CONFRONTING THE CORONAVIRUS BY ELAINE GUREGIAN
You go through this process of feeling very heavy, and then also feeling very numb from time to time because you just know that you have to do this for the patients. You have to get it done. And then you come back and you realize how human it is and you watch human emotions and it kind of affects you in that way.”
hat was it like, caring for patients in a hospital during a global pandemic? Sahil Pandya, M.D. (’14), was carrying out his third-year pulmonary critical care fellowship at the University of Kansas Medical Center in Kansas City, Kansas. Across the country, Tyler Jones, M.D. (’14) was continuing a surgical critical care fellowship at the Yale School of Medicine, where he also worked in trauma and emergency general surgery. Each of these former College of Medicine classmates treated patients in hospital intensive care units in late winter 2020, as COVID-19 began surging in the United States. In these comments, condensed from conversations and emails, the physicians speak of the confusion of dealing with an unknown virus that was spreading even Illustration: Dave Szalay
– Sahil Pandya, M.D. (’14) as patients, families and caregivers struggled with the emotional toll.
SAHIL PANDYA, M.D. What were some of your initial concerns as you prepared, and when was your hospital hardest hit? Some of the biggest concerns that we faced were how to ensure that personal protective equipment was strategically distributed to our staff. We realized that a lot of people had not been appropriately fit-tested yet. [The wearer puts the mask on, and the tester sprays it with a flavored mist. If the wearer can taste the mist, it means the mask isn’t the right size, and it won’t protect them.] Our team predicted the number of cases and the ventilator need based on the
curve on various dates and data from New York, Kansas City and Missouri. Our best guess was that we had enough ventilators, but we considered alternatives as backup — like a CPAP machine for a person who has sleep apnea, or an alternative version of that called a BiPap machine, for people who are not intubated or using breathing tubes but are on the verge of it. We created a respiratory therapist curriculum and taught all of our department how to convert CPAP and BiPaps into ventilators, should the need arise. We also realized that our respiratory therapists do a lot for ventilated patients without the physicians. If many more people than usual were on ventilators, it was going to be too much for them to handle alone, so they taught us physicians how to do basic kind of machine equipNORTHEAST OHIO MEDIC AL UNIVERSITY