COVID-19 Update from Dr. Smith: 4/7/20

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,

I first heard about the ring fence concept from a prosperous hospital far west of the Hudson that was interested in preserving its ability to do elective (and lucrative) cardiac surgery during the pandemic.  It’s a simple idea—erect a “ring fence” that keeps COVID out.  After some discussion, they could see the drawbacks and abandoned the idea.  But it had already jumped species, emerging in the strategies of at least one prestigious cancer hospital, and in the initial plans for the Javits Center and USNS Comfort here at home.  Javits and Comfort quickly yielded to reality.  A virus with R0 2.2 and 10-25% asymptomatic carriers cannot be kept out by any fence.  Even universal testing will miss a few asymptomatic early-stage infections.  In a disease as prevalent as COVID-19, it’s only a matter of time before something unworthy slips through the privileged airlock.  “Masque of the Red Death” (Poe) is a quick read for those interested in gruesome ring-fence allegory.

A zoo is a ring-fence isomer, theoretically protecting us from them.  In the past few days we’ve learned that Nadia, a 4-year-old Malayan tiger in the Bronx Zoo, has coronavirus.  She presented with cough, wheezing, and poor appetite.  Her sister, two other tigers, and three lions are also symptomatic.  I mention this not to provoke terror over animal-to-human infection, which is considered very unlikely, it’s just dismaying to see innocent captives dragged into our calamity.  Released penguins strolling amiably through the exhibits in the Shedd Aquarium, closed by the pandemic, was a much more charming thing to see.  Safe from harm, at least?  Only if they stay away from those humans.  An asymptomatic caretaker is suspected to be the source of the Bronx Zoo outbreak.

Some days positives are not thick on the ground.  We’re far enough into this battle to realize that we won’t be achieving miraculous cure rates compared to other countries, just because we’re us.  At least it still appears true that the vast majority of patients survive and thrive, eventually.  It’s very positive to note that Bright Horizons will, after all, stay open to provide childcare for our healthcare workers. 

While sheltering in place, try tuning into the DIY Network or HGTV, and watch earnest young renovators in comfortable clothing use a toothbrush to polish drawer-pulls that always come out gleaming.  Or stream old episodes of Bob Ross.  All very soothing.  At the very least, don’t miss tonight’s “supermoon.”  Best of 2020, and it won’t be matched until May 26, 2021, when all of this will be a distant memory.

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

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