April 1, 2020, By V.L. Hendrickson

Dara Kass of Columbia Medical Center has recovered from the virus and continues to see hundreds of patients via telemedicine, and now she’s returning to the E.R.





Dr. Dara Kass’s best advice for New Yorkers during the coronavirus crisis is “stay home and trust us.” So much so that she’s been treating patients via telemedicine.

“It decompresses the E.R., which helps in a big way,” said Kass, an emergency medicine physician at New York-Presbyterian Hospital since 2017 and an associate professor at Columbia University Irving Medical Center in Washington Heights in Manhattan. “But it also keeps as many patients at home as possible.”

But there’s another big reason the native New Yorker has been seeing patients from home: She has had the virus.

Kass, 42, developed symptoms about two weeks ago — fever, fatigue, muscle aches, cough, chest pains, shortness of breath, loss of taste and smell — after seeing patients at the hospital. She’s recovered now, but having had the illness helps her relate to patients.

“There’s a sense of solidarity,” she said. “I start off by making a joke about Sy Sperling, the [late] president of the HairClub for Men: ‘I am not only a COVID doctor, but also a client.’”

The joke puts patients, understandably nervous, at ease.

“They see me and think, ‘you’re OK, so I’ll be OK, too,’” Kass explained.

Kass is one of the more than 43,000 people who have developed the COVID-19 virus in New York City, which is currently the epicenter of the epidemic. More than 1,100 have died. Hospitals in the city have been swamped with patients, with space and equipment getting more scarce as the number of infected grows.

The doctor is also one of the thousands of health-care professionals fighting the disease on the front lines. As hospitals continue to be overwhelmed by patients, telemedicine is helping keep hospital space open for the most dire cases.

“That’s one bed we didn’t use,” she said. “And we don’t want people getting sicker when they come to the E.R.”

Kass had shifted about half of her practice to telemedicine before the crisis began, she said. The other half is on the floor of the E.R., where she will return at the end of the week. She’s been in close touch with her colleagues there, but these days, she sees “solidly 30” patients a day using the videoconferencing technology.

During an appointment, Kass can watch patients breathe, hear about their symptoms and observe their energy levels to get a sense of how much distress they are in. She offers guidance on how to take care of themselves, as well as reassurance in a “scary time.”

One patient wrote to thank her for her care when he was struggling to breathe.

“My breathing didn’t return to normal until a few days later, but I was able to stay home and stay calm and get better because of the confidence you shared with me when we spoke,” the patient wrote, Kass said.

Indeed, the vast majority of the people she sees are able to stay home to rest and get better. Of the hundreds of patients she’s seen, she’s only sent three to an emergency room for further evaluation.

“My job is to find the needle in the haystack,” Kass noted. “I counsel patients, but I’m also looking for the ones that should go to the hospital.”

Overall, about 13% of patients who contract COVID-19 will be hospitalized, she said, with about 3% ending up in intensive care.

Kass was not one of those patients, and she has been cleared to physically return to the E.R. Once she’s back, she knows it will be “all COVID, all the time.”

“It’s really bad,” she said. “The volume of patients is just staggering.”

Moving out

Kass’s own family moved out of their Brooklyn apartment several weeks ago, and she hasn’t seen them since. But her husband and three children will soon be returning home, and Kass will relocate.

“I’m planning to move out for the duration of the pandemic response in New York,” she said. “I need to be available to work all the time.”

Some of her colleagues have moved into their basements or guest rooms, but the notion of isolating within the family apartment was not an option. Social distancing from her children while in the same physical space is too much of a challenge.

“I don’t want to bring the emotional weight home,” Kass explained. “But also I couldn’t handle it. I can talk to my husband through a door, but I can’t yell at my son not to hug me.”

She was considering moving to a friend’s apartment, but now may be staying at the Four Seasons in Manhattan. The luxury hotel has offered rooms to health-care professionals working through the coronavirus crisis.

Kass and her colleagues are “inserting emotionally safe spaces” into their days as they battle the worst cases of the virus on the front lines. That could be baking or taking a walk.

For Kass, it’s watching Netflix while scrolling Twitter, where she posts several times daily, or calling friends who are also working on the front lines to make sure they are OK.

“I’ve been watching ‘Tiger King,’” she said, referencing the popular documentary about the bizarre world of big-cat breeding. “It’s visceral Darwinism….There’s a level of absurdity, even in a pandemic.”

The “born and bred” New Yorker is proud of the efforts of the city’s hospitals and health-care workers. And she trusts Gov. Andrew Cuomo with her life, she said.

“This wasn’t supposed to be our pandemic,” she noted, adding that doctors thought that the West Coast would initially be hit the hardest. “But it’s very New York to be the leader and to show the country how it’s done.”

Still, Kass’s advice to New Yorkers remains the same.

“Give us more time to flatten the curve,” she said. “It’s working. We are seeing the effects of social distancing.”

https://www.marketwatch.com/story/nyc-do...ring-2020-04-01