Interviewer(s): Henry
Interviewee(s): Hesh

Henry: OK, so I'm going to be recording this. Is that OK?

Hesh: Yep. Great.

Henry: And will not name your employer in the interview. I will pseudonymize you if you want, etc., etc.. OK. So first question, what was your job in January of 2020?

Hesh: Physician. Scientist.

Henry: Yeah? Where?

Hesh: Can I say the university? The [organization]

Henry: New York City?

Hesh: Yeah.

Henry: So when did you first hear about the novel virus?

Hesh: I heard about it in January 2020 while traveling in the Far East.

Henry: And how did you hear about it?

Hesh: I heard about it through the news, and it was during the Chinese New Year. There's lots of travelers wearing masks And that was the first time that I realized that there was something going on. And the hotels began to check your temperature.

Henry: So what were your first thoughts?

Hesh: My first thoughts… My first thought was that I was not at all concerned, that I viewed it as a flu. And I thought that the people who were wearing masks were just being excessively anxious. So I definitely underplayed the the the crisis, the the looming crisis, the very beginning.

Henry: Do you remember, why did you think that?

Hesh: Well, I’ve seen as a doctor, seeing lots of epidemics and pandemics? And I just felt that it was in that same category. No, I mean, I just felt that would be a seasonal flu, uh, a flu. And being around lots of infectious diseases, as a doctor, I tend to be a little bit more cavalier about about that than the general population. And I lived through the HIV crisis, and that was quite bad. And so I'm used to being around infectious diseases. So I kind of had this this this, you know, this attitude of I'm watching the infections, but I can't get it because I’m a doctor.

Henry: OK. Did you discuss the virus at this time with anybody?

Hesh: Well, I was traveling with my family and that we discussed the virus for sure.

Henry: Any coworkers?

Hesh: Not that… no.

Henry: So the first wave of COVID hit New York around mid-March.

Hesh: Mm hmm.

Henry: Did your perception of COVID change before then?

Hesh: It changed drastically, in March.

Henry: In March?

Hesh: Yeah.

Henry: How so?

Hesh: Well, I got it. I got infected and my wife got infected. And we got infected on March the eighth at a birthday party. And we were in a dining room for a party with 21 to 22 people. And of that 21 or 22, almost everybody had been traveling around the world. And seven people got infected at that party, and one person died. And that person was an older person that he gave it to his wife, and she died. And the person that I think transmitted it to me and my wife got very, very, very, very sick. So that's when it really hit home that this is something quite serious.

Henry: By the time… But when you went to that party, did you still think it was not serious?

Hesh: Well, I went to the party It was definitely an issue because two days before that was my birthday party, of my father who turned 99. And we met we met as a family at his nursing home at his assisted living facility. And it was definitely an issue, a concern that maybe we shouldn't be doing this. But the nursing home facility allowed it and we were probably the last get together for family at that place for the remaining- for two more years, probably. It was the very last get together for families where families were allowed to meet. So I was definitely concerned at that time that this is a mistake, that we should not be doing this. But it wasn't enough of a concern. In retrospect, we would have definitely opted out. But at the time, it was still… it was a concern, but not an emergency. Not the emergency that it became OK.

Henry: So can you describe how you were feeling around this time?

Hesh: I mean, as with with respect to the pandemic or with respect to how I feel about getting sick?

Henry: With respect to the pandemic. But before you got sick.

Hesh: OK, so it was starting to emerge that this is much more serious than we thought And I was concerned. It was now going beyond typical seasonal flu. That was in early March. The mortality rate was starting to climb and it was not typical of of influenza. So my my antenna were raised, let's put it that way.

Henry: So what did your what did your hospital or your university do to prepare for the impending crisis?

Hesh: The preparation was poor. Very, very poor, in fact. But it was not unique. I mean, it was that the whole medical system was unprepared because at the time it was a great fear that that masks and PPE would be in short, supply for medical personnel. At that time, it was really aware, people were aware that doctors and nurses and other health professionals needed to be protected against the virus. It was known that it was transmitted by air. And because there's a shortage, it was hard to get… It was hard for regular people to get to get masks. And when I finally got started, I was unable to get a covid test. So even at this major medical center, we could not get tested for this virus.

Henry: OK, so you said the preparation was poor, but is there anything… what else is there, aside from the lack of PPE?

