A discussion organized by the Hellenic Medical Society of New York on what the doctors have experienced in the thick of battle against the Coronavirus
New York.- By Vicki James Yiannias
“The horrific COVID-19 has affected the lives of all of us, especially my colleagues who are fighting every day to save lives. And because of the heterogeneity of the presentation of the virus, its uncertainty and its unpredictability, we are all forced to put our lives on hold.” said Dr. Lorraine Chrisomalis-Valasiadis, 2nd Vice President of the Hellenic Medical Society of New York (HMSNY) introducing the HMSNY-organized May 23 discussion with six Greek American doctors of various specialties, titled “Doctors on the Frontline During the Covid-19 Pandemic.” But in comparison with what the doctors have experienced in the thick of battle against COVID-19 for approximately three-months, letting up only in the last weeks, putting our lives “on hold” during this crisis seems less like an imposition, and more like a luxury.
The heroic New York and New Jersey doctors sharing their experiences and insights on the pandemic are Dr. Helen Gouzoulis-Koutsos MD|Internal Medicine Private Practice, Manhattan, NY, HMS Secretary; Dr. Marianna Karounos DO|Head of Emergency, St. Joseph’s Hospital, Paterson NJ; Dr. Ioanna Katsa MD|Cardiology Fellow, Montefiore Medical Center; Dr. Apostolos K. Tassiopoulos, MD|Professor of Surgery; Dr. George Coritsidis MD|Critical Care Medicine Specialist, Elmhurst, NY; Dr. Panagiotis Manolas MD|General Surgeon, Astoria, NY, Hellenic Medical Society President.
Dr. Helen Gouzoulis-Koutsos’ story is as personal as possible in that she experienced COVID-19 herself, contracting the virus sometime in early March when she was swabbing patients for the virus while not always wearing a mask. “We knew Coronavirus existed, but we didn’t know all the ways in which it could be transmitted, said Gouzoulis-Koutsos. Having developed flu-like symptoms, fever, muscle aches, then pneumonia, she stayed home and started on various medication. Her condition continued worsening. In mid-March, she was admitted at Lenox Hill Hospital and tested negative for the virus (oddly, she continuied to test negative until a later stage). Two days later, A CTSCAN revealed white spots on her lungs. “That night, Dr. Bushra Mina [Pulmonologist], who was fantastic, saved my life, I believe. Because of the cysts I couldn’t breathe and was ready for intubation… In two days, I was discharged.” Recovered from feeling very weak and shaky, Dr. Gouzoulis-Koutsos feels better physically and emotionally. Still testing positive, however, Dr. Gouzoulis-Koutsos is holding telemedicine sessions. But she finds them lacking, “I don’t feel as connected to my patients through the computer; it’s just not the same. It’s new to me, but I’m trying my best.”
Dr. Marianna Garounas, Head of the Emergency Department at St, Joseph’s Hospital in Paterson NJ described how COVID-19 evolved in her department beginning with “one of our own PM physicians,” also part of her administrative team, whose official diagnosis on March 8 created chaos: half the team had been exposed to him so went into quarantine that day. Dealing with the complexity of “running a department of 90 beds, 60 physicians, and 150 nurses from home… was an administrative skill set” that Dr. Garounas “hadn’t ever acquired.” Five or six days after their March 18 return to work (no one had gotten sick), “became possibly the most chaotic thing I will ever experience in my life,” she said, “We call it the ‘80/80 Phenomenon’ that we never want to experience again…we had80 bed holds and 80 people in the waiting room. Our hospital system had 140 intubated patients and 36 of them were intubated and held in the Emergency Department.” The challenges she describes were immense,
involving staffing quarantine and illness, support of the staff of 60 physicians that she manages on a daily basis, 24 residents, and 150 nurses during a “very scary time” of changing guidelines on whom to intubate, who should have a ventilator, and countless other decisions, calculations, and demands.
Dr. Garounas was clearly saddened by sometimes being among the only people allowed at a dying patient’s bedside, “having to communicate things to their families, holding their hands and trying to tell them you’re there for them.” Dr. Garounas grew silent, saying she can’t put these experiences into words. “It was like that continuously for three weeks—chaos–then suddenly cases started to slowly trickle down.”
Dr. Garounas next talked about a problem which clearly deeply concerns her, the wellbeing of her staff under today’s changing circumstances, “When the number of intubated patients stayed low, we had this complete swing to the other side, to where, ‘how do you support your staff when you’re being told you have to cut their hours?’ The emotional roller coaster of this frontline staff that worked above and beyond what we thought they were capable of, who were called heroes, who were sent food every day and touted as ‘the reason why people are making it through.’ And then all of a sudden, they want to cut your hours and they want to cut your pay; they aren’t sending food anymore, and not calling you a hero anymore. How do you support the staff and give them what they need to help them keep going, because the battle is still happening; it’s still very real. People are still getting sick and coming in. We’re still intubating people. People are still dying from COVID-19.
“In addition to the obvious clinical pieces–the things that we’ve learned about how to serve, how to deal with mass casualties, and drills, the PPE shortages, and all the other things that we’ve prepared for, we have to learn what we need to put in place to help the staff; what we need to put in place to help them later, like outlets for them to talk and express their feelings so they’re able to come to terms with what they’ve gone through and what they will continue to go through.”
Dr. Ioanna Katsa noted that from the perspective of the Cardiology Fellows at Montefiore Medical Center COVID-19 developed rapidly from the first days of March, when she noticed certain occurrences, such as the sudden disappearance of masks and some fear amongst the personnel. Transitioned to the CCU, where there are normally patients with massive heart failure that need transplants, she noticed within the span of a week that patients with serious heart problem were coming back, with multi-organ failure and shock brought on by COVID-19. “In a week or ten days the entire CCU had changed; there were only jCOVID-19 patients with multi-organ failure.” Her observation in the beginning that there was a shortage equipment and a lack of information about procedures was real, “We were not prepared for this as we should have been.”
Dr. Katsa related the depressing situation of having to question whether a patient with a very poor prognosis should be offered what patients with multi-organ failure are normally offered, such as renal replacement therapies, etc., and our training changed a lot, because instead of just seeing cardiac
patients we were asked to do procedures primarily on shock patients. I think we have learned a lot about the disease, how much it affects the heart and the cardiovascular system, and we have a first-hand approach to dealing with it.”
The talks of Dr. Panagiotis Manolas, Dr. Apostolos K. Tassiopoulos, and Dr. George Coritsidis will
appear next week.
To view this webinar go to: (https://www.youtube.com/watch?v=CKLvhVNd24g&feature=youtu.be)