Interviewer(s): Henry
Interviewee(s): Amelia

Henry: I think we've discussed what this interview is going to be about. Right?

Amelia: Yeah.

Henry: Okay. So I guess, let's get started. So, what's your name?

Amelia: Amelia.

Henry: And how old are you, Amelia?

Amelia: I'm 30.

Henry: And where are you living right now?

Amelia: I'm living in [location].

Henry: And what's your job?

Amelia: I'm a P.A.(Physician’s Assistant) in the emergency room, as well as in urgent care.

Henry: And what was your job in January? 2020?

Amelia: I was a P.A. at [hospital] E.R..

Henry: In New York City?

Amelia: In New York City, in the Bronx.

Henry: When did you leave that.

Amelia: I switched to per diem in February 2021. But I officially left, I think like a couple of weeks ago because I have a different ER job.

Henry: And have you been there for a while? How long did you work at that job?

Amelia: I was there almost three years before I left, like two and a half.

Henry: So when did you first hear about COVID?

Amelia: So the beginning of 2020, like January. We were starting to hear about it. But it, you know, it was very vague, sounded like another virus going around. We weren't really that sure or convinced, at least here in the United States. That it was going to be at the extent that it was, to the extent that it was. Around the end of February, I believe, is when it began to like, spread to here.

And we were starting to be very concerned in the in our ERs because we weren't seeing it in January here. We were just hearing about these cases internationally.

Henry: When you say we…?

Amelia: My coworkers and I, my hospital in our emails and our conversations and also the patients that we were seeing, we weren't really… maybe we were seeing patients that were sick, but we weren't really testing for COVID like that. We really started doing the testing, and I think it really started to spread in New York, end of February, beginning of March.

Henry: You mentioned this a little, but what were your initial thoughts?

Amelia: I think honestly, we all generally (genuinely?) didn't see it coming at first. We just thought, oh, here's another virus. You know, maybe people are freaking out. But we didn't think much of it until we saw it ourselves. It was getting scary when we were hearing the news of what was going on internationally. And some of our colleagues have friends internationally so for example, in Italy, that's when it started becoming very scary.

So before any real cases like that were happening, it was just like, OK, what's going on? Not much. But once, once patients were getting very sick from, from this virus, that's when we were starting to get concerned. And then when we were seeing it ourselves with our own eyes in our own ERs, then it's obviously a reality.

Henry: Thank you. So you said you discussed this with your coworkers. Anybody else?

Amelia: Yeah, we would discuss it at home in the beginning. So we're still talking about before I came to New York or is this after?

Henry: This is all up until it comes to New York.

Amelia: Yeah. So honestly, before it came to New York or before it even spread severely in Europe as well, or in other countries as well, before it started, we started to see like severe cases, even though in our ERs sometimes you would even be jokes you know, like, oh, here we go. Like another thing people are getting crazy about in the media, blah, blah.

But then slowly it started to get more serious. So we would hear more serious cases, people being ventilated on all that in other countries. And then we're like, Oh, now what are we about to experience? So we would definitely talk about it at home with our friends. It was the only thing people were talking about really. And we didn't know, like the hospitals were getting ready with our with everything.

Like we were just having meetings about it. And once it comes to New York, because New York is such a big city, and it's so busy and people live so close, like how are we going to tackle it? But conversations don't really get serious until it hits your own place.

Henry: It's so we had meetings at the hospital about it.

Amelia: Yeah, we just have we definitely started to have meetings when it came to New York, that's for sure. Like huddles, like they come like the upper management comes to the E.R., but they always do that. But during COVID, it was more frequent, huddles about safety and protocols that we're making sure to upkeep, and updates on what we're getting as far as PPE for ourselves and, you know, just things to keep in mind.

Definitely daily. It became daily at some point.

Henry: Daily huddles.

Amelia: And also emails, of course, constantly.

Henry: What would this have been in February or March?

Amelia: Not so much in February, but in March. Yeah. I mean, we always get huddles, like we always have meetings, but they're not always daily. So starting March, it was just like every day Okay.

Henry: Did you guys do anything to prepare?

