah,
it is one of the people both who were drawn
to that specialty tend to like to figure out puzzles
and and and are okay making decisions based on you know,
sort of limited information. You know, there's other specialties where people,
(06:14):
you know, you want to gather all of the data first,
and you know, you know, sort of put together lists
and and you know, and do things in a very
organized fashion. And emergency massins a little bit more mcgever
sort of seat of the pants, you know, cowboy. Yeah,
and you're everybody was making it up as as as
we went along because the information. I remember seeing a
(06:39):
YouTube video that got around in I would say late March,
and it was made by I think he was an
E R doctor in New York City and he made
it for his family, for his extended family. But then um,
it kind of went viral and because it was very
soothing because what he was saying at the time was
all you have to do is wash your hands in
(07:00):
in touch your face. And he just kept on saying
like it's really that simple, and that's so true, and
and that is that is very true, and and yes
we we you know, there was a lot of craziness
to that, you know, in among that sort of you know,
flurry and and just just tidal wave of information was
(07:20):
all sorts of stuff that you having to do with
you know, being able to detect samples of virus on
hard surfaces, you know, days later, so you know which
which you know freaked people out and and you know
made it, you know, you created this paranoia about touching
any anything, you know, which you know, if if you
(07:43):
look at the way we do testing and sampling, and
you know, there was a lot of errors in there,
and there you have to sort of you have to
sometimes just sort of step back and and and that's
you know, that's that's that's hard to do. It's hard
to it's hard to convey that inftion um a tool
k one day who has a lot of writing. You know,
that surge at Harvard harvarded written a couple of things
(08:04):
that that along those lines that that were you know,
looking at what happened in China with it. You know,
the sort of the first wave of this, health care
workers were dropping like flies, unfortunately because in the very beginning,
because they were not taking these you know, sort of
the necessary measures. As soon as they did and they
started wearing masks, and they started, you know, do inappropriate perspective,
(08:26):
you know, far and distancing. You know, the morbidity and
mortality among the healthcare workers dropped, you know, almost to
not almost zero, and that's been the case. And it's
well and again, these things are not this is not
pure sterile aseptic technique like you have in the operating room.
You know, we we try to cover up, we try
(08:46):
to make sure that patients are covering up. We wash
your hands ridiculously um and you just be very conscious
of what you touched and touching your face, and you can,
you know, dramatically slow to spread. One of the things
I'm curious about is were there I kept on thinking
about people who had other emergencies during this time, you know,
(09:07):
like what what if somebody hit their head or had
a heart attack, or what happened to people during that
period of time where you know, the hospitals were converted
almost entirely into COVID units, and people did everything they
possibly could to not have to go to the hospital
unless they well know that's actor. That was a that
became a real problem, a real sort of you know,
(09:29):
unanticipated uh, you know, consequence of all the preparedness and
everything everybody was doing, you know, the social all of
the measures people were taking, and the fact that we
shut everything down was you know, to slow the spread
of the virus, but in particular to avoid overwhelming health
care system. So that was sort of all focused. I
think people took it to such an extreme that that
(09:51):
you know, we saw this dramatic drop in visits and
overall visits to emergency departments across the country. Obviously we
also images of the you know now for queens and
places in Seattle, you know, where they're they're packed and
overwhelmed that that was really that was a tiny minority
even within even in New York City in my colleagues
(10:13):
and described reductions in overall business to the ear. And
then we you know, the words started to spread. We know,
we were comparing notes about the fact that we wait
to say, where are the heart attacks? Where are the strokes?
Those shouldn't have stopped happening, you know, Unfortunately people who
were avoiding you know, the e r to a to
(10:37):
a fault and there I'm sure there was a lot
of mortality there were, you know, and and we're going
to continue to see and I mean we have seen
you know, the effected that you know, I personally have
seen appendicitis is that were that ruptured because people avoided
coming to the are probably at silent heart attacks or
heart attacks that they attributed to indiingestion or just didn't
(10:58):
want to go to the ear, you know, will end
up with you know, permanent disability as a result of that.
Um and and and so a couple of weeks into
this when we were seeing this I mean organizations like
the mertain colleges and wimsy positions. You put out public
service announcements saying please don't please come, don't don't we're
we're and we were all taking a lot of precautions
(11:19):
to to to keep things as safe and separate and
sterile as as as possible, given the availability of testing.
