A black and white photo of a woman looking intensely into the camera Pre-COVID we were a fairly busy ER; there were always 40 to 60 people, almost every room full. No one was wearing masks. It was very hustle-and-bustle. Now our numbers are way down. And that’s true across the country. The emergencies we used to see—heart attacks, stroke, appendicitis—those patients have disappeared. We don’t know where they’ve gone. The concern is they are staying home because they are afraid to come to the hospital, even though they have real pathology. They are waiting until their disease progresses and becomes much worse, or possibly even dying at home.

Now we have a completely separate unit of possibly infectious people. We’re wearing full personal protective equipment in that area. And then in the regular ER it’s very quiet, with very few patients at a time. And everyone’s wearing masks.

People think that if they have a cough, they immediately have to get tested. We’re not testing everyone who comes in—we don’t have mass-testing capabilities, so we’re still limiting who gets tested. There’s a lot of confusion and fear that creates this vortex of panic around the virus. What we tell them is, even if we test you, it won’t change anything, because either way, you’re going to have to go home and stay home until you’re asymptomatic for at least three days. So whether you test positive or not, it’s not really going to change what we’re going to do. Even if you’re positive, you’re not going to come back to the hospital as long as you’re not having any problems breathing.

I’ve also been involved in figuring out how to reuse PPE in case we run out. We haven’t run out yet. We set up shelves that have hanging UV lights—it has to be UV-C light—and you leave the N95 masks there for 15 minutes. We’ve also bought Tyvek suits, and we’ve been washing them down with quaternary ammonium, a strong cleaning product, so we can reuse them.

Next year I’m moving to Boston to do a fellowship in disaster medicine. I was accepted before the pandemic. I wanted to do something that had to do with response, where I could still apply my emergency medicine skills.

Dr. Natasha Brown ’11, third-year resident in emergency medicine, Mount Sinai Medical Center, Miami