Amelia: Yeah, we, so I think in the beginning it was more of the how do we separate our patients when they come in. So in the beginning, we were trying to keep patients that were exposed or had symptoms in one area of the ER, and other patients in different areas. But the beginning was so hectic and so crazy because we didn't really have the resources, like we didn't have PCR tests.

So no one was really getting tested unless they were severely sick or getting admitted so we couldn't really test people. We were just telling them to go home if they were OK. And then even the division, because the hospital, I mean, for example, [hopsital], their population size and the amount of patients we see, it's a lot. So a lot of times they're sitting on chairs or right next to each other so separating them once they started coming in like we had these like curtains, like basically that's all we had. So they were in a separate area but not in a separate room with walls, so separation really couldn't be that good because of the fact that we [indistinct].

Henry: Was that because of… was that in the plan or was that just because of the lack of testing?

Amelia: Oh, for the PCRs. Yeah, we just didn't have any.

Henry: So I'm having a little trouble hearing you.

Amelia: Oh, I'm sorry. Yeah, we weren't we weren't getting any. We didn't have any. We have very few PCR, so we had to reserve them for patients that were going to be admitted to the hospital if they were very sick. So in the, in February, like no one was getting tested like that. We just didn't have any we didn't have any tests.

Henry: And that's when the, the mixing of the patients was happening.

Amelia: Yeah. Yeah. More so. I mean, we started trying, but it was really like questions like, did you travel from China? Like, but it was everywhere else, right? So like, our questions were limited and our separations were limited too. Was lack of space in general, too many patients, not enough space so you don't really have the ability to separate them as well as you want to.

Henry: So this is this is what your hospital did, your ER did. Did you personally change your behavior at all?

Amelia: Yeah. I mean, we started… all of us, were trying to take care more not to get it and spread it. So if a patient was tested positive, all we could do is like put them in a in a bed and like with a closed curtain around, that's all we had, was a closing curtain around them, but our hospital did starting started to get we did start to get PPE very early.

So I mean, we were using our N95 all day. Like typically you're not supposed to, but we did have to use it every day. But we did get like daily N95. We did have some sort of gown, so we did immediately start to wear as much as we can. So it was, it was interesting because we were covered in PPE, can barely recognize us.

You know, we're most of the time talking a little bit further away from the patient unless we had to do the obvious. Obviously when we're examining them, making sure their mask was on, you know, we did start immediately, so protect ourselves.

Henry: So it sounds like things were pretty visually different.

Amelia: Yeah.

Henry: So can you can you describe how you were feeling about this.

Amelia: Once COVID started.

Henry: Around this time.

Amelia: Once it came up, I mean, it was pretty isolating with patients. Like we really were it came to a point where we were wearing those those what we called bunny suits, those hazmat suits. And you could not recognize us so much that we started printing these, like laminated pictures of ourselves and wearing them as necklaces to like, show our patients that there's a person behind all of this because you could really only barely see our eyes.

Like I was wearing a hazmat suit and all of this like face covering and even my eyes actually had we had ski masks that were donated to us. I was wearing ski masks. You can't really even see my eyes. So it was it was a weird time, especially when you go into medicine to help people and you want to interact with them and figure out what's going on.

And there's like a layer that's completely removed and especially for patients that weren't doing well at all, for the critical ones, they're already scared and they're just like surrounded by these faceless beings. And we're just trying our hardest. So that was very strange and very heartbreaking. And, you know, I almost immediately stopped seeing my family like I stopped seeing my parents, my brother, my cousins.

I just like from beginning of March, the 1st of March, and on, I didn't see them for almost a year because I was very close, close to it, because I was seeing like critical patients. So it was it was lonesome, but also mostly heartbreaking for like the patients more so than us. I think we, we tend to remove ourselves from the situation and just kind of like be there for our patients.

So I wasn't really thinking of myself that much. I think that comes like after the fact, you know, like we were just going with it, but seeing patients not be there with family, just completely alone. That, that that was harder than any other part.

Henry: It sounds incredibly isolating.

Amelia: Yeah. And then the hardest part is to see patients struggle so much, some of them not making it, some of them barely making it, and the interactions we were having in the E.R. and then to hear friends or see on the news like, oh, it's not real or we don't have too wear masks, like not taking it seriously.