And but you know, unfortunately it was a little bit
of an overreaction mm hmmah. That was very real and
and you know, unfortunately part of I think a consequence
of the fact that we had such a piotic health
(11:40):
care system in this country and all hand sort of
lack of leadership. Yeah. Yeah, it's certainly been brought into
the darkest possible relief. Connecticut has I believe, correct me
if I'm wrong, but the lowest number of new COVID
nineteen cases in the country at this moment. You're probably right,
I trust I trust you. I hadn't actually heard that
(12:01):
within the last few days, but I believe it. But again,
this is this is always made me crazy, the whole thing.
You know, we're you gotta remember that there's the denominator
and we're also like the second smallest state. Yeah, we're
a pretty popular state. You know, it's a relatively but
it's still a re hoptively small arm, you know. So
so if you're talking about absolute numbers, for sure, but
it's it's the per capita number that that sort is
more important. So I don't know exactly, couldn't right, but
(12:24):
I but I encourage everybody always sort of asked that
question when they're saying China or or or you know, American,
I said, you know has the most number of cases. Well,
you know, of course we also have the most number
of people, and so you know, what what is it?
What's the the rate the case per per capita. No,
that's a good point, um, And I don't think people
actually really understand that uma. And I think it's also
(12:48):
creating a little bit of a sense of hubris maybe
where my son actually forwarded me a newspiece out of
New Haven the other day, um that they had to
closed down a bar because it had a thousand people
in it. And I worry about just people. We're all
(13:10):
so longing to go back to quote unquote normal and
just snap back into everything being just fine again. And
I think sometimes thinking things like you know, the lowest
number of cases or or just yeah, and there's no
there's no national kind of messaging about any of this.
When you think about the next oh, I don't know,
(13:32):
like a year or eighteen months, what do you think
it's going to look like. I certainly have no crystal ball,
and I you know, don't claim to be a you know,
epidemiologist or um. And I've been I've been wrong, you know,
other times during this whole thing. So with that, with
that caveat, certainly we flattened the curve very you know,
(13:55):
very effectively. You know, we probably overall the country and
and you stay, you know, lab and saved hundreds of
thousands of lives. But there the sort of an unfortunate
side effect of that is that they're they're we slow
down the spread so of the relatively small number of
people you know, have have been infected. And you know,
(14:18):
whether or not infection confirmed immunity, we still don't know.
It probably does to some extent, but we're gonna be
seeing subsequent ways. So there's gonna be ways and and
and it's going to be you know, it's gonna be
it's gonna be legional. There's going to be outbreaks here
and there, um, I mean you know, we're going to
have to be shutting things down again. It may not
(14:40):
have to be the massive across the board, you know,
things that we had done in the past. You know,
the world is different, and it's going to be for
the foreseeable future. I mean, the idea of people packing
into stadiums and or or you know, music festivals or
you know bars, you know, is not going to be
(15:01):
happening at least until we get a vaccine and a
vaccine widely distributed. So you know, that's that's that's not
on the horizon just yet, hopefully within two years, you know,
sixteen months or two years. Um. The I do worry
a lot about the fall, you know, as we get
into the fall and winter and usual respiratory illnesses and
(15:24):
the flu and and and just cold um season starts,
you know, whose symptoms are very hard to distinguish from
you know, coronavirus and initially, um, it's it's going to
get that's going to be it's gonna be rough in
health care settings. And just on a public health perspective,
(15:46):
did you in the e er have a lot of
people coming in who were anxious that they that they
had the coronavirus and who didn't, who had just a
more flu or a milder Was there just something. It
wasn't that bad because um, you know, there we were
(16:07):
sort of coming out of flu in the very beginning.
It was we were still at the tail in the
flu season, so we were testing everybody for flu at
the same time. And again it was it was pretty
hard because we also didn't have available testing. I mean
I work in a number of different settings. I mean
it was in each place was a little bit different.