Hesh: I wouldn't I think that the country wasn’t ready. If the country was ready then there would have been a ready supply of PPE for the hospitals and mass general population. And that would have been, you know, good preparation. We didn't have that. As the pandemic emerged then, you know, there were more masks being manufactured and things like that. But at the time, everybody was caught very short on these supplies. And that's why the message from the CDC was so, well, was incorrect, was also necessary because people were afraid that the CDC, that PPE would run out So the preparation was that there was a nationwide lack of preparedness as opposed to the medical field not being prepared.

Henry: Right, but you're saying this is something that arrived in March, correct?

Hesh: Yes.

Henry: So the first cases were in January.

Hesh: That's right. Yeah, that's right. But when you see a couple of cases you don't get, it doesn't raise your consciousness, doesn’t raise your antenna. You don't see that it's anything serious until it starts to explode. And it exploded quite quickly. But in February, the concern was there, but it was still not… people did not anticipate that a million Americans were die. It was people just didn't view it that way. So people were concerned, but not as much as… in hindsight it's very easy to look back and say this should have been done. But while it was happening? People were just not … it didn't reach the level of fear, like the AIDS crisis, when AIDS exploded, it really exploded. And but at that time, it exploded only in certain communities. And you didn't have this fear that it would go to you because of the ways that it was transmitted. As a doctor, we were very, very concerned that it might be more transmissible than it is. And people were concerned about examining patients with HIV, people were concerned about doing surgery. That was a very legitimate concern. People in the medical community were very, very fearful when… we were very afraid when AIDS came out. And it exploded this did also. But people didn't make the same kind of connection because, you know, people were more vulnerable with COVID than with HIV. But the feeling was a similar feeling. There's still you know, there's a level of anxiety with HIV that I had then that I didn't have with COVID until it exploded.

Henry: So at the hospital or in these medical settings, were there any meetings or group discussions about the response?

Hesh: Well, no. So there were meetings by the dean designated a few officials, medical deans and doctors and researchers to come up with a COVID plan. And then when the COVID plan was was made, it was transmitted to all of us by email blast. So we were not part of the discussion; a committee came up with the protocol. And then we learned about it.

Henry: Do you remember when that was?

Hesh: That was probably in late March. Early April.

Henry: Late March. Early April.

Hesh: Right. When the lockdown when the lockdown occurred was when we we we you know, the schools was basically locked down. And we got the emails about what should be done, what what would happen if you got infected, that sort of thing.

Henry: So were there any but were there any meetings or discussions in February? before things really started exploding?

Hesh: Exploded? No, no. The meetings occurred, the plan of attack occurred after mid-March, when the when the lockdown happened.

Henry: Do you remember if anyone was trying to push for action early?

Hesh: No, I was not aware of anybody doing that. Maybe there were individuals doing that. But I was totally unaware that that was happening behind the scenes.

Henry: Are you saying maybe there were individuals doing that? Or you don't know?

Hesh: I don't know. OK. I wasn't I wasn't calling my colleagues and saying, what should we do? So in my circle, my circle was was more research and clinicians. So so to give you a sense, I work at a clinic and there was no discussion among clinic doctors and the clinic administrators about any kind of protocol. Only after [organizations] created the protocol and after mid-March, when the lockdown occurred, then we had these discussions. But before that, there was no individuals saying we should act now, and make a complete plan before the administration tells us what to do.

Henry: Do you think that the hierarchy has something to do with that?

Hesh: No, I don't think so. I think that it just that was a very complicated issue, and I think people will, people were waiting for the committee; people on the committee were able to devote their time to trying to figure out what to do. Those of us who were not on the committee doing that didn't have the time to look at the CDC data and go through the CDC recommendations. So we were all kind of waiting for guidance because that's what happens. It's hard to make your own decisions because you don't have as much information as the committee does. So we were- I think I mean, that was for me, me and the few doctors that did contact my clinic, we were waiting for some kind of an executive decision.

Henry: So you did contact some of your colleagues.

Hesh: Colleagues by email contact? I contacted contacted a couple of people in the program basically to find out what the plan was. needed. So we were thinking about what should we do? And we were waiting for the executive branch of the medical center to come up with a plan. Now, if that happened now, if we saw something similar to what was happening then, I think people might act earlier. But at the time, it was y’know standard protocol to sort of wait and see what the people who were in charge said to do. They they're the ones who had all the data and the time to think about a plan.

Henry: So when you were talking with the other clinicians, this would have been this would have been February because you got COVID in March.

Hesh: No, we had no discussions in February. There was a window after we got after I got infected in March. And when… Well, there was a small window before we got the word from [medical school and hospital] about what the plan should be.