And it's like I don't even I don't know what conversation to have with you because it cannot get more real to me than like a 36 year old coming in. Can't breathe, ventilator, now he has to go on ECMO, and some of them made it, some of them didn't. Like I don't you know how do you it's disappointing to have to have that conversation, you know, so that I saw a lot of providers in the beginning get very frustrated and mad when they were having these conversations with people that weren't in the medical field seeing it right? So I didn't even, in the beginning, I would have all these conversations get really angry and like

my voice got elevated. But then after a year, I'm like, I'm done having the conversation. Now you've all seen what it is. So if you don't care about it now, like it's not because of lack of information, but in the beginning it was like, maybe they don't know. I don't know.

Henry: So yeah, I'm very glad I got out of the business.

Amelia: Khkhkhkh Yeah.

Henry: So you said in the beginning there is this, this frustration with people saying it wasn't real.

Amelia: Right? Or taking it not seriously, right.

Henry: Are you talking are you talking about by March at this point or you two or even earlier?

Amelia: No, like a little after, a little after March.

Henry: So you're really getting hit then. And these people were saying it was’t real?

Amelia: Yeah, yeah. I mean, when we really were going through it and there were people still. But like not in the hospital because in the hospital you see it. But, you know, the outside world.

Henry: Yeah. Well, so how do I put this… I mean, this sounds incredibly traumatic.

Amelia: Yeah.

Henry: And this seemed this seems to have started in the beginning of March when you were getting hit and you have said that you were worried about COVID in February and you had these meetings, correct?

Amelia: Yeah.

Henry: Was there, was there like a eureka moment when you realized how bad it was going to be?

Amelia: I mean, it really it did start when Italy was going through it really bad. We we were our conversations changed. They were less light, you know, in the beginning, our conversations were more light, you know, we didn't really know what's going on. But then when we saw what was going on, I think, in some other parts of the world, and how disproportionate it was that this virus was doing this, like it shouldn't be causing this much damage.

Then we're like, OK, we all kind of we're just like, so this is going to be serious.

So I guess I guess we realized it before it really came to our ERs. But again, I mean, nothing's like seeing it yourself.

Henry: So OK, so I see you said your hospital. So so you said your hospital had had meetings. You didn't it seems like you didn't have the PPE shortages that other hospitals had.

Amelia: Some hospitals had it much worse. Like they had to use 1 N95 per week or two per week. We I think most of the time we had a daily supply. Our gowns were also we had them, but they were horrible material. I'm not going to lie. It was like this thin plastic, not sure how much protection it was really giving, but we did get like, that's that's all we could get, but we did get daily supply of it.

So we, we were getting as much as, we were getting much more than some of the smaller hospitals for sure, because a lot of them didn't get like a daily N95, for example. And we were getting so much donated like the ski masks, and we had these welder masks and those big ones that were really good. And we had plenty of people make like make head caps for us, like they were sewing.

So we were getting a lot from it was that was actually one of this sweet parts to see the community get together, especially the local places. They were bringing food every day, you know, every like local restaurant was bringing us food and everyone's cousin was sewing something for us. Or if someone had us, you know, extra stuff, they would just bring it like it was, it was very sweet to see that.

Henry: The banging the pots.

Amelia: The banging the pots. Yeah. Like, OK, we're not used to this love.

Henry: But in January and February, though. Was anyone trying to push the hospital to do more to prepare.

Amelia: Oh, like any of us. Like the colleagues? I'm not sure that in January or early February, we were taking it that… I don't think we were aware of what it was going to be. To be honest, I don't think that information had spread to the United States that well. We really weren't thinking of it like that in January for sure in January. And February, it started, so we weren't aware enough to even push for anything.

Henry: So OK. So now if you thank you for this. So a few wrap up questions now. So anything you wish that the hospital had done differently?

Amelia: Oh, such a tough question because, you know, when something comes out of nowhere, really you know, everyone tries to do their best. I think I think if I'm not speaking just about my own hospital, PPE and safety for their own coworkers and patients was lacking in general, you know, like a faster response to be more prepared? Like we had no tests.

We had these like garbage bag looking gowns that we were wearing. At one point we were putting like these plastic bags over over the patient and we had these hands that we were going in, to intubate a patient. So we were like that. We were just like making makeshift things to… yeah, we were like completely like so we were working with our hands in our like plastic bags and like trying to intubate a patient like...

