COVID-19 Update from Dr. Smith: 4/5/20

Each day during the COVID-19 crisis, Dr. Craig Smith, Chair of the Department of Surgery, sends an update to faculty and staff about pandemic response and priorities. Stay up to date with us.

Dear Colleagues,

We yearn to find our invincible spring, but we are hurtling into weeks predicted to be our worst. Our Gettysburg, our Somme, our Iwo Jima, our Khe Sanh, our Fallujah. Epidemiologically speaking, we need to reach the point at which deaths and recoveries exceed new cases—the bent-to-broken curve. The steadily positive slope we’ve watched for a month is grinding and relentless. Scanning the daily statistics for the NYP system I can squint, angulate the page, and see the hint of a suggestion that the new-case curve has flattened slightly over the past few days. A curve with zero slope will be a nice start, but the two-week per patient ventilatory support experience we’re confronting means we will still be waiting for our very large rabbit to move through the boa constrictor. But that seems a comparatively small price to pay, and I’ll fall to my knees and rejoice for a flat curve the moment we reach it.

How are we performing, here in the epicenter? Mortality is 2.9% in New York State, derived from incidence and death data in yesterday's New York Times. The coronavirus can make it here. This figure implies that some other countries have done better, but the world is a very long way from having epidemiologically comparable statistics. Any country with leaky reporting may boast a lower mortality. Countries with widespread testing increase their denominator by identifying asymptomatic cases and may appear to have treated their patients more effectively than we have. I don’t think I need to emphasize that widespread testing does not describe New York or the United States. I do know that right now we are waist-deep in execution, in the fog of war. We are preoccupied with patients presenting to our hospital—a high-risk group. The heroic efforts I witness every day are second to none. Many more lives are being saved than lost. Let the referees count the strokes at the end of the round.

Craig R. Smith, MD
Chair, Department of Surgery
Surgeon-in-Chief, NYP/CUIMC

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