COVID-19 Update from Dr. Smith: 3/29/20

Each day during the COVID-19 crisis, Dr. Craig Smith, Chair of the Department of Surgery, sends an update to faculty and staff about pandemic response and priorities. Stay up to date with us.

Dear Colleagues,

The slope of the new-case curve is steady.  As long as that remains true, and for some period after the peak, we will be dealing with ED and ICU demands that are beyond anything we have seen in our lifetimes.  NYP, NY State, and federal surge efforts should help with capacity, but not today.  Regardless, the most precious limiting reagent will still be our people.  Non-COVID-related surgery continues to be done, but priorities are certain to become even more narrowly defined, which means that our colleagues in the Department at all levels are doing a small percentage of what they usually do.  Attending surgeons, residents, NPs, and PAs have been voluntarily going over the top every day to work in relatively unfamiliar, demanding, and stressful roles.  It is possible that everyone will have been redeployed by the time the pandemic ebbs.  I’m sure you recognize that COVID-19 will continue to infect health care workers at a significant rate. That contributes to the demands for redeployment, even though mitigated by the COVID+ people who are just beginning to return.

Today I don’t want my parables and literary flourishes to get in the way of the redeployment punchline, which is this:  we will not leave you alone out there!  I want everyone who has been or soon will be redeployed to know that we are processing our roster every day to match people to the requests coming in.  We are responding as quickly as possible.  We will keep pumping out people as long as we have people to pump.  I hope we frontload this process enough to create some slack in the first week or so.  Redundancy will cushion the inefficiencies and stresses accompanying sudden transition into unfamiliar and demanding roles, and will allow us to thoughtfully titrate duty hours to match the mental and physical demands of each assignment.  Even if we reach a point when everyone has left the trenches, energetic redeployment now should also delay a time when extending working hours becomes the only way to meet demand.  With a little luck we’ll never reach that point, but it would be unrealistic not to recognize that we might.

The New York Times features a full page of COVID-19 obituaries today.  That will continue for a while.  The first Western expedition to traverse Africa, covering 7,000 miles over 3 years, lasted from 1874 to 1877.  The dangers, privations, and assaults by disease were biblical.  It started with 228 souls (including 36 women and 10 children).  There were a few recruitments and desertions along the way, and 114 died—50% mortality.  They managed to bring 108 souls home.  It would have been 105, except that 3 children were born on the journey and survived to the end.  Life finds a way.

Craig R. Smith, MD
Chair, Department of Surgery
Surgeon-in-Chief, NYP/CUIMC

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