- Dr. Craig Spencerdirector of global health in emergency medicine at NewYork-Presbyterian and associate professor at the Columbia University Medical Center.
We look at the skyrocketing number of COVID infections. Coronavirus cases hit record highs this week, with global cases climbing 70% from last week to 9.5 million and the U.S. reporting a single-day record of 1 million new cases on Monday. In the U.S., the extraordinary volume of cases is filling up emergency rooms nationwide and exhausting healthcare workers, says emergency room physician Dr. Craig Spencer, who has been treating coronavirus patients since the pandemic began. “We’re much better at treating this disease now,” says Spencer, “but the problem is that the amount of volume that we’re seeing threatens to really wash away any added benefit from either a milder variant or even all that experience that we’ve learned and those tools that we’ve built up over the past few years.” Spencer also critiques the U.S. government’s role in prolonging the pandemic, saying, “Global vaccine inequity has been one of the most profound and disappointing aspects of this pandemic over the past year.”
AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman, as we look now at the skyrocketing number of COVID infections. The World Health Organization says global coronavirus cases reached a record nine-and-a-half million last week, up 70% from the prior week. On Monday, the U.S. reported a single-day record of 1 million new infections. The CDC predicts in the next month more than 84,000 people in the U.S. could die of COVID-19.
WHO Director-General Tedros Adhanom Ghebreyesus warned Thursday the fast-spreading Omicron variant should not be categorized as a “mild” virus.
TEDROS ADHANOM GHEBREYESUS: Just like previous variants, Omicron is hospitalizing people, and it’s killing people. In fact, the tsunami of cases is so huge and quick that it is overwhelming health systems around the world.
AMY GOODMAN: This comes as health experts on Biden’s advisory team during his campaign published several critical op-eds Thursday in the Journal of the American Medical Association urging him to adopt more aggressive use of vaccine mandates and a verification system for vaccination. Today the Supreme Court is hearing arguments in cases that challenge federal efforts to enforce a vaccine-or-testing requirement for large employers, as well as a vaccine mandate for most healthcare workers. The cases could determine vaccine requirements for some 80 million people.
Meanwhile, the surge in COVID-19 infections is filling up emergency rooms nationwide, with the National Guard being called in to help in a number of states.
For more, we’re joined by New York emergency room physician Dr. Craig Spencer, whose tweet Monday night went viral. It began, quote, “Just leaving the ER. It was a long day. And a stunning amount of Covid. Today I worked in an area that was temporarily converted into a makeshift ICU during the first COVID wave. Here’s what different from then. And also what challenges we’re facing with this surge in NYC.”
Dr. Spencer, welcome back to Democracy Now! Can you lay out what you’re seeing?
DR. CRAIG SPENCER: Absolutely. As I pointed out a couple days ago, you know, in some ways, things are relatively better. You know, we’re not seeing the same number of patients that need immediate stabilization with a breathing tube, that need to be put on life support. A lot of that is due to the fact that we’re much better at treating this disease now. We have tools. We have high-flow oxygen. We have other things that we can go to because we’ve learned so much over the past few years.
But the problem is, is that the amount of volume that we’re seeing threatens to really wash away any added benefit from either a milder variant or even all that experience that we’ve learned and those tools that we built up over the past few years. So what we’re seeing is just a lot of people, especially here in New York City, where it feels like nearly everyone has COVID, coming in, you know, many, primarily the unvaccinated, with classic symptoms — short of breath, needing oxygen — but many other patients for whom COVID is exacerbating underlying or chronic illnesses, putting them in the hospital and making them worse.
AMY GOODMAN: So, you describe “Diabetics in whom Covid precipitated diabetic ketoacidosis, a serious and life-threatening condition. Older folks sick with Covid just too weak to get out of bed. Can’t walk. So can’t leave the hospital. … Relatively few needed oxygen… But still so many needed hospitalization.” And the COVID patients next to the non-COVID patients, people who spent so much time protecting themselves from COVID.
