JUDY WOODRUFF: As you know, there's growing concern around the country about how health
care workers will deal with a potential surge of patients and the fears that doctors, nurses
and others have for their own safety, as well as for their families.
William Brangham and I are going to explore some of these questions this evening with
several voices.
We're going to start with William and focus on the biggest hot spot in the U.S. we begin
with a view from one emergency department in New York City. That's one of the city's
hardest hit by this outbreak so far. And for that I am joined by Dr. Billy Goldberg. He's
an emergency room physician at
We're going to start with William and a focus on the biggest hot spot in the U.S.
WILLIAM BRANGHAM: We begin with a view from one emergency room in New York City. That's
one of the cities hardest-hit by this outbreak so far.
And for that, I'm joined by Dr. Billy Goldberg. He's an emergency room physician at NYU Langone
Health.
Dr. Goldberg, thank you very much for doing this.
Can you just give us a sense of what it's like in the hospital today?
DR. BILLY GOLDBERG, NYU Langone Health: It changes every day.
So you know, what it was like yesterday and what it is like today is a different story.
Things are getting real here in New York. We're getting sicker and sicker patients.
We are all concerned about what is going to happen in the days and weeks to come.
But we're hanging in there. This is what we are trained for, as emergency medicine doctors.
And we are there for you.
WILLIAM BRANGHAM: One of the things that we have read a good deal about is this concern
that there is simply not enough protective gear for masks, face shields, gowns for people
like yourself.
Are you guys OK on equipment right now?
DR. BILLY GOLDBERG: So, describe OK.
We're not exactly where we want to be. Both of our hospital systems, both NYU and Bellevue,
are doing everything we can to get the gear we need. On a normal day, when we see a patient,
like a patient with COVID -- prior to COVID, that is -- we would be free to put on the
full protective equipment that we need.
When we leave the room, we change that equipment and we put on new equipment for the next patient.
That is not the case now. We do have equipment for the short term, but we don't know what
is going to happen.
And we are doing things like using a mask for the entire shift, until it visibly soiled.
And those are things that are tricky for us on the front line.
WILLIAM BRANGHAM: So, normally, you would take one mask, one face shield per patient?
DR. BILLY GOLDBERG: Yes, the whole concept is, is, you want to protect yourself, you
want to take anything that may have gotten on that, carefully remove the mask, and discard
it, and then you start fresh with the next patient.
So, sometimes, we have what we are calling super spreader events. And these are events,
such as an intubation, which is when we have to put a breathing tube down somebody's trachea.
Now, these are super spreader events, because the virus is spread much more rapidly. It's
because we are aerosolizing the virus. Mostly, we're concerned about droplet transmission.
But in these cases, because of the proximity to the airway and the exposure to the virus,
it's much more risky for those of us in the health care field.
So we're trying to really protect ourselves during those times. And we will have a shield
that kind of protects the mask. So you're hoping that no splash gets on the mask.
But, again, when the virus is everywhere, it's inevitable that this these -- you know,
these precautions are not perfect.
WILLIAM BRANGHAM: So you're talking about the need to put someone on a ventilator. That's
something else that we have heard that there is a great deal of concern about that, that
we simply don't have enough ventilators for all the patients who might need them.
Are you guys equipped well enough now, or not?
DR. BILLY GOLDBERG: So, again, now, yes, but tomorrow, we don't know.
We're seeing more and more patients like this. We have a shift report at the end of every
day, and, occasionally, we will put one or two people to shift on a ventilator. Yesterday,
I got a shift report that said 10 people in one 12-hour period.
And the numbers are just -- just increasing. So we don't know where this is going. So we
need more supplies.
WILLIAM BRANGHAM: So many of us, of course, were following what was going on with the
medical staff at all of those hospitals in Italy and the sort of heart-wrenching struggles
that they had to make about who to care for and who not, simply because they had run out
of that capacity.
Were you following that? Were you reading those dispatches from doctors? And were you
talking amongst your colleagues about this?
DR. BILLY GOLDBERG: So it's a very active thing that a lot of us are doing, not only
to follow the stories, the way everybody is, but also to learn about the disease process.
So we're learning things all the time through our physician chat groups, through some of
these online discussions. And, yes, we're following it. And we think about patients.
What's in their best interest? We try to discuss advanced directives with them.
It is going to become a much different situation with this, because, as we get closer to kind
of running out of some of these supplies, we're going to have to make tough decisions
about who has the highest likelihood of surviving.
And that may mean you're not providing this high level of care to patients who perhaps
could have had a chance.
WILLIAM BRANGHAM: And how are you -- I'm just curious how you're personally doing. I mean,
this seems to be something that much of the nation is alarmed about and watching the news
and scared and worried and hoping for the best.
But, as someone who is obviously directly on the front lines of all of this, how are
you personally doing?
DR. BILLY GOLDBERG: You know, we're hanging in there. This is what we're trained to do.
It's scary. We're still trying to protect our families and protect ourselves. There's
a lot of people -- people are paying a lot of attention to E.R. doctors now, which is
great, but our colleagues in the ICU and on the medicine floors and all the people who
work in the hospital are also dealing with it, the clerks, the people who clean the floors.
It's -- we're all together in this. It's a scary time. I think our reserve is a little
low, so small little things will tip us off. But we're trying to do the best we can to
seek solace in the people who are doing the same things and just keep pushing along.
