A message from my sister-in-law Jessica Franklin, MD, after her first full day treating COVID-19 patients at Valley Hospital in Ridgewood, a region (meaning New York City and its immediate suburbs) that’s been described as “the epicenter of the global pandemic.” Her message begins in the block quote below the fold.

As a one-time hospital “environmental services worker” (aka “janitor”), I particularly appreciate Jess’s inclusion of that profession in what she says below. If physicians and nurses will have to go without personal protective equipment, what do you think will happen to janitors? I can tell you what happened to us when I was working as a hospital janitor at Overlook Hospital in my 20s. We were told to clean up hazardous waste without any personal protective equipment at all. Because if we didn’t do it, who would? At that wage, what choice would anyone have? Say “no”?

As a hospital-based physician, many people have asked me how I am doing.  I am going to be honest.  I am angry.  Here in the NYC metro area, we are locked down, as we need to be.  I am hearing about those here and elsewhere who are still having social events, going to exercise classes, hanging out at the pool, having playdates, going on vacation.  The excuses that are used is that we haven’t seen COVID in my town, my county, my state–so no need.   

I just have one question.  What can you live with?  Just take a moment and really ask yourself – what can you live with?  I ask this because if you are not sheltering in place right now, then you are making things worse.   

Let me be specific.  When you go to your clubhouse or gym because it hasn’t been shut down, and you think you are keeping away from people, and you rest your hand on a table that someone sneezed on fifteen minutes before?  Maybe that person is an asymptomatic carrier and you get it.  Okay, you think, so that is just me.  Tell that to the nurse who checks you in in the ER.  Tell that to the person who came in to check your blood sugar.  Tell that to the environmental services person who cleans your room.  They certainly never signed up to have their lives threatened by your selfishness.  Can you live with that?   

The playdate that you had two days ago?  Seemed legit because your kid was fine, and so was theirs.  That family then has dinner with a great aunt two days later.  Five days later after that, she is in the hospital, in the ICU, with dangerously low oxygen levels.  You didn’t mean for this to happen, but can you live with the fact that it did? 

Can you live with it if you go to your Zumba class, then visit with your daughter and grand-children. and two days later, you get a sore throat and low-grade fever.  Your daughter with asthma can’t catch her breath.  The last thing she sees?  The eyes of a masked stranger.  Why aren’t you there, holding her hand?  Most hospitals that are dealing with COVID cases aren’t allowing any visitors.  If you think I am just blowing smoke and trying to frighten you because young healthy people don’t get as sick with COVID?  Tell that to the patient in their forties who has never had a medical problem who asked me today if they were going to die.   

So, what can you live with?  Those of us who survive will have to answer that question.  I know what my answer will be.  What will yours be?