DR. CRAIG SPENCER: Yeah, this is what a big concern for a lot of us is now, is that, you know, look, coming into the Omicron surge, we already had hospitals that were filled to capacity from Delta and from non-COVID illness, from people who had put off some of their elective care or had put off going to the hospital because of fear of the virus or issues around insurance, many other problems that we’ve seen in a healthcare system that, quite frankly, even before the pandemic wasn’t up to the task. And then, what we’re seeing over the past few weeks with more and more patients being brought in is that, you know, we’re having to put patients anywhere we can. We don’t have the space. We also don’t have the providers. We have so many of my colleagues — even though the majority of us are thankfully vaccinated and are not going to get really sick from an infection, a lot of people, being around COVID all day, are getting exposed, are getting mild breakthrough infections, and that’s forcing them to be sidelined for, you know, five, seven, 10 days, putting an even greater staffing crisis on top of a space crisis and the surge of cases that we’re seeing.
AMY GOODMAN: Can you talk about that, Dr. Spencer, both the psychology and the health of the healthcare workers and what this means? I mean, we’re moving into the third year of this pandemic. And how people are keeping up their strength, and how many healthcare workers are leaving?
DR. CRAIG SPENCER: It’s a really good question. I remember in March 2020, I said then that this was going to scar a generation of healthcare workers. And that was before this impacted the rest of the country the way that it had here in the Northeast.
You know, look, imagine — if you’re not healthcare worker listening to this, imagine how sick you are of this pandemic, of the cancellation of birthday parties or family meetups. For us, it’s the exact same, except that we have to go to work every single day seeing our colleagues get sick, seeing patients that are really unwell, continuing to do this year after year at this point. It’s incredibly exhausting.
A lot of people have left the profession. A lot of people just can’t deal with the physical or, more importantly, the mental toll now of seeing this, you know, day in and day out, and are leaving the profession. And it is causing a crisis. And on top of that crisis, we’re seeing staffing levels now at record lows, and it’s challenging our ability to provide the high-quality care we want to, not for just COVID patients but for non-COVID patients, as well, that are coming to emergency rooms and hospitals in ever-increasing numbers.
AMY GOODMAN: And can you talk about the confusing CDC guidance, saying people can go back to work after five days without a test if they mask up? And people saying, “Well, wait a second here. Are you just saying that because there aren’t enough tests to go around?” And then the whole issue of masking, that cloth masks do not make it right now, that we’re talking about having to have KN or N95 or KN or N94 masks, you know, many-ply masks, and what that means for people who can’t afford or don’t have access to this kind of mask that everyone should be wearing?
DR. CRAIG SPENCER: Well, I think both of those are related, and I’ll address those separately. But, collectively, I think what’s important is that it is shameful that, two years into this, we don’t have a system whereby every person in this country, and even more so around the world, should have access to those high-quality masks that we’ve needed not just over the past few weeks but longer, or that it’s so difficult for people to get a test. The fact that it costs $10 to $12 or $15 per test is absolutely incredulous and unacceptable at this point.
We should have been doing more before Omicron arrived, and even once we knew that Omicron was coming at the end of November, to get tests out to every single person in this country, because right now what we’re seeing is that people with means and resources are able to go out and find them and buy them online, are able to stockpile, and they’re using that to keep their families safe, but, as we’ve seen throughout this pandemic, this is disproportionately impacting the people that do not have the means and the resources to spend the time in line getting a test or to spend a bunch of time online at night finding out where they can get tests from, or different types of masks, and research what may be best for them. The fact is, is that we should have collectively done more, as opposed to focusing, like the CDC guidance does, on individual decisions and the impact of those individual decisions.
I think that the CDC guidance around testing is actually probably, for the majority of people, quite true. After five days, the likelihood that you’re going to infect other people is probably pretty low. But, collectively, as we have Omicron spreading everywhere, this being the most transmissible virus perhaps that we’ve ever seen as humankind, we need guidance that helps us collectively make the right decisions, because every one of these infections has a collective impact.