Henry: But this window was during the first wave, correct?

Hesh: It was really a very narrow window because once there was a nationwide lockdown, then you know, it came pretty quickly. The higher ups came up with a plan quite quickly. I don’t remember the exact time because it was really was within days.

Henry: So one more question about the hospital. Then it's a few more psychological questions. So what do you wish, if anything, that they would have done differently?

Hesh: Well, OK. I’ll be honest with you, I think that it was handled pretty well. I think that given the the the speed with which everything took off and the lack of knowledge about the infections and all that, I think that that on the on the hospital level, they were, you know, more or less appropriate. I mean, it would’ve been nice to be able to get tested at that time. But very few people were, there were no tests available. So I think that the major thing is that this was a nationwide problem, that it really impared the response. Because the government can order, can make things on a deficit. The hospitals can't just order masks and PPE without having a major economic compromise. The government can do that. They can go into debt and pay for it. So really in my view, it was a nationwide lapse as opposed to a health care system lapse.

Henry: So is there anything you would have done differently as an individual?

Hesh: Yeah, I definitely would not have encouraged a birthday party for a ninety-nine year old in a nursing home two days before I got sick. And actually, I was very, very concerned that that I might have actually gotten the infection earlier and transmitted to people there. But my father was hospitalized about two weeks after that. He was congestive heart failure and he was negative. He eventually turned positive. But he was negative at that time. So that was a fear, I think, that I would have been more… I wouldn’t have had this macho attitude that as a doctor, I can't get sick. I would have been paying much more attention to going on March 6th to that nursing home. And March eight at the party. It didn’t even cross my mind on March eight that we should not be doing this because I was gonna be around healthy people. And, you know, I just had no clue that this was going to be an issue. So now you know, I would never go into like a crowded bar. So knowing that in retrospect, I would not have wanted to go into a crowded room. But you only know that know that now. There's no way anybody could have been, you know, as cautious as we are now, you couldn’t have been that cautious in early march, there just weren't enough cases. It didn’t explode.

Henry: So we've covered this a little bit, but what would you like to tell me about the way you felt in early 2020? Before you got sick.

Hesh: I had, you know, I had no fear. I definitely thought about what was happening in China and how millions of people were traveling because of the Chinese New Year, and how this might lead to a major problem. I just never thought that I would be, I would get sick. That's just, you know, you know, this this kind of macho attitude that some doctors have because we get exposed to so many things. I would have paid much more attention to traveling. I would probably have worn a mask. But if I had known then what I know now, I certainly would’ve worn a mask in these hotels and followed the lead of the Chinese tourists, many of whom were wearing masks. I remember thinking that it was ridiculous to take somebody's temperature because, you know, you really can't capture what's going on with just a fever. So I thought it was a bit of an annoyance to get checked every time to check going into the kitchen, into the dining room. I definitely was way too cavalier and in the next pandemic, if there is another pandemic, then me and most of society, we would take precautions much earlier than we did. You know, when you look at the history of pandemics, in the world, it's it's very abstract. Then now we're living through it. You know, we didn't live through the 1918 flu. We only read about it, when you're actually living in it you attitude is is very different but in January, February or early March you still weren't living in it. But now when we see an infectious disease or even a very serious flu coming down the pipe, I think that I would react really swiftly in trying to reduce the risk of getting infected. No question about it. Avoid crowded places, wear masks all the time indoors, with people. And it’s definitely changed my attitude for possible future respiratory transmitted viruses.

Henry: So you've mentioned, you've mentioned these visible disruptions a few times. So the mask temperature checks, the visibly empty restaurants during the Chinese New Year, how did you feel looking at those? That was in late January, early February.

Hesh: I really felt that they were being you know, too cautious. And in New York City, in Chinatown, people wear masks quite a bit. And I always thought that was a little bit odd. And kind of I felt the way I think Republicans feel about masks now. You know, ‘Why are you doing that, you’re being excessively cautious, it’s not cool’ and that kind of thing. And I view that the same way the way the way Republicans view mask wearing during the Covid crisis, [that] is the way I view seeing these Chinese tourists wear masks, they were being excessively cautious and it was not necessary, and again, it can only affect you and not be that's the big lesson.

Henry: That's your that's the top line argument? You saw these things, but you felt that it wasn’t….

Hesh: I felt, I felt immune. I felt immune. And also, I didn't feel vulnerable at all. Because my age, because I'm healthy. And also the 1918 pandemic affected, it was the exact reversible state was in college in 1980 in the worst cases and the highest locality was among the young and here it's it's worse in people who are older so… I don't I don't I don't feel my age […] I didn't feel vulnerable.