And and the literally the protocol for who we could
(16:28):
test and not test would change two and three times
in a in a given shift or day, you know,
as we would run out of of you know, re agent,
or we would change the lab that we would you
be using, or um you know, it was but so
did you know. There were a lot of people very
(16:49):
anxious about it and wanted testing, but the word got
out that they were really that we weren't testing, so
people were We actually were. It wasn't like we were
overwhelmed or overrun by a lot of those patients in
the ear in the e R. And I think people
were scared to death of showing up the right you know.
Around around that time, you know, I was, I do
(17:09):
working settings, and the urgent care clinics just kind of
shut down and you know, told people do not you're
not allowed to come and lift in the door, but
if you have these symptoms, you know, and all the
medical opposite. So so people were, you know, sort of
there wasn't a stampede. I mean there was. There was
a lot of anxiety, and and the anxiety still happen
(17:29):
to me people the effects of just general kind of
anxiety from just everything that's going on. Um want the patients, Yeah, yeah,
I think that's going to go on for a long
time to come. There's, like me, waves of PTSD on
top of waves of of of of the virus. M.
So my last question for you is, well, it's kind
(17:51):
of too. It's a two for um, how are you
and your colleagues taking care of yourselves during this time
when it's exciting, but you know, the the flip side
of exciting is it's got to be incredibly stressful. And
then the second question is what's bringing you hope? It's tiring,
and it's also and it's there's also you know, the
(18:13):
way it has changed the way we interact with patients.
You know, having to gown and gloves and put on
masks and things. You know, you can't be part of
the the art of medicine was you know, it was
the human touch. And you know now just to see
the look of fear on people's faces as you go
into the rooms, you know, the elderly patients towards kids.
(18:33):
You know, when you're all you look like a spaceman.
So you know, so that that's that's that's part of that.
How do you deal with that? You know, we we
just the way we usually do. We eat pizza and
drink cold coffee and and and have sort of gallows
humor and you know, share, you know, dark you know,
jokes and camaraderie the way soldiers I would imagine. And
(18:57):
so you know is that I don't know if that's
the healthy thing. But then obviously there's then there's family.
But a lot of stress has been put on that
we you know, we we people are figuring out different ways.
A lot of people are living in there in guest
rooms or and and have you know, I'm not making
any physical contact with their family or you know, I
spent three months, you know, in a guest house of
(19:17):
a friend. Um, so that I wouldn't expose my my family.
Um and so, um, you know, there's there, there are resources,
there are sort of mental health resources we've made available.
But it's also something that health care workers are mhm
Bible and about accessing because sometimes creates a label which
(19:39):
can affect your credentialing and your licensing. So so I
don't know, I'm sorry that I'm not that I wish
I had a good answer. It's it's taking its toll
on health care workers. Um. But but you know, obviously
we also buy the same top. And the outpouring of
of of gratitude of you know, all the signs that
you see up in down the street, the the gifts
(20:01):
of food that we get from people that you know,
cards from kids is amazing, you know, none We've never
never experienced that sort of shill of love that I
must say. That's it's tremendous. And and really the fact
that everybody did what they did, you know, the fact
that actually put their lives on hold, you know, to
these so they did in order to protect their their
(20:22):
local nurses and inductors and health care workers, you know,
says volume. So I think we gained a lot of uh,
sort of love and strength from that. Yeah, and that's that,
that's that's a hopeful sign of just of you know,
(20:43):
the human spirit and the human condition. Absolutely absolutely, it's
you know, and that was overwhelming and it really was,
I mean, an amazing demonstration of exactly the human spirit
of goodness you know people, Eric, thank you so much
for taking the time to to talk about all this.
I think people, UM really want to want to know
(21:06):
and want to hear you know, what's going on in
in all of these in all of these ways and
in all of these places and with all of these people,
and especially I've had a few healthcare workers UM on
the show, but not an e R doctor. And I
am just really glad to be able to talk to you,
So thanks again again. Mine is just one little perspective,
(21:27):
you know, from one corner of the system. So so
but I hope that I hope that cell And thank you,
thank you very much for for having me here. It's
always a pleasure to talk with you. And this was
fun good. I'm glad me too. Thanks for listening to
(21:49):
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(22:09):
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(22:34):
For more podcasts from I heart Radio, visit the I
heart Radio app, Apple Podcasts, or wherever you get your podcasts.
