Dara Kass is a doctor but she is also a public speaker, a political activist, and a Park Slope mother of three. Over the course of the past few weeks, however, she has reoriented her life so that she can put the health of the people of New York City first. Her children have been sent to live with her parents. She has divided up her house to minimize contact with her husband.

Tell me about your regular work life.

I work at Columbia University’s hospital, which is part of New York Presbyterian. Normally I work part time as an attending in the ER, so I do very few shifts and a lot of telemedicine; this means I’m on the phone with patients all day. We have a very good direct-to-consumer virtual urgent care program. The minute this outbreak started, all the telemedicine clinics in the city saw the number of patients they were seeing explode. I have worked every day for the past 12 days, whether through telemedicine or at the hospital.

What are you seeing on the ground in the ER right now?

It’s changing every day. A point I want to emphasize, though, is that the federal government set us up for failure. They should have paid attention to what the forecasters were saying months ago, but they ignored the warning signs and stuck their heads in the sand. The under-reporting and under-testing has made us fundamentally unable to combat this effectively. The New York government has been remarkable; Cuomo has been doing a great job. But the lack of federal oversight means that there will be pockets of success and pockets of failure. It makes it that much harder for us to combat this on a global level. On the ground, I’m seeing health care professionals do their best to catch up. New York has the highest number of infections of all the states in America, and we’re going to see that number increase exponentially.

The testing criteria is changing day to day, but we are not able to test enough people—just a fraction of the patients we see are getting tested. People who live with their 85-year-old grandmother and are displaying symptoms are not getting tested. People who have symptoms need a positive test in order to keep getting paid by their employer while they’re not working are not getting tested. Right now, we are saving the tests for people who are in critical condition.

We’re all wearing as much PPE [personal protective equipment] as possible, including goggles that were given to us by the hospital. But we don’t know how long the supplies are going to last.

You’ve tweeted about the extensive guidelines that Alibaba founder Jack Ma put out to help combat the spread of COVID-19. What did you learn from reading those guidelines?

We don’t have the capacity to do a fraction of the things they are suggesting. Across the country, we’re not testing health care workers regularly and we’re not “cohorting” them like they did in China. The report recommends keeping health care workers away from their families—intra-family transmission is 80%. When you live in the same house as a health-care worker, you can be considered exposed. I moved my kids out of the city before I saw a single patient because my son had a liver transplant. They’re now living with my parents. In China they even had “halfway house” programs to re-integrate health care workers back into their families. They would move into these facilities for 14 days to make sure they were not contagious. They would test them multiple times.

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