Henry: So it seems like you weren't ever anxious at all or scared?

Hesh: No no.

Henry: And how did you treat the uncertainty about the new virus?

Hesh: Well, I basically followed the advice I locked down with everybody else. I followed the advice of the CDC and worked remotely. And the only thing we did that I did that was different, and again, this was a clinic wide policy, we only saw patients remotely. Patients came in for the treatment and they weren't being seen one on one the way we ordinarily do. So a lot of precautions were taken, but even I just never felt… I never felt vulnerable. I don't know what it is. I saw patients who eventually who had COVID infections coughing. I mean, I just took precautions. And, you know, doctors take risks when it comes to infections. And it's part of the it's part of the mentality. And I think that that was definitely my mentality, too, that it's, you know, we were brave soldiers exposing ourselves to the front line, attacked. There is that mentality in medicine for sure. Ebola would’ve scared me.

Henry: Why?

Hesh: Well, the mortality is very high. Yeah that’s the other thing. I think that the mortality of COVID was the same ballpark as smallpox and bubonic plague and Ebola, I think that I would have been much much more frightened being around people, much more. But because the mortality was 1% or less, I just didn't feel as… that nervous. I wasn’t nervous that I was gonna die. But if I had Ebola, if I was an Ebola endemic the setting of this had the mortality of smallpox, I would have had a very, very different lens. But [the mortality rate] 1%. You always say it's the other person who's going to get sick.

Henry: This 1% was known pretty early yeah?

Hesh: I was looking at the numbers and, you know, I did very simple math making rough calculations about whether or not the numbers of cases were accurate. The mortality was pretty accurate. The number of cases is not. and I was saying, right away, that that it was under 1%. Higher if you were high risk. lower if you if you healthy.

And it was it is quite clear at the very beginning that that old people in nursing homes were really, really high risk, so so my parents facility, half the people got infected and half of those died. One quarter of the elderly died during the pandemic. But again, it's them and not me.

Henry: But you were doing these calculations in like January and February, right?

Hesh: No, no. I was doing it in March when when the pandemic really exploded. When you were seeing thousands and thousands and thousands of cases every day. And when the papers were reporting mortality, that's when me and everybody else started looking at thea numbers. And then only after a couple of weeks, after my father got sick, when I inquired about the infection rates, that's when I realized that that nursing homes were very, very high risk. But again, it's how you assess personal risk and risk to the society. If I was someone who was immunocompromised, if I was ninety years old, I would’ve assessed risk very differently, and I would have been, I think, more frightened. But in my set, the way I felt, I had I had no real fear. … I've been exposed. I've been exposed to a lot worse.

Henry: I mean, you've had needle sticks, right?

Hesh: I had a ton of needle sticks. And yeah, because we were sloppy. And two people in my year as an intern got Hep C, and we had a couple of people who had exposure to TB and the skin test turned positive they had to be treated. And I was I was exposed to quite a bit of TB in the late 1970s and that was much more and even then, even when I was treating, I was treating a patient who, who bled out from tuberculosis. She exsanguinated in front of me from a hemorrhage, hemorrhage in her lung, and she was spitting out God knows how many tuberculosis bacilli. And even then I didn't feel at all nervous. So that's just being cocky and young.

Henry: Well in this case… in this case, is it cockiness, or is it… obviously you work more than a full time job, so is this cockiness, or is this not doing the calculations?

Hesh: No I think… well, I think that I was being cocky is naturally part of who you are as a health care professional. And the numbers were not that bad, but I have to tell you something. If I was working in the hospital the way my colleagues were, I think I would’ve been much more nervous.

Henry: Really?

Hesh: Oh, yeah. I would have gone in if I was called. I mean, I would’ve gone in and done the PPE and all that stuff. But the seeing and hearing about nurses and doctors getting sick and dying, I definitely would have been much more cautious. So part of it is being cocky, but part of it is also the fact that I was not exposed in the way that my colleagues were exposed to it. I was not- I was working in a clinic and not in the hospital, and I think that working in the hospital would’ve changed would’ve taken away some of this cocky attitude.

Henry: OK, OK, we're getting up there in time. So I think we should I think we can end this interview pretty soon. Unless there is anything else to like to say?

Hesh: No. I think that when you interview your friends that they would be very happy to talk about it. It's somewhat therapeutic.