I'm Danny Shapiro, and this is the Way We Live Now.
Today is day one and twelve since we started seeing
endless ads for lounge wear and a fifty six of
this podcast. My guest today is someone I've wanted to
have on this podcast from the start, but at the
start a hundred and twelve days ago, he was well,
(00:27):
he was pretty busy, and he's still busy, but he
thankfully has enough time to catch up with us Today.
Here's Eric Salk, a physician whose specialty has long been
emergency medicine. Eric, thanks so much for joining me to
talk about the way we live now. Very excited to
(00:49):
be here. So I've started this podcast as a way
of reaching out to others so that we could still
gather during this time of social distancing and have windows
into each other's lives. So to that end, would you
describe for us where you are as we're having this conversation,
what you're looking at, like, what's out your window, anything
(01:10):
about your surroundings. So I am here in beautiful northwest Connecticut, um,
and in my home and just using my bedroom which
happens to have to be a little bit quieter, um,
but but it's a beautiful day and um, and surrounded
by natural beauty around here, which is which is one
(01:32):
of the great things about living in this corner of
the world. You and I are more or less neighbors,
and it's been such a stark contrast to look out
the window at all of this beauty, all that's natural beauty,
and to be, you know, so hyper conscious of what's
going on in the world around us. But you have
a bigger, way, bigger window on that than than I do,
(01:55):
which is really why I wanted to have you on
the show. So you've been an e R doctor for
a long time and you've seen a lot um When
did you realize that we were facing something huge and
unprecedented at least in our lifetimes. There were those early rumblings,
you know, in the earliest early part of this year. Um,
(02:17):
you know, after the sort of holidays, we we were
hearing about this outbreak in China, in the e R,
in the medical world. You know, we're hearing about the
same thing that everybody else was. You know, it started
to get a little more serious in sort of February,
and you know, alarm bells were going off and you know,
(02:39):
the react people's reaction was sort of all over the map.
Many people were becoming quite anxious, and others sort of
you know taking it into pride and minimizing and and
UM and I, you know, I was guilty of probably
both extremes at some at some point. And you know,
as the as the information was coming across. So when
(03:01):
COVID nineteen did arrive here, what was the beginning of
the pandemic like for you? What were your what were
your days like? Because of where we are, um sort
of not in in an epic center or a place
where people international travelers are coming going, we were we
were are Our wave hit a little bit later than
New York and Seattle, so we had time to get ready.
(03:24):
But in those weeks that we were getting ready, you know,
it was getting it was pretty anxious. We just had
sort of the level of anxiety. Of uncertainty is the
thing that I remember most. And stress levels were running high.
We were building out, you know, structures in the parking
lot in order to you know, handle potential hordes of people,
(03:45):
um and trying to you know, sort through and sequester
those who were less thick and more sick, and we
were figuring out plans to you know, how to expand
our i CU capabilities, and how to redeploy staff and
close down certain services like the services and stuff. So
a lot of that was going on. As the cases
started to show up, you know, we had to start
(04:07):
getting serious about personal predictive equipment and isolation and and
and figure out routines for testing. And as that progressed, um,
it was a sort of a wild ride. Information changed,
you know, the new information came out daily, and this
was happening so quickly that that the usual sort of
(04:30):
way that we digest scientific information and studies, you know,
it was irrelevant. We you know, we were using social media,
web conferences and blogs of critical care medicine people and
emergency medicine people sort of sharing anecdotal information and early
studies and some of those, you know, the ways that
(04:51):
we approached patients in those early days, you know, using
the best information we had, you know, and the experience
it's you know, we were learning from from China, from
Italy was appropriate for the moment, but as things unfolded
it we ended up turning things upside down. And the
way that we were you know, managing patients in subsequent weeks,
(05:13):
it was vastly different, you know, and hopefully we were
getting better every day, but it was you know, it
was challenging. It was also very exciting. I mean, it's
never in the twenty five plus years that I've been
at this did we have something changing unfolding that quickly.
