DAVID GREENE, HOST:
This morning, we're bringing you the first of several conversations in a series we're calling Connections. We want to connect people from different states or different parts of the world who are facing similar challenges as a result of the coronavirus. Today, two doctors - one in Seattle, one in New York. They both work in emergency medicine. Both are treating COVID-19 patients in places with major outbreaks. Dr. Zachary Levy at North Shore University Hospital on Long Island said he and his staff are making different decisions these days.
ZACHARY LEVY: Our threshold to admit someone to the intensive care unit and to put them on a ventilator is probably much higher than it would be otherwise. And there's ongoing drug shortages that have forced us to look into second-line and third-line therapy for pain management and for sedation.
GREENE: All right, that's New York. In Seattle, Dr. Nick Johnson said things at Harborview Medical Center are not quite as severe.
NICK JOHNSON: I think in Seattle, we've been fortunate in that the rate of rise has not been as fast as in New York and some other places, and so we've been able to essentially continue to practice our usual standards of care, with a few small exceptions.
GREENE: Have either of you lost anyone who you feel like you may have been able to save in a normal time?
JOHNSON: I think that the patients that we've lost here have been patients who probably would have died prior to this.
LEVY: I wish I could say the same thing. But we have had some younger patients expire as well, patients in their 40s and 50s. And for patients who suffer an out-of-hospital cardiac arrest, our protocol now is to not bring them to the hospital unless the medics on the scene are able to resuscitate them, able to get a pulse back.
And so I've gotten a number of calls - one even just about a day and a half ago - of a 33-year-old who the paramedics said had a fever for a week and didn't have any comorbidities and had collapsed at home. And they had worked on him for a little while, and they couldn't bring him back, and I ended up pronouncing him in the scene. And so someone like that, you know, it's hard to speculate, but, you know, that is certainly not the type of patient that you expect to lose otherwise, if not for the really unprecedented nature of what's going on right now.
GREENE: And when you say unprecedented nature, it's not just this disease; it's a health care system that just can't handle so many people at once.
LEVY: I mean, we're not built for this. We're not.
GREENE: Do either of you have either a question for one another or a piece of advice you could give since, you know, your hospitals and your cities are kind of at different stages of going through this?
LEVY: You know, I would be interested to know - because, you know, Seattle was - that region seemed to have been hard hit early on, and I'm wondering what steps did you take that we maybe should have considered sooner? What did you do to put yourself in the position where you are now?
JOHNSON: Yeah, I don't know that I have an easy answer to that one. I think that, from a leadership level, a regional leadership level, there were really early efforts around social distancing and really understanding this disease on a couple of levels. One, I think a lot of the bigger companies that employ a huge number of people in this area sort of shut down operations in early March, when we first started learning about these cases. And there was a lot of local and regional discussion around social distancing that I think people took fairly seriously early on.
And then, also, our ability to test was ramped up very quickly, and I've never seen our health system work together like it's working right now. It's been quite impressive.
GREENE: Is there a single moment that stays with either of you, whether it's something with your own family or with a patient or with a colleague, that you just can't get out of your head?
LEVY: My wife is also a physician. She's an oncologist by training, but she's been pulled into the fight alongside the rest of us. And our son, we had to make the decision to send him away. So he's up in the Berkshires right now with Grandma while Mommy and Daddy are holding down the fort at home. And we come home every night, and, you know, we have ourselves, but our family is sort of incomplete and on hold right now. And we're just waiting for the day where we could all be together again.
JOHNSON: I think the moment for me that sticks out the most is hearing about two colleagues and another emergency physician from another hospital in the area and a nurse who became ill themselves and required critical care and a ventilator. And that brought a level of concern not really just for my personal safety but for the safety of my colleagues and the level of caution that we were going to have to exercise when taking care of these patients that I'd previously not been aware of since we were so early in the process.
And now there are many reports of health care providers being sick and being taken out of work. But it really struck home when I learned of two people in my own field getting sick fairly early on in this process.
GREENE: How are they doing?
JOHNSON: Both are doing quite well from what I understand - one I know well and is doing phenomenally well and hopefully going to be leaving the hospital, and the other, I hear, is recovering nicely as well. So it's good to hear those success stories, but, sure, there were some scary moments early on.
GREENE: Anything else you guys want to add to one another or add to the conversation?
LEVY: You know, I appreciate all the support that we have gotten from our colleagues on the West Coast. I'm hopeful that we can reconvene when all of this is done and talk about what we've learned and prepare ourselves to face it head on the next time around.
JOHNSON: And we're learning so much from you all because you're really becoming the experts in managing this disease. And out here, we really appreciate and respect all that you're doing and thinking about you and all your colleagues.
LEVY: Thank you, Nick.
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GREENE: Dr. Zachary Levy in New York connecting with Dr. Nick Johnson in Seattle. And we'll have more of these connections to come here on MORNING EDITION soon.
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