So we should have been more prepared because we probably were not as privy to information as our, our leaders were. And so for that response to be so slow in the beginning, it was detrimental, because I think we were just so unprepared. We were so unprepared in the beginning.

And then once we got, you know, more… we got some better PPE and we started learning more about how to treat COVID. But there were a like a month in the beginning where we were intubating too many patients. You know, we didn't know what to do. But I think if we were learning more and paying attention to what was going on outside of America, which I don't think we were doing much of? I'm not talking about my own hospital. I'm talking about like in general, as a country, you know, so we weren't we weren't listening and paying attention to what's going on so that we could be so much more prepared for a pandemic. We should have been prepared for a pandemic. We were due for one. Right. So this should have been like a written plan before it even started. But…

Henry: Speaking of intubation, actually, what kind of PPE were you using on the intubations?

Amelia: Definitely in 95. Definitely goggles.

Henry: Always?

Amelia: That was like and you can't go in there without that.

Henry: But so this… is that standard practice? Like in January February.

Amelia: February… Probably later February. Yeah, not January.

Henry: OK, so you're intubating people.

Amelia: With like a regular surgical mask in January.

Henry: So you’re wearing a mask Just not an N95.

Amelia: Yeah. Whenever we intubate, we do try to wear a mask because we're so close to them to their face and sometimes they can gag and they can vomit. So we always do try to wear something. But but a regular mask doesn't protect against COVID really that much. So once we once COVID became more real, we were wearing N95 and eye goggles no matter what. And then, you know, sometimes you'd have those like welder masks that would be like on top of that. With time, we just kept adding more and more.

Henry: It wasn't standard practice to do goggles?

Amelia: I mean, yeah, you should. But, you know, you don't always wear goggles. You should just because of that same fact that they may vomit. But before COVID, we really weren't wearing them. But you should.

Henry: OK, this is a tough question. Is there anything looking back that you would've done differently as an individual?

Amelia: Oh, yeah, it's tough. I mean, as a health care provider, you can always go back and think of what to do differently. But …… I don't know because we all did the best we could. We were thrown in the fire and, you know, we were just kind of like, alone. Because even the people that were making our decisions, they're not there, like dealing with the actual virus and the patients. So everyone kind of disappears. I think we all did the best we could, honestly. Maybe individual research about what was going on in the world. And not just kind of in the beginning, like relying on our management, you know, or in our country. But we really did try immediately to be safer and to treat our patients safer. So I think health care providers, we always want the best for our patients. So we always try to do that.

It's hard to answer that one to do some inward thinking.

Henry: So we've covered this a bit, but what would you like to tell me about the way you felt in early 2020? So like January up until March.

Amelia: I was probably – that’s one of the things that I would change. Like during that time, hindsight is 20-20, right? If you knew that there was going to be a pandemic, would you be as lighthearted during January, be like, OK, another virus like it's probably going to be just like a flu or something. You know, we had, we had the swine flu and we had something like it.

We thought it was going to be something like that. So maybe during that time it was a concern but not the kind of concern that we probably should have all had. So we were just kind of like on the surface concerned. And we're like, OK, we're ready. But I don't think any of us knew what was really coming.

So in January, in January, we were pretty aloof. Like, we were pretty… we almost joked about, you know, like, oh, you know, what's going on? Like, we really didn't think it was going to turn out to be like what it was. In January. In February, it started becoming more real, and we were starting to get a little more scared.

But still, you know, we weren't really… I think when you ask like what that moment is, like seeing it yourself here, that's when we start to be scared and it becomes real… I don't know if I answer your question.

Henry: You did. This is great stuff. And that's actually it. Is there anything else that you'd like to tell me?

Amelia: I don't know. I hope we're towards the end of it. I don't think it will ever be gone, but I've we're definitely not where we were in the beginning. So we're hopeful.

Henry: Any questions that you think I should have asked that I didn't know?

Amelia: I think you're fine. We're more focused on, like, the beginning of it, right? Yeah. That's what you're writing on. Yeah.

Henry: So OK, so that's actually the end of my questions. You actually took half of them in your answers, which is great. So we started – do you want me to fill you in on what exactly I'm doing here.

Amelia: Yeah, why not?