And the need to sort of synthesize and digest information
as it as it came through and you know, work
(05:33):
together with colleagues and compare notes and you know, that
part of it was exciting at the same time as
as it was anxiety for book. That's so interesting because
I would imagine that somebody, somebody who goes into emergency
medicine up for that kind of daily, you know, minute
(05:54):
by minute challenge of meeting the moment whatever it is. Yeah,
it is one of the people both who were drawn
to that specialty tend to like to figure out puzzles
and and and are okay making decisions based on you know,
sort of limited information. You know, there's other specialties where people,
(06:14):
you know, you want to gather all of the data first,
and you know, you know, sort of put together lists
and and you know, and do things in a very
organized fashion. And emergency massins a little bit more mcgever
sort of seat of the pants, you know, cowboy. Yeah,
and you're everybody was making it up as as as
we went along because the information. I remember seeing a
(06:39):
YouTube video that got around in I would say late March,
and it was made by I think he was an
E R doctor in New York City and he made
it for his family, for his extended family. But then um,
it kind of went viral and because it was very
soothing because what he was saying at the time was
all you have to do is wash your hands in
(07:00):
in touch your face. And he just kept on saying
like it's really that simple, and that's so true, and
and that is that is very true, and and yes
we we you know, there was a lot of craziness
to that, you know, in among that sort of you know,
flurry and and just just tidal wave of information was
(07:20):
all sorts of stuff that you having to do with
you know, being able to detect samples of virus on
hard surfaces, you know, days later, so you know which
which you know freaked people out and and you know
made it, you know, you created this paranoia about touching
any anything, you know, which you know, if if you
(07:43):
look at the way we do testing and sampling, and
you know, there was a lot of errors in there,
and there you have to sort of you have to
sometimes just sort of step back and and and that's
you know, that's that's that's hard to do. It's hard
to it's hard to convey that inftion um a tool
k one day who has a lot of writing. You know,
that surge at Harvard harvarded written a couple of things
(08:04):
that that along those lines that that were you know,
looking at what happened in China with it. You know,
the sort of the first wave of this, health care
workers were dropping like flies, unfortunately because in the very beginning,
because they were not taking these you know, sort of
the necessary measures. As soon as they did and they
started wearing masks, and they started, you know, do inappropriate perspective,
(08:26):
you know, far and distancing. You know, the morbidity and
mortality among the healthcare workers dropped, you know, almost to
not almost zero, and that's been the case. And it's
well and again, these things are not this is not
pure sterile aseptic technique like you have in the operating room.
You know, we we try to cover up, we try
(08:46):
to make sure that patients are covering up. We wash
your hands ridiculously um and you just be very conscious
of what you touched and touching your face, and you can,
you know, dramatically slow to spread. One of the things
I'm curious about is were there I kept on thinking
about people who had other emergencies during this time, you know,
(09:07):
like what what if somebody hit their head or had
a heart attack, or what happened to people during that
period of time where you know, the hospitals were converted
almost entirely into COVID units, and people did everything they
possibly could to not have to go to the hospital
unless they well know that's actor. That was a that
became a real problem, a real sort of you know,
(09:29):
unanticipated uh, you know, consequence of all the preparedness and
everything everybody was doing, you know, the social all of
the measures people were taking, and the fact that we
shut everything down was you know, to slow the spread
of the virus, but in particular to avoid overwhelming health
care system. So that was sort of all focused. I
think people took it to such an extreme that that
(09:51):
you know, we saw this dramatic drop in visits and
overall visits to emergency departments across the country. Obviously we
also images of the you know now for queens and
places in Seattle, you know, where they're they're packed and
overwhelmed that that was really that was a tiny minority
even within even in New York City in my colleagues
(10:13):
and described reductions in overall business to the ear. And
then we you know, the words started to spread. We know,
we were comparing notes about the fact that we wait
to say, where are the heart attacks? Where are the strokes?
Those shouldn't have stopped happening, you know, Unfortunately people who
were avoiding you know, the e r to a to
(10:37):
a fault and there I'm sure there was a lot
of mortality there were, you know, and and we're going
to continue to see and I mean we have seen
you know, the effected that you know, I personally have
seen appendicitis is that were that ruptured because people avoided
coming to the are probably at silent heart attacks or
heart attacks that they attributed to indiingestion or just didn't
(10:58):
want to go to the ear, you know, will end
up with you know, permanent disability as a result of that.
