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| ‘Thanking God for My Breath’: Dispatch From New York’s Frontline | ‘Thanking God for My Breath’: Dispatch From New York’s Frontline |
| (3 days later) | |
| — Dr. Dara Kass, associate professor of emergency medicine at Columbia University Medical Center | — Dr. Dara Kass, associate professor of emergency medicine at Columbia University Medical Center |
| [In Her Words is available as a newsletter and this profile is part of a series looking at women at the forefront of the fight against coronavirus. Sign up here for more profiles in the weeks ahead.] | [In Her Words is available as a newsletter and this profile is part of a series looking at women at the forefront of the fight against coronavirus. Sign up here for more profiles in the weeks ahead.] |
| One Sunday last month Dr. Dara Kass reported to an emergency room in the Washington Heights neighborhood of Manhattan. In some ways, it was a morning just like any other. She chugged a coffee, scrubbed in, greeted her co-workers. She was sent to an area of the E.R. designated for patients with respiratory issues. And that’s when the morning took a turn — it was Dr. Kass’s first day on coronavirus duty. | One Sunday last month Dr. Dara Kass reported to an emergency room in the Washington Heights neighborhood of Manhattan. In some ways, it was a morning just like any other. She chugged a coffee, scrubbed in, greeted her co-workers. She was sent to an area of the E.R. designated for patients with respiratory issues. And that’s when the morning took a turn — it was Dr. Kass’s first day on coronavirus duty. |
| Instead of the normal abdominal pains and headaches, nearly every patient that Dr. Kass saw had the same telltale Covid-19 symptoms: cough, fever, shortness of breath. And tensions among the E.R. staff were running high. | Instead of the normal abdominal pains and headaches, nearly every patient that Dr. Kass saw had the same telltale Covid-19 symptoms: cough, fever, shortness of breath. And tensions among the E.R. staff were running high. |
| Dr. Kass recalled that the hospital unit felt “like a pressure cooker,” all of the physicians and nurses doing their best to stay calm as some speculated about what their work would look like once the number of Covid-19 cases surged. | Dr. Kass recalled that the hospital unit felt “like a pressure cooker,” all of the physicians and nurses doing their best to stay calm as some speculated about what their work would look like once the number of Covid-19 cases surged. |
| For Dr. Kass, the pressure had been mounting for weeks. She started worrying about coronavirus long before her neighbors were stockpiling toilet paper and news headlines screamed “pandemic.” Last month she sat down to brunch with friends, who asked casually how her work at the hospital was going. “You guys, this is going to touch all of our lives,” she told the group. | For Dr. Kass, the pressure had been mounting for weeks. She started worrying about coronavirus long before her neighbors were stockpiling toilet paper and news headlines screamed “pandemic.” Last month she sat down to brunch with friends, who asked casually how her work at the hospital was going. “You guys, this is going to touch all of our lives,” she told the group. |
| Dr. Kass has always been quick to notice threats to public health. She said that’s because for her, her roles as a physician and as a family caretaker are intertwined. Being an emergency doctor makes her a better mom, she said, because she’s always on the lookout for risks that others might miss. Being a mom makes her a better physician because she pays attention to her patients’ unarticulated needs, the emotional, as well as the physical. | Dr. Kass has always been quick to notice threats to public health. She said that’s because for her, her roles as a physician and as a family caretaker are intertwined. Being an emergency doctor makes her a better mom, she said, because she’s always on the lookout for risks that others might miss. Being a mom makes her a better physician because she pays attention to her patients’ unarticulated needs, the emotional, as well as the physical. |
| But as a doctor, and as a mom, recent weeks have been especially tough. Once news reports began to project a surge of coronavirus cases in New York, Dr. Kass knew that she’d be needed on the front lines. She knew that she’d inevitably be exposed to Covid-19. And she had read that up to 80 percent of clustered infections reported in China were within households, suggesting high intrafamily transmission rates. So she sat down with her three children, ages 12, 10 and 7, and told them that they would need to spend the next several weeks at their grandparents’ house in New Jersey. | But as a doctor, and as a mom, recent weeks have been especially tough. Once news reports began to project a surge of coronavirus cases in New York, Dr. Kass knew that she’d be needed on the front lines. She knew that she’d inevitably be exposed to Covid-19. And she had read that up to 80 percent of clustered infections reported in China were within households, suggesting high intrafamily transmission rates. So she sat down with her three children, ages 12, 10 and 7, and told them that they would need to spend the next several weeks at their grandparents’ house in New Jersey. |
| It feels unfair, even nonsensical, to be deprived of her source of comfort — her kids — during the most challenging period of her career. But Dr. Kass realizes it’s a sacrifice that comes with her professional territory. “How can we expect health care workers to not hug and kiss their families? But then how can we expect them not to be exposed?” she said. “The choice I made was to not have to look my kids in the eye and say, ‘I won’t hug and kiss you right now.’” | It feels unfair, even nonsensical, to be deprived of her source of comfort — her kids — during the most challenging period of her career. But Dr. Kass realizes it’s a sacrifice that comes with her professional territory. “How can we expect health care workers to not hug and kiss their families? But then how can we expect them not to be exposed?” she said. “The choice I made was to not have to look my kids in the eye and say, ‘I won’t hug and kiss you right now.’” |
