Dear Mr. President,
I am an emergency medicine resident physician in one of the biggest hospital systems in New York City, the epicenter of the COVID-19 pandemic in the United States. In the past several weeks, I have taken care of countless patients with COVID-19 ― some who didn’t seem so sick and some blue in the face and gasping for air 70 times a minute. I have put my face inches from theirs and inserted breathing tubes into their trachea, putting myself and everyone else in the room at exponentially higher risk of contracting this disease.
As I’ve sat in a room full of coughing patients for 60 hours a week, I have worried about my own safety now and in the coming months as this pandemic gets worse and our completely inadequate supply of personal protective equipment rapidly disappears. There is a major shortage of face masks, along with other supplies, across the country and without them, it can be next to impossible to keep health care workers safe and working to support the increasing number of patients who are arriving at our hospital and clinic doors.
I have sent some not-so-sick patients home and I have seen some patients die right in front of my eyes. I have spoken on the phone to the sobbing mother of a young man admitted to the intensive care unit, and told her, “No, you are not allowed to enter the hospital to see your critically ill son because we are not letting family members into the hospital during this pandemic.” To say that I have experienced countless heartbreaking moments over the past several weeks would be an understatement.
In the next couple of days or weeks, we will run out of hospital beds and ventilators. The number of critically ill COVID-19 patients who come to my hospital seems to double every day. If things continue this way, I will soon be forced to make decisions about who deserves a shot at life and who I will allow to die, and that is an unthinkable thing to have to consider, much less do.
Tell me ― when there is only one ventilator available, should it go to the young nurse or the elderly woman with multiple comorbidities who has an advanced directive that says “do not intubate/do not resuscitate”? How about the single mother of three? Or the deeply respected emergency medicine attending doctor I worked with last week? How about the middle-aged man with some medical comorbidities and corny jokes who reminds me of my father ― or is my father? Or maybe the person in prison for rape? How about the person of color in jail for marijuana possession? How about a beloved and wealthy celebrity? How about the homeless person with alcohol use disorder who spits on my fellow medical professionals and me when we try to help? How about the homeless person who lives on my street corner and smiles at me every day and says “God bless you”? It’s not so easy choose, is it?
If things continue this way, I will soon be forced to make decisions about who deserves a shot at life and who I will allow to die and that is an unthinkable thing to have to consider, much less do.
This past week, between 12-hour shifts working in the emergency department and the newly created COVID respiratory unit, I have done everything I can think of to stop that nightmare scenario from arriving. I have posted on social media begging my friends and family to stay home. I have signed countless petitions and contacted my local government pleading for more personal protective equipment and ventilators. If I learn of other things I can do, I will do those, too.
My governor, Andrew Cuomo, has tirelessly worked to obtain more personal protective equipment and ventilators. He has begged you to nationalize the effort to acquire medical supplies and you have denied him. He’s begged for citizens to stay home and, while some are listening, many are not and if they don’t, it will be disastrous. But there’s only so much the governor ― or any of us ― can do alone. At this point, there may be only so much we can do together. But we must try.
On Tuesday you told Fox News you would “ love to have the country opened up and raring to go by Easter.” You said you chose Easter because, “you will have packed churches all over our country, I think it would be a beautiful time and it is just about the timeline that I think is right.” The thought of this makes me nauseous. If we do that, exponentially more people will get this disease, our hospital system will not have the capacity to handle it, and health care professionals like me will have to let countless people die while continuing to put our own lives ― and possibly the lives of the people we love ― at risk.
When we run out of ventilators ― and we will if we lift the social distancing restrictions that are in place and this pandemic continues to spread as it already has ― I will not be ready to make these decisions about who deserves to live and who deserves to die. When those moments come, I do not know how I will be able to sleep at night. Will you? Now is not the time to let our guards down.
You have the power to be remembered as someone who did the right thing. I beg you to help me and other health care workers save countless lives ― possibly including our own ― so that we as a nation don’t have to suffer the unthinkable devastation looming on the horizon. I beg you to take this pandemic more seriously and I am begging you to do it now.
Rachel Sobolev, MD