ER doctor says 'everything is so much better’ after initial coronavirus response

Emergency Medicine Physician at New York-Presbyterian Dr. Jason Hill joins Yahoo Finance’s Zack Guzman to discuss the CDC’s new guidelines for reopening businesses and schools amid COVID-19.

Video Transcript

- Of course, none of this is in a vacuum. A lot of it has to do with the way that a lot of businesses went into lockdown in the wake of the coronavirus crisis that we're battling with. Still, here in the US-- and a lot of questions surrounding what might be the next steps as economies reopen, whether or not there are health risks associated with that.

We finally have new updated guidelines from the CDC after pushback from the White House on a lot of those guidelines, and so those are out there now, offering at least some insight into the way that businesses should be operating. And for more on that, we want to talk to an ER doctor that has been watching all of this play out on the front lines. Dr. Jason Hill joins us now, an emergency medicine physician at two New York Presbyterian hospitals here in New York City.

And, Dr. Hill, I mean, you've been documenting what it's like to be operating through this environment right now on the front lines been very honest and forthright, and-- you know, in what you've been seeing. But how as the cases kind of come down, as we put these stay-at-home measures in place, how much better has it improved on the front lines?

DR. JASON HILL: Thanks for having me on. Everything is better now. Everything is so much better. You know, the-- the peak from mid-March to mid-April was overwhelming. It was hellacious. It was horrific. We were overrun. There was just death and dying everywhere all around us.

And it is night and day relative to that now, which is-- we are so thankful for. And most of that is due to social distancing and people self-isolating in self-quarantine. It seems like our hospitals have had a chance to catch up. Our capacity is much better. Operationally, we have more things in place, and now it's just a waiting game to see what comes next.

- You know, we've seen the case count here. I mean, obviously Governor Andrew Cuomo in New York has been giving the updates in terms of the optimism and seeing, you know, hospitalizations come down. And as you're saying, a lot of hospitals are seeing the stresses relieved a little bit here. But as we get those guidelines in terms of businesses reopening, people start going back to work, the fear is that maybe some of these issues might not be taken as seriously and how they did flatten the curve.

As you're seeing some of these things play out-- I mean, Wisconsin had a bar after their stay-at-home order was overturned by the Supreme Court there-- flooding of people into a bar-- very close proximity, no masks being used. You're watching that play out, and you see the guidelines being released by the CDC here. How big are the fears that maybe you could see a return to some of these rising cases?

DR. JASON HILL: Yeah, I think the fears are very real. You know, I think what we do next is critical. I think none of us-- certainly in my job-- want to go back to how things were. It was absolutely horrific, both for us as well as our patients, as well as our families who were nervous and scared.

I think that nobody knows exactly what to do next and how it's going to play out. But I am a huge fan of listening to our public-health officials, listening to the CDC guidelines. These are the guys who have been thinking about it the longest. They're the best trained in it. And I think our best chance to move forward safely is-- is really going slowly, being open to adaptability if we make mistakes.

Because, you know, make no mistake, if we spark an outbreak that we cannot control, not only is everything we have done so far and everything we've sacrificed going to be for naught, but a lot of people are going to die, and a lot of people are going to lose family members. And that is going to be even worse for our economy. And my friends and colleagues and I are going to have to be there for it, and we do not like that part of the job.

- Yeah, that's kind of my fear too, watching all this play out because there have been, you know, those fears talked about in terms of the second wave being worse than the first because you have people thinking, oh, we made it. We did all we were supposed to do. We stayed home. We flattened the curve. And then come out not wearing masks, crowding in bars like we saw in Wisconsin.

And then also you kind of have all the fear that this could blow up into a major problem, dissipating as well. And we see structures placed in New York kind of being taken down because there is no overflow need right now for patients. So in your mind, I mean, you've been dealing with these problems on the front lines in terms of PPE and getting those things. Have you seen an improvement at least on the PPE front and whether or not if there is a second wave you could be prepared to battle it?

DR. JASON HILL: Yeah. I think certainly we're far more prepared than we are now. In the early days we were-- we were all underprepared. We did not have enough bed space. We did not have enough-- really doctors and nurses who are available for the extra volume that was coming in. And our PPE was very touch and go in those early days, which made all of us very nervous.

Now everything is better, and we've had time to ramp up and scale up and change the way the hospital works and have contingency plans. And right now, we have more resources than we need. Now that is all in preparation for the worst-case scenarios. And I think other hospitals out there that did not get hit as hard as we are need to take a lesson from that and make sure that they have plans in place in case they get volumes and numbers far more than they may-- than they may expect.

- Yeah, and, Dr. Hill, you have been describing your experience on the front line, and that's something we like profiling on this show just because, you know, detached from it, you can look at case counts, but you might not know necessarily what's going on in the hospitals dealing with all these problems. I just want to read an excerpt from a bit of the diary that you published through BuzzFeed, documenting the emotional and actual mental toll that this job requires. Specifically you highlighted the moment that you've been putting patients on ventilators, and I just want to read this part because it struck a chord with me.

You said, quote, "Autonomy fades into trust, uncertainty into acceptance, and all the patient has left is placed firmly in your gloved hands. It's brief, and you're busy, and time is essential, but you find a few seconds to share this breath. That stare lasts a moment. That stare lasts a lifetime. And the eyes stay with you."

I mean, it's powerful stuff that you're describing there. I don't know if you can kind of expand on the point of actually being there with these patients when you are not sure what's going to be happening-- what that's like when you're trying to support somebody.

DR. JASON HILL: Sure. You know, what-- what we found is kind of crazy about this disease. So you can imagine, as an emergency doctor all my career, I've had to intubate people. And most of the times when we intubate people they're-- they're chronically ill, or they're-- have a very poor mental status.

It's very rare that a relatively healthy person comes in who is awake and alert and was absolutely fine and healthy a few days before and now is in extremis, now is on the verge of dying without being intubated but still alert and still able to talk to you and express their wishes very clearly. And we not only had a few of those. That was the vast majority of the patients who would come in and be intubated, and this was one to two an hour.

And so having very frank conversations with people who felt fine a few days ago about how sick they really are and how we don't know what's going to happen next, and we can't say anything about their chances of survival if they get intubated. And talking with them very frankly and very openly and very humanely about what they can expect next and what their options are-- it is, you know, a pretty intense taxing thing.

We're good at it. We're trained at it, and we're prepared to do it. But, it is emotionally taxing, and, you know, all of us hope that we keep this virus from infecting as many people as we can so that we have to do this a lot less often.

- Yeah, and hopefully-- I mean, we see these measures as businesses open up, following the guidelines, making sure that people out are being smart so we do see fewer conversations like the one you're describing right now. But, Dr. Jason Hill, I appreciate you taking the time. Good luck out there on the front line, and thanks again. I know you're very busy, but appreciate you chatting with us.

DR. JASON HILL: Thank you.