COVID -19 and The City: A doctor’s experience.

My professional experience with COVID-19 was that I lost my clinic.  I am a pediatrician working in a school-based health center on a high school campus in the South Bronx.  When Governor Cuomo and Mayor DeBlasio discussed whether or not to close the public schools, I was on the edge of my seat for many reasons. My gut instinct told me that this novel virus would have dangerous effects across the city and the country. As a doctor trained in public health, I was worried about the teachers and the school staff getting sick. I was also concerned about protecting myself and the other clinic staff from contracting the disease.  However, the other part of me was worried about where I would work.  I knew that something had to give.  

We got the news on a Sunday that the schools were closed.  Our staff of over two hundred was to report to the administration building the following morning if we wanted to work.  We then received notifications to stay home and be on call for the entire day, as too many of us wanted to work. The following day, we received instructions to report to our regular clinics.  Initially, the school buildings were open for the first week because the teachers were preparing to start remote learning.

The following two weeks were a time of uncertainty.  We got an email that all of us doctors could be deployed to the hospital. Emotions were high. The news at the time was filled with stories about hospitals not having sufficient PPE.  Our medical center was sending emails about giving new N95 masks only twice a week.  Our colleagues around the city and the country were contracting COVID, and some were losing their lives.  The death toll in the state was climbing higher and higher.  The subways were getting more crowded, and trains came less frequently due to increasing numbers of transit workers contracting the virus.  Due to the overcrowded trains and the lack of social distancing, I started wearing a mask and gloves on public transit even before it was recommended.  I honestly feel that this was the primary reason why I didn’t contract COVID-19.

The month of April 2020 in New York City is one that I will never forget.  A once vibrant city became desolate, with grocery stores and barely a few restaurants open.  The subway system, the only one in the world running twenty-four hours a day,  closed for four hours a night for cleaning.  There were long lines to get into the grocery stores.  The subways I mentioned earlier became very clean and empty.  We heard the constant sounds of ambulance sirens going off all day and night, taking patients to the local hospitals. There were also the sounds of cheering and clanging of pots and pans at seven o’clock every night to cheer for the healthcare workers who were working diligently to save the lives of their fellow New Yorkers.  

A few nurse practitioners and doctors, including myself, ended up working in our school clinics in enrichment centers. These enrichment centers provided daycare for the children of essential workers. My hospital system initially had inadequate telehealth capacity, which rapidly changed during the early stages of the pandemic. Initially, we tried to reach out to our patients who received reproductive health services.  This proved to be a challenge because we didn’t have confidential numbers for the patients or if we had the numbers, they were no longer in service.  Some of our patients were obeying the stay at home order; however, there were enough patients that still were engaging in sexual activity and needed our services.  We were calling in prescriptions for birth control, and we did see patients in the clinic for Depo-Provera shots and long-acting – reversible contraception (LARC.)  

As time went on, we reached out to other patients, such as those with asthma.  It was great hearing from the students and their families, and they were happy to hear from us.  Many of the students themselves or their parents had contracted COVID. A few had relatives who had passed from the virus.  Some of the students were suffering from depression or anxiety, and we were able to refer them to mental health services.  

Now that we are entering November, things are still changing daily.  I have been back in my school clinic doing telehealth and a few in-person visits.  We adjust to the changes with students who are doing blended learning vs. remote, only to serve them best.  We have two department of health nurses triaging sick kids for COVID-19.  There have been schools that have closed due to multiple positive tests.  We now have neighborhoods with COVID clusters that have resumed restrictions to prevent further spread of the virus.  As for myself and my colleagues, in addition to preparing to see patients safely in our clinic, we are facing more uncertainty due to rumors of budget cuts and layoffs.  

This virus is not going anywhere anytime soon.  We are eight months into this pandemic, and numbers are still high in many states.  Due to our hard work, New Yorkers made it down COVID-19 mountain, and we are still working hard to keep our infection rate below one percent. Please wear a mask- “I protect you, and you protect me.” 

Dr. Jennifer Davis is a teen and adolescent physician specialist who practices in New York City. She is co-author of the Women in White Coats book two and is a Women in White Coats Fellow. She is on Instagram @jaydee_md

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