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An Editor’s Invitation: COVID-19

April’s More Voices theme is COVID-19.

What else could it be?

I hope that you’ll take a few moments to send us a short first-person piece on how COVID-19, a term that was utterly foreign to us just a few weeks ago, has impacted you.

Here’s how it’s changed my workplace: As of yesterday, my hospital in the Bronx had about 500 patients admitted with the COVID-19 diagnosis. Over sixty of those were in the ICU.

Our emergency room is overrun with patients who are coughing and short of breath.

Our hospital’s Grand Hall, an elegant space designed for gatherings of hospital dignitaries, is now a hospital ward.

Every resident has been yanked from other responsibilities to take care of desperately ill COVID-19 patients.

Some of us, because of our age and/or underlying medical conditions, have not been summoned up–yet.

While nursing a sense of guilt, I’ve spent the last days conducting visits by phone for patients who are mine and patients who belong to doctors now in harm’s way, staffing the hospital.

Part of the stress is learning new rules of documentation as the hospital looks to get these visits reimbursed.

At midnight, while finishing up yesterday’s notes, I opened an email from a hospital coding analyst. Because I’d neglected to include specific verbiage in some notes, they were deemed inadequate.

What was that verbiage?

I had to include in each note a sentence saying that the patient had specifically consented to a telephone visit.

It’s a testament to the lamentable state of health care that someone thought such verbiage was necessary in order to make a medical visit worthy of payment–and that intelligent people are scrutinizing every telephone note written by every clinician in the hospital to make sure that such verbiage is included.

And it’s a sign of how accommodating–some might say docile–we clinicians have become that, when notified of this deficiency, rather than raising a defiant hand in protest, I went back to those half-dozen notes at midnight and meekly inserted the bureaucratic disclaimer.

Another instance of lunacy: an insurance company refusing to okay a generic inhaler for a coughing asthmatic patient because the patient’s plan requires a specific brand–which is nowhere to be found, and won’t be available until the end of April.

That was yesterday.

Today, this Catch-22:  a patient with all the symptoms of COVID-19, except fever, was ordered by physicians to stay out of work for two weeks. His job, however, will only compensate him if he can produce a positive test result. And without a fever, he’s unable to obtain that test.

How many people in this great city, I wonder, are going to work with symptoms because they won’t get a paycheck if they don’t show up?

Today a security guard called, reporting a cough, chest pain and muscle aches. Calling from work. Not wearing a mask.

This guard works at the entrance to a health facility.

“You’ve got to put on a mask,” I said, “and go home.”

No wonder this virus is spreading,
I thought. The horses are out of the barn. And without widespread testing, we can’t locate them, let alone round them up.

Meanwhile, in Brooklyn, my two daughters have been working from home. At day’s end, they put their confinement to creative use: One of them now has blue hair.

And so it is with COVID-19, impacting each of us where we live.

Now it’s your turn: Tell us your COVID-19 story.

Paul Gross
New Rochelle, NY


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