Um and and and so a couple of weeks into
this when we were seeing this I mean organizations like
the mertain colleges and wimsy positions. You put out public
service announcements saying please don't please come, don't don't we're
we're and we were all taking a lot of precautions
(11:19):
to to to keep things as safe and separate and
sterile as as as possible, given the availability of testing.
And but you know, unfortunately it was a little bit
of an overreaction mm hmmah. That was very real and
and you know, unfortunately part of I think a consequence
of the fact that we had such a piotic health
(11:40):
care system in this country and all hand sort of
lack of leadership. Yeah. Yeah, it's certainly been brought into
the darkest possible relief. Connecticut has I believe, correct me
if I'm wrong, but the lowest number of new COVID
nineteen cases in the country at this moment. You're probably right,
I trust I trust you. I hadn't actually heard that
(12:01):
within the last few days, but I believe it. But again,
this is this is always made me crazy, the whole thing.
You know, we're you gotta remember that there's the denominator
and we're also like the second smallest state. Yeah, we're
a pretty popular state. You know, it's a relatively but
it's still a re hoptively small arm, you know. So
so if you're talking about absolute numbers, for sure, but
it's it's the per capita number that that sort is
more important. So I don't know exactly, couldn't right, but
(12:24):
I but I encourage everybody always sort of asked that
question when they're saying China or or or you know, American,
I said, you know has the most number of cases. Well,
you know, of course we also have the most number
of people, and so you know, what what is it?
What's the the rate the case per per capita. No,
that's a good point, um, And I don't think people
actually really understand that uma. And I think it's also
(12:48):
creating a little bit of a sense of hubris maybe
where my son actually forwarded me a newspiece out of
New Haven the other day, um that they had to
closed down a bar because it had a thousand people
in it. And I worry about just people. We're all
(13:10):
so longing to go back to quote unquote normal and
just snap back into everything being just fine again. And
I think sometimes thinking things like you know, the lowest
number of cases or or just yeah, and there's no
there's no national kind of messaging about any of this.
When you think about the next oh, I don't know,
(13:32):
like a year or eighteen months, what do you think
it's going to look like. I certainly have no crystal ball,
and I you know, don't claim to be a you know,
epidemiologist or um. And I've been I've been wrong, you know,
other times during this whole thing. So with that, with
that caveat, certainly we flattened the curve very you know,
(13:55):
very effectively. You know, we probably overall the country and
and you stay, you know, lab and saved hundreds of
thousands of lives. But there the sort of an unfortunate
side effect of that is that they're they're we slow
down the spread so of the relatively small number of
people you know, have have been infected. And you know,
(14:18):
whether or not infection confirmed immunity, we still don't know.
It probably does to some extent, but we're gonna be
seeing subsequent ways. So there's gonna be ways and and
and it's going to be you know, it's gonna be
it's gonna be legional. There's going to be outbreaks here
and there, um, I mean you know, we're going to
have to be shutting things down again. It may not
(14:40):
have to be the massive across the board, you know,
things that we had done in the past. You know,
the world is different, and it's going to be for
the foreseeable future. I mean, the idea of people packing
into stadiums and or or you know, music festivals or
you know bars, you know, is not going to be
(15:01):
happening at least until we get a vaccine and a
vaccine widely distributed. So you know, that's that's that's not
on the horizon just yet, hopefully within two years, you know,
sixteen months or two years. Um. The I do worry
a lot about the fall, you know, as we get
into the fall and winter and usual respiratory illnesses and
(15:24):
the flu and and and just cold um season starts,
you know, whose symptoms are very hard to distinguish from
you know, coronavirus and initially, um, it's it's going to
get that's going to be it's gonna be rough in
health care settings. And just on a public health perspective,
(15:46):
did you in the e er have a lot of
people coming in who were anxious that they that they
had the coronavirus and who didn't, who had just a
more flu or a milder Was there just something. It
wasn't that bad because um, you know, there we were
(16:07):
sort of coming out of flu in the very beginning.
It was we were still at the tail in the
flu season, so we were testing everybody for flu at
the same time. And again it was it was pretty
hard because we also didn't have available testing. I mean
I work in a number of different settings. I mean
it was in each place was a little bit different.
