COVID-19 Update from Dr. Smith: 4/1/20

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,

March 2020 is now behind us.  Most of us, and I include myself, started the month secretly unconvinced that this could happen here.  Then the new cases started doubling.  Defects in reality-testing don’t survive exponential contagion.  It’s rational to be pleased that we are now doubling every 7 days, after doubling every 3 days for much of the month, but what about the month ahead of us?  All evidence suggests that April will be worse than March.  I hope I’m wrong.  Come what may, there is no better place and there are no better people to take this on.

There is new information today on the continuing evolution of our testing policy.  Our machine capacity for PCR viral antigen assays is very large but remains resource-constrained (swabs, reagents).  Nonetheless, the PCR test is being expanded to include all patients who are being admitted, regardless of symptoms or exposure history.  This applies to all patients having urgent or emergent operations, which has obvious relevance to our Department.  NYP is eager to include testing for all health care workers, but today our capacity is still too limited for that step.  That population will likely be addressed with a combination of PCR testing for antigen and serum testing for antibody.  Antibody testing keeps coming tomorrow, rather than today, but I’m confident we’ll get there.  I have the impression that media descriptions of testing availability are woefully disconnected from actual capabilities on the ground, at least here in the epicenter, which makes it difficult to establish realistic expectations. 

Writing on April 1, late in the day, I can’t possibly be the first person to shout out the first four lines of "The Waste Land" (TS Eliot).  But first or not, I can’t resist:  “April is the cruelest month, breeding / Lilacs out of the dead land, mixing / Memory and desire, stirring / Dull roots with spring rain.”  The rest of the poem is much too long, too grim and overwrought for my taste.  The line-breaks that highlight three verbs (breeding, mixing, stirring) are a nice writerly touch, but I admire it most for one phrase—mixing memory and desire.  In an April that may be apocalyptically cruel, that is how we are poised, desiring spring.

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

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