'NEVER SEEN A MORE-DANGEROUS SITUATION FOR MEDICAL PERSONNEL': New York State Nurses Association members picketed outside Harlem Hospital April 6, while observing social distancing, to protest conditions including a lack of personal protective equipment that former Doctors Council President Barry Liebowitz said added to what was already an extremely vulnerable atmosphere for them. 'They're fighting an unknown, and nobody is immune to it,' he said of all medical staff dealing with coronavirus patients.

A veteran firefighter April 7 replied to my phone message with an email declining to discuss in depth the situation at a job in which more than 300 colleagues had already tested positive for the coronavirus.

He did write, "As for life inside the [firehouse] during this pandemic, it's dealt with [using] the same gallows humor that we deal with everything....I can tell you guys [are] being vigilant with safety precautions."

What he did want to do at greater length was pay tribute to those workers who were most exposed to COVID-19 while trying to save lives. "As for risk," he wrote, "it is the medical professionals who have taken the brunt of this burden head-on. We face exposure to the virus, but not to the degree that they do. They are on the front lines."

Ex-Doctors Council Head: Shows the Dedication

A fuller perspective was offered by Dr. Barry Liebowitz, a retired pediatrician who spent 34 years as the president of the Doctors Council before stepping down six years ago.

"This is exceedingly frightening for the medical world, the establishment and people who are on the line on a daily basis," he said in a phone interview that afternoon. The medical staff treating coronavirus patients is "probably one of the most-vulnerable groups we'll find. They have worked in many instances in an unprotected environment," with personal protective equipment more available than a week or two earlier but "still not in surplus."

This was clearly a source of anxiety, as detailed by nurses at Harlem Hospital during a press conference the previous morning. That they and fellow nurses and doctors continue showing up despite the considerable risks, Dr. Liebowitz said, "does show the dedication. No one is opting out and not coming back to work. They're fighting an unknown, and nobody is immune to it."

He continued, "When they come home to their families, there's also the anxiety of infecting them, and so many will sequester themselves. It's a lonely existence, it's a dangerous existence and the equipment is not always there."

Early in his medical career, he served as the doctor for a tour sponsored by the Scripps Oceanographic Institute of the Amazon jungle, which led to Dr. Liebowitz setting up a clinic treating indigenous people there, sometimes forced to use home-made supplies. Nonetheless, he said, "I have never seen any more-dangerous situation for medical personnel" than the one being confronted by hospital staff here.

Referring to the start of the AIDS crisis in New York in the early 1980s, when there wasn't yet definitive information about how doctors and nurses might become infected, he said, "Even in the HIV days, there was fear, but not to the degree you see now. If you were a health-care worker, the major problem was if you stuck a needle in your finger by accident" while drawing patients' blood.

In the current crisis, he noted, "You are looking in someone's mouth—you're really up close and personal."

Further reason for concern, he said, resulted from New York City Health+Hospitals recently instructing nursing staff to use N95 protective masks for a full week before disposing of them.

"The ideal use of the N95 is to wear them once and discard them," he said, "After five days, probably the N95 filter will no longer be effective--it will degrade to a point that it will not be safe. It will enable a small particle to get into a bigger hole. It's not the best scenario."

A Psychological Toll

Beyond the physical risks, Dr. Liebowitz added, there is a mental toll that goes beyond the anxiety about contracting the disease and won't dissipate once the crisis eases.

"After the emergency is over, we expect everyone to come back to normal. But like PTSD in war, I think they're going to come away with a lot of psychological scars that are going to have to be dealt with," he said.

Asked whether those might be particularly acute for doctors and nurses at Elmhurst Hospital, who endured the deaths of 13 patients in a 24-hour period late last month, the former union leader demurred, saying, "I think it'll be like that for all of them," even if staff at other area hospitals didn't have such a nightmarish situation in a short period of time.

"Everyone wants to do right," he said of medical professionals. "You've got a certain amount of energy, and even when you use it up, you'll keep going."

But beyond the stress employees feel from the "trauma" of patients dying, Dr. Liebowitz said, during the pandemic "the possibility of our own deaths is there every single day."

Questioned about government's slow-developing response, from the local level to Washington, D.C., he remarked, "They're playing catch-up right now. I'd say they're better now; they're not fully there yet. The salient thing is we were totally unprepared for this, although there were predictions that eventually something like this would happen."

'Be Prepared'

"If we learned anything from this," Dr. Liebowitz said, "it's gonna be: be prepared. We should know that at any time, something like this could happen. And so you warehouse equipment so you have a surplus of ventilators that hopefully you'll never use. A surplus of gowns, a surplus of masks."

While thousands of retired medical professionals answered the calls from Governor Cuomo and Mayor de Blasio to volunteer their services to assist in the response to the coronavirus, Dr. Liebowitz, who is 83, was not among them. "I've been painting more than anything," he said of how he's been staying busy at the eastern Long Island home he shares with his wife, Maureen Connelly, a veteran political consultant.

Given his age, did he feel particularly vulnerable? Because he is in good health and has a mental outlook he likened to Peter Pan, Dr. Liebowitz replied, "I personally do not feel the vulnerability. But remember, I've isolated myself, so there definitely is fear."

But, he added, "It's not a vulnerability of age. It's a vulnerability of being human, and knowing there is an invisible force that can destroy you." 

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