Thoughts from an anesthesia/ICU doc during corona

Today, a few things happened around my hospital and corona that got me thinking, both for good and for bad:

Positive thoughts first:

1. Today we opened a second Corona ICU in the old building of Hadassah (alongside a Corona Ward, and the first Corona ICU). Four years ago Hadassah opened the new Davidson Building, moving all the wards and ORs there, and leaving the old building empty. It means that we essentially have enough space to build an entire second hospital there, and fill it with corona patients if needed. It doesn’t look like we are going to run out of physical space any time soon.
2. A friend of mine (another doctor) has been fitting exponential curves to corona diagnosis numbers in Israel. Less than a week ago he predicted at least 7,705 cases for last night. The real number was 4,695. I know that this could be biased by testing rates etc, but I prefer to think that we are now dipping below exponential in Israel, and that the lockdown is working. The number of cases is still increasing, and the rate of increase is still increasing, but at least it is less than exponential.
3. The new corona ICU is under the department where I work (anaesthesia), and the boss just told us that all of us senior enough to help, will be doing extra on-calls to cover it. This is more work for each of us, but it is still well within what we can live with. Doing a few extra on-calls is nothing so unusual, and won’t push us over our limits.

But next to these positive thoughts, there were also some less positive realisations:

4. Opening one extra unit feels like no biggie, and neither is doing 1-2 extra on-calls per month. Given that ultimately we all went into this profession because we enjoy our work, it may even give us a sense of satisfaction in being able to help. But some estimates talk about the number of ICU patients doubling over the next 1.5 – 5 days. That starts to be hard work. And if it doubles again, things could get really tough.
5. Pesach is coming up. If people ignore Ministry of Health instructions and invite extended family or friends round, even ones who seem healthy, even ones who have had no contacts with corona cases, then we will get a spike in corona patients. In truth, I see it as almost inevitable that people won’t follow advice, and that we will get this spike. Only time will tell whether that will push us too far.

So the bottom line: For now things are going fine, and we are in a far better position than hospitals in many other countries across Europe and the States. How long it remains like that will depend on how well the public manages to push down infection rates.

Dressed in preparation to treating a COVID-19 patient