Henry: So when you have, like, a crisis like this. A lot of in with, like, in emergency management, basically, how the crisis plays out, a lot of that is decided by decisions made prior to the crisis, right? Like a hurricane. The damage done by a hurricane is kind of decided by how well you build the walls, how well you built the levees, right? So I'm looking into this period immediately before the crisis to see, you know, why these decisions were made, like why it got so bad and so unexpectedly.

Amelia: Yeah.

Henry: Like, you say that Italy woke you up?

Amelia: Yeah. Yeah. Italy was like, like a scary moment for sure. Because people were dying. But I don't… maybe my memory, it's you know, it's been also quite a lot, quite a long time now. I don't remember because like patients, I mean, it was also in China because there were some really bad cases there, too. So we did we did start to get worried from then as well.

But remember, like, Italy just had it so bad because they just, like, didn't have space in their hospitals. They didn't have space for their patients. Like, it was just like really scary. So I don't know what kind of preparation our leaders had. They like, I may have just not been privy to that information. I don't know. But I think just all around, all around, we were not prepared before this even started happening. And like you get thrown in. You know? you hear those stories like what was it in China? Like one of the doctors spoke up about something and…

Henry: Li Wenyang. You know, I was in China when it started.

Amelia: So, you know, like there are people speaking up. I'm sure everywhere there was there was a doctor that spoke up and from [name] Hospital, there's a whole article written about her. You should look into it if you want. [PII REDACTED]. She spoke up about what was going on in the hospital and how unprepared they were.

You know, they only got these low-come coverage, which was like when people come to work temporarily when there's a big need, we you get that after the fact. So like, we as I said earlier, we should have listened more to what was going on /from the beginning/. And Corona was around before January when because we always start in January when we start talking about it.

But that's not when it started. It started before. We just didn't know that information. So no one was taking it seriously, even though there was bound to be like a pandemic in history. So you should you know, the infectious disease doctors, everyone that you know is in charge of this kind of movement, like that. That should have been more, there should have been more preparation.

Why do we have no tests /in March/? Right. It's March, and coronavirus was present before January. Why? We had no test. When I say no test, like like I could have brought my father to be tested, and I didn't have any pull because there's just no tests, right? Like only people that were getting admitted that had symptoms were getting tested. That is unacceptable. Because it, you know, so many people could have had it.

And we just did. Like, those numbers are not there. We didn't we wouldn't know. Right. Why didn't we build tents before? We had patients sick in the beginning and we were like putting them in this corner of the e.R. But as I said, it's small, like a corner. And and in the beginning, there wasn't even a curtain. So it's just like the corner over there. And I had patients, but like walk two steps, there were the regular patients. so there were some silly precautions, like, we were trying. Right. But in the beginning, it really wasn't so good.

Henry: Well, I have to say, in December. So in December in china, I was like, looking through my diary in december in china, i was on a bus and like a bunch of factory workers with their foldable bikes, and all of them were coughing up lungs and I have a line like, if i die in the next pandemic and some Shanghai factory worker gave me the virus, I'm going to be really annoyed.

And then later that month, there was like a plague outbreak in in Inner Mongolia. And we were like, oh, this is just a thing that happens here, I guess. So they said new virus. And it's like, oh, it's just like the plague outbreak. It's the thing that happens in China.

Amelia: Yeah, yeah, yeah. In the beginning, we were all like, OK, whatever just a new virus. But really, like, so unprepared. And, you know, I was like, oh, don't wear masks and then wear masks, and then this and that. And, you know, it's just a mess. In the beginning, it was more of a mess than it really should have been.

But hey, I caught it finally this last November, but I didn't catch it my entire E.R. work. Like the whole first year, I was good. Two years later,

Henry: Omicron is more infectious.

Amelia: Yeah.

Henry: I don't know if it works but I’ve been taking an herb completely untested for for the past two years, that's been active on the ACE-2 Receptor.

Amelia: Nice. We got it. You never got it?

Henry: I don't know. I got very sick after a club in October for a few days, but I tested negative, and I don't know.

Amelia: When I was. Yeah, well, I hope that untested herb is working. I’ll take anything. Nice.

Henry: OK, on that note, I'm going to stop recording unless there's something else you'd like to add.

Amelia: No, it's fine.