WILLIAM BRANGHAM: OK, Dr. Billy Goldberg from NYU Langone Health, thank you so much, and
best of luck to you out there.
DR. BILLY GOLDBERG: Thank you.
WILLIAM BRANGHAM: And now we turn to get a broader perspective, how an entire health
system is preparing for this outbreak.
For that, I am joined by Dr. Anish Mahajan. He's the chief medical officer for Harbor
UCLA Medical Center, which is operated by the Los Angeles County Health Department.
Dr. Mahajan, thank you very much for being with us.
Could you just give us a sense of how your hospital system is doing? How are preparations
going?
DR. ANISH MAHAJAN, Harbor UCLA Medical Center: Well, we are working very hard to be prepared
for a larger number of patients that we anticipate as we get into the curve.
Here in Southern California. we are maybe a few days behind New York City and other
places, certainly around the world. And so we are working very hard to increase our capacity
through ICU level care and other types of care.
WILLIAM BRANGHAM: Approximately how many COVID patients do you have right now?
DR. ANISH MAHAJAN: Well, I will speak for the public hospital system here in L.A. County.
We have about 10, or maybe a few more than that, that are confirmed positive. But, as
you know, there's very little testing available. And we know that, in the community in L.A.
County, there are likely to be many more confirmed cases of COVID. We just don't have the ability
to test them.
WILLIAM BRANGHAM: So, is that your sense, that, absent good testing, we really just
don't understand how widespread the virus is right now?
DR. ANISH MAHAJAN: That's correct.
We have proxies without testing, such as patients that we are seeing presenting with flu-like
type illness. So that gives us a sense, but we know already that there is community transmission
occurring here in Southern California and many other places in the nation -- community
transmission, of course, being patients acquiring the infection, but not really knowing that
they had contact with someone who was positive.
WILLIAM BRANGHAM: You mentioned that, systemwide, you're going through a lot of preparation.
What does that preparation look like? What are you guys actually doing?
DR. ANISH MAHAJAN: Well, a number of things.
One of the first things we're doing are making sure that we have sufficient protective gear
on hand, and using that protective gear wisely and when it's absolutely needed to protect
staff from getting the infection.
The second thing we're doing is making sure that we're protecting patients from each other,
ensuring that patients that have symptoms that suggest flu-like, or in this case coronavirus,
are separated from other patients that we're seeing.
A third thing we have done is, of course, cancel all nonessential care, such as nonessential
clinic visits, operations and surgeries. We're doing that, one, so that people can stay out
of the hospital and clinics, so that they can be safe.
WILLIAM BRANGHAM: And are you confident that you have that capacity? I mean, do you have
enough protective gear, do you have enough ventilator, do you have enough beds to do
all of those things if the spike is, as we -- as many people fear, the worst could be?
DR. ANISH MAHAJAN: Well, we are working very hard to shore up our resources on all of those
things.
You know -- you have heard and all of us know that there's global shortages of protective
gear. As it relates to ventilators, same thing. All jurisdictions at all levels of government
are helping us find those ventilators.
But perhaps the most significant problem is that we need staffing for these critical care
beds. And so we are asking nurses who used to practice critical care who may be in administrative
roles to reacquaint themselves with how it is to take care of patients, because this
is really going to be an all-hands-on-deck approach, if we don't flatten the curve.
WILLIAM BRANGHAM: What is the general sense amongst the staff?
I mean, for those of us who are reading reports, say, out of Italy, there seems to be a great
deal of concern amongst medical staff about the difficult road that lies ahead. How are
staff telling you, how are they doing, how are they coping with all of this?
DR. ANISH MAHAJAN: Well, I think Americans know that people who come to work in hospitals
and clinics are compassionate.
And these are not just the doctors and nurses, also the clerks, the people who clean the
rooms and make sure they're safe and turn over the rooms. These people are very compassionate
and mission-driven.
But what we are seeing now is, they're showing courage, because, in a public health crisis
like this, where the infection can be transmitted so easily, naturally, our staff want to continue
to help their patients and the community, but they also have to protect themselves.
And so, yes, we are seeing a lot of anxiety among all levels of staff about whether they
may bring the infection home to their kids or to their parents. How do they protect themselves
when we have shortages of protective gear?
WILLIAM BRANGHAM: We know your governor, Gavin Newsom, issued basically a stay-at-home order
for the entire state.
Is it your sense that people thus far have been heeding that? Have you noticed more people
seeming to stay away, to stay at home, to isolate themselves?
DR. ANISH MAHAJAN: Well, certainly, we have probably all seen the reports of the fact
that L.A. freeways are no longer choked. We can get around easily. Pollution is down in
major cities that have stay-at-home orders.
That said...
WILLIAM BRANGHAM: One small silver lining to this crisis, I take it.
(LAUGHTER)
DR. ANISH MAHAJAN: Right, and a proxy that people are generally staying home.
That said, there are groups of patient -- people who maybe don't yet understand the message,
and particularly young people. Young people in general feel they're invincible. So, it's
extraordinarily important that everybody heed the stay-at-home orders, so that they protect
the entire community and protect the -- protect us from the infection spreading very rapidly,
because, as you know, if the infection spreads rapidly, we will quickly be overwhelmed in
being able to take care of the patients that need the help.
WILLIAM BRANGHAM: All right, Dr. Anish Mahajan, chief medical officer of Harbor UCLA Medical
Center, thank you very much.
And from all of us, best of luck to you out there.
DR. ANISH MAHAJAN: Thank you very much.