COVID-19 Update from Dr. Smith: 4/3/20

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,

This morning the NYP system has ~2,000 COVID+ inpatients. The number of patients in ICUs is hovering stubbornly at ~25%. At CUIMC that figure is ~30%, 98% of whom are on ventilators. More distressing than the percentage of ventilated patients is the chronicity of the average patient’s illness. Even the surviving patients who’ve been extubated tended to stay on mechanical ventilation for about two weeks, and those who expire appear to be following a similar course. We are still too early in this onslaught to accurately calculate the mortality associated with mechanical ventilation, but even if we are blessed to learn that most survive, if every patient stays on a ventilator for two weeks the burden on our resources is enormous. Under these conditions, when we surge to 1,000 ICU beds we’ll be able to handle about 2,000 patients per month. If we could get each patient well in 5 days, we could handle about 6,000 patients per month.

The NYP 10:00 AM briefing today ended with a moving video produced by the idled Broadway cast of Come From Away, the plot of which is based on real events surrounding 9/11. The cast sang, and read tributes to all of us from a broad range of grateful individuals. Like NYP’s gift announcement yesterday, and the tributes from firefighters and police to our hospital teams in days previous, this is another example of how grateful people are for the show healthcare has been putting on. This is our performance, our curtain call. Bow deep and thank people for thanking us. Bathe in it, because you know that the truest tests of professionalism lie between events like this, in the long gaps when we do our job every day because we love to do it. Years of education and training, long hours, emotional stress, and social-life sacrifices are rewarded by the simple gratitude of patients, one at a time. I imagine the cast of Come From Away has similar feelings about their years of training, auditioning, waiting on tables, rehearsing, and performing in venues large and small. I hope before too much time passes we can rise to our feet in the theater to shout “bravo" for them, and for our journey back to normality.

Along with many other sporting-event casualties, it was announced two days ago that Wimbledon has been canceled for 2020. Inscribed on the wall over the players entrance to center court at Wimbledon is this excerpt from “If,” by Rudyard Kipling: “If you can meet with Triumph and Disaster / And treat those two imposters just the same;” We’re still playing.

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

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