And and the literally the protocol for who we could
(16:28):
test and not test would change two and three times
in a in a given shift or day, you know,
as we would run out of of you know, re agent,
or we would change the lab that we would you
be using, or um you know, it was but so
did you know. There were a lot of people very
(16:49):
anxious about it and wanted testing, but the word got
out that they were really that we weren't testing, so
people were We actually were. It wasn't like we were
overwhelmed or overrun by a lot of those patients in
the ear in the e R. And I think people
were scared to death of showing up the right you know.
Around around that time, you know, I was, I do
(17:09):
working settings, and the urgent care clinics just kind of
shut down and you know, told people do not you're
not allowed to come and lift in the door, but
if you have these symptoms, you know, and all the
medical opposite. So so people were, you know, sort of
there wasn't a stampede. I mean there was. There was
a lot of anxiety, and and the anxiety still happen
(17:29):
to me people the effects of just general kind of
anxiety from just everything that's going on. Um want the patients, Yeah, yeah,
I think that's going to go on for a long
time to come. There's, like me, waves of PTSD on
top of waves of of of of the virus. M.
So my last question for you is, well, it's kind
(17:51):
of too. It's a two for um, how are you
and your colleagues taking care of yourselves during this time
when it's exciting, but you know, the the flip side
of exciting is it's got to be incredibly stressful. And
then the second question is what's bringing you hope? It's tiring,
and it's also and it's there's also you know, the
(18:13):
way it has changed the way we interact with patients.
You know, having to gown and gloves and put on
masks and things. You know, you can't be part of
the the art of medicine was you know, it was
the human touch. And you know now just to see
the look of fear on people's faces as you go
into the rooms, you know, the elderly patients towards kids.
(18:33):
You know, when you're all you look like a spaceman.
So you know, so that that's that's that's part of that.
How do you deal with that? You know, we we
just the way we usually do. We eat pizza and
drink cold coffee and and and have sort of gallows
humor and you know, share, you know, dark you know,
jokes and camaraderie the way soldiers I would imagine. And
(18:57):
so you know is that I don't know if that's
the healthy thing. But then obviously there's then there's family.
But a lot of stress has been put on that
we you know, we we people are figuring out different ways.
A lot of people are living in there in guest
rooms or and and have you know, I'm not making
any physical contact with their family or you know, I
spent three months, you know, in a guest house of
(19:17):
a friend. Um, so that I wouldn't expose my my family.
Um and so, um, you know, there's there, there are resources,
there are sort of mental health resources we've made available.
But it's also something that health care workers are mhm
Bible and about accessing because sometimes creates a label which
(19:39):
can affect your credentialing and your licensing. So so I
don't know, I'm sorry that I'm not that I wish
I had a good answer. It's it's taking its toll
on health care workers. Um. But but you know, obviously
we also buy the same top. And the outpouring of
of of gratitude of you know, all the signs that
you see up in down the street, the the gifts
(20:01):
of food that we get from people that you know,
cards from kids is amazing, you know, none We've never
never experienced that sort of shill of love that I
must say. That's it's tremendous. And and really the fact
that everybody did what they did, you know, the fact
that actually put their lives on hold, you know, to
these so they did in order to protect their their
(20:22):
local nurses and inductors and health care workers, you know,
says volume. So I think we gained a lot of uh,
sort of love and strength from that. Yeah, and that's that,
that's that's a hopeful sign of just of you know,
(20:43):
the human spirit and the human condition. Absolutely absolutely, it's
you know, and that was overwhelming and it really was,
I mean, an amazing demonstration of exactly the human spirit
of goodness you know people, Eric, thank you so much
for taking the time to to talk about all this.
I think people, UM really want to want to know
(21:06):
and want to hear you know, what's going on in
in all of these in all of these ways and
in all of these places and with all of these people,
and especially I've had a few healthcare workers UM on
the show, but not an e R doctor. And I
am just really glad to be able to talk to you,
So thanks again again. Mine is just one little perspective,
(21:27):
you know, from one corner of the system. So so
but I hope that I hope that cell And thank you,
thank you very much for for having me here. It's
always a pleasure to talk with you. And this was
fun good. I'm glad me too. Thanks for listening to
(21:49):
the way we live now. Tell us the way you're
living now, we want to hear call us on you
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(22:09):
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