| On March 13, Dr. Kass and her husband drove their children across the river to New Jersey. She squeezed them tight and told them to think of the coming months like summer camp with Grandma. Back at home, she began to prepare for her first coronavirus-focused E.R. shift. | On March 13, Dr. Kass and her husband drove their children across the river to New Jersey. She squeezed them tight and told them to think of the coming months like summer camp with Grandma. Back at home, she began to prepare for her first coronavirus-focused E.R. shift. |
| Dr. Kass spent 24 hours in the emergency room that weekend. At some point the hours all began to bleed together as she rushed between patients. She took people’s vitals, listened for wheezing and looked for evidence of pneumonia, and offered words of comfort to others in a panic. She was careful to wear gloves, an N-95 mask and goggles. No patients coughed on her directly, and she got home figuring she was safe from infection, for now. | Dr. Kass spent 24 hours in the emergency room that weekend. At some point the hours all began to bleed together as she rushed between patients. She took people’s vitals, listened for wheezing and looked for evidence of pneumonia, and offered words of comfort to others in a panic. She was careful to wear gloves, an N-95 mask and goggles. No patients coughed on her directly, and she got home figuring she was safe from infection, for now. |
| That Monday, Dr. Kass woke up with a jolt of pain shooting up her back. Her whole body felt heavy, fatigued. “Wow, am I so out of shape I can’t work two shifts in a row?” she wondered. She noticed, too, that her senses were blunted; a cup of coffee tasted like water. But she pressed ahead with her day — she had patients to see virtually, using telemedicine, many of them showing coronavirus symptoms, and she didn’t want to cancel. | That Monday, Dr. Kass woke up with a jolt of pain shooting up her back. Her whole body felt heavy, fatigued. “Wow, am I so out of shape I can’t work two shifts in a row?” she wondered. She noticed, too, that her senses were blunted; a cup of coffee tasted like water. But she pressed ahead with her day — she had patients to see virtually, using telemedicine, many of them showing coronavirus symptoms, and she didn’t want to cancel. |
| The next day, Dr. Kass developed a hacking cough. It grew worse by the hour, and her breath began to quicken. Even the thought of walking up a flight of stairs was exhausting; the idea of cycling, as she normally does, was “unfathomable.” She did a telemedicine visit to urgent care and was told to get tested for the virus. Her results came back that Thursday night: positive, Covid-19. | The next day, Dr. Kass developed a hacking cough. It grew worse by the hour, and her breath began to quicken. Even the thought of walking up a flight of stairs was exhausting; the idea of cycling, as she normally does, was “unfathomable.” She did a telemedicine visit to urgent care and was told to get tested for the virus. Her results came back that Thursday night: positive, Covid-19. |
| From the moment Dr. Kass began tracking the outbreak, she knew that she would probably get coronavirus. But she didn’t expect to be infected so soon. The hardest part was telling her kids — through her coughs — that she was sick. “Guys, don’t I make coronavirus look good?” she said over FaceTime, trying to make them crack a smile. | From the moment Dr. Kass began tracking the outbreak, she knew that she would probably get coronavirus. But she didn’t expect to be infected so soon. The hardest part was telling her kids — through her coughs — that she was sick. “Guys, don’t I make coronavirus look good?” she said over FaceTime, trying to make them crack a smile. |
| Asked how she was feeling days later, Dr. Kass’s answer was straightforward. “Right now I’m getting up and literally thanking God for my breath,” she said. “The same advice I’ve given to my patients is the advice I’m giving myself, which is as long as you can get through this breath you’re OK.” | Asked how she was feeling days later, Dr. Kass’s answer was straightforward. “Right now I’m getting up and literally thanking God for my breath,” she said. “The same advice I’ve given to my patients is the advice I’m giving myself, which is as long as you can get through this breath you’re OK.” |
| Last week, Dr. Kass moved into the Four Seasons hotel, in midtown Manhattan, which is offering free accommodations for medical personnel. After her house was cleaned and sanitized, her kids came home on Friday to Brooklyn. | Last week, Dr. Kass moved into the Four Seasons hotel, in midtown Manhattan, which is offering free accommodations for medical personnel. After her house was cleaned and sanitized, her kids came home on Friday to Brooklyn. |
| Updated June 12, 2020 | Updated June 12, 2020 |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| This Sunday, three weeks after her initial exposure in the emergency room, Dr. Kass returned for her first shift post-infection. Three hours into that shift, she got a call with good news: Her antibody test showed she was immune and eligible to donate plasma for Covid-19 clinical trials, which are testing whether blood transfusions from recovered Covid-19 patients can be used for treatment of the disease. | This Sunday, three weeks after her initial exposure in the emergency room, Dr. Kass returned for her first shift post-infection. Three hours into that shift, she got a call with good news: Her antibody test showed she was immune and eligible to donate plasma for Covid-19 clinical trials, which are testing whether blood transfusions from recovered Covid-19 patients can be used for treatment of the disease. |
| Now, mingled with her relief, Dr. Kass feels a sense of urgent purpose. “Because I’m immune, I feel like I have a sense of responsibility,” she said. “I feel empowered by my own antibodies.” | Now, mingled with her relief, Dr. Kass feels a sense of urgent purpose. “Because I’m immune, I feel like I have a sense of responsibility,” she said. “I feel empowered by my own antibodies.” |
| Readers, do you know of any women affected by and leading the charge against the pandemic? Let us know at inherwords@nytimes.com. | Readers, do you know of any women affected by and leading the charge against the pandemic? Let us know at inherwords@nytimes.com. |
| Today’s In Her Words is written by Emma Goldberg and edited by Francesca Donner. Our art director is Catherine Gilmore-Barnes, and our photo editor is Sandra Stevenson. | Today’s In Her Words is written by Emma Goldberg and edited by Francesca Donner. Our art director is Catherine Gilmore-Barnes, and our photo editor is Sandra Stevenson. |
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