AMY GOODMAN: Dr. Craig Spencer, you’re not only a New York City emergency room doctor, but you are director of global health in emergency medicine at Columbia University. You yourself had Ebola, working with people in Africa years ago, and had to be jetted back to the United States to be treated. You certainly know about deadly epidemics. And I wanted to ask about this issue of vaccine equity. Next week we’re going to be speaking with a man who was part of the Moderna trial. And now he is not going to continue to be a part of a trial for boosters as each vaccine has to be changed, because he says Moderna and Pfizer and these corporations are making billions yet not making these vaccines available to the world. Can you talk about the significance of this?
DR. CRAIG SPENCER: Absolutely. Global vaccine inequity has been, I think, one of the most profound and disappointing aspects of this pandemic over the past year. You know, it’s great that everyone here has the ability to walk into a pharmacy now and get a vaccine or get a booster that can keep us and our families safe, but people around the world should have the same access. And there has been a very intentional campaign by pharmaceutical companies to do whatever they can to reap the most profit of this at the expense of people all around the world that continue to lack access, to healthcare workers, you know, over 115,000 of my colleagues that have died around the world, and so many of them, the majority of them in places like sub-Saharan Africa, still haven’t been able to receive access to a vaccine. I was texting with a good friend of mine the other day who lives and works in East Africa, in Burundi, and he said, you know, he’s going to try to take the trip to the capital to see if there’s a vaccine available, but he’s not sure that there is.
Now, this is completely unacceptable. It is responsible, as we’ve seen, to leading to the conditions where more potentially immune-evasive variants can arrive and potentially undermine the efficacy of our vaccines here. We should have, not as a country but as a globe, done incredibly more, since day one, to scale up the production of these highly effective vaccines, not just here in the U.S., where they’ve long been made and where they can make a big profit, but everywhere all around the world, including in sub-Saharan Africa, where over 99% of all vaccines before the pandemic had to be brought in from other countries, because the capacity had never been built up and hadn’t been supported. And we’re going to end this pandemic in a not much better position than when we started it.
AMY GOODMAN: And the whole issue of these variants, that are rapidly changing, that if we don’t vaccinate the world, this will continue. The new discussion of a variant that’s come out of Cameroon, and now in France. Of course, Omicron, you had South Africa, and then you had Delta, India — although we don’t really know where they start. You know, Omicron might have gone to South Africa from Europe. But what it means, if you don’t take a global approach, no one is safe.
DR. CRAIG SPENCER: Absolutely. We have been — I’ve been saying this for years, you know, after our response to Ebola and many other infectious pathogens. Look, the United States has more resources than really anyone else in the world, but there is absolutely no wall that we can build high enough to keep infectious disease threats that may originate in other places away from attacking and impacting our population here. Unless we think about how to manage not just COVID but all other infectious threats globally, not just with a domestic focus, we will find ourselves hit time and time again. And there is no vaccine strong enough and, as I said, no wall big enough or moat large enough that it’s going to be able to keep these infectious diseases from coming to our shores. We need to be more proactive in doing more for the world and less focused on what we can just for our own population at home. That is a losing strategy time and time again.
AMY GOODMAN: The idea that the U.S. is the most powerful, richest country in the world, has the worst record when it comes to COVID.
DR. CRAIG SPENCER: Yeah.
AMY GOODMAN: I mean, you have the global picture, where there has to be a global health system, and you have the picture at home. What does this say to you about having public healthcare in the United States, the idea of Medicare for All? How do you see it as intimately linked to dealing with pandemics like these, what we’ve lost by not having it?
DR. CRAIG SPENCER: I think for so many people that maybe didn’t buy into this idea a couple years ago, if it has not become obvious over the past two years, I don’t know what will make it so.
Look, we had issues around vaccine hesitancy. And we know that one of the best ways to get people vaccinated, who may have questions at first, is to not shame them into doing so. It’s to have a conversation with them. And the people that need to be having those conversation are healthcare providers that people trust.
But we have underfunded primary healthcare in this country for so long. A lot of people don’t have access to a primary healthcare provider, or, if they do, it’s many months out. Sure, you can go see a specialist. Sure, you can see — we haven’t focused on the right things, which is preventative care, stopping people from getting out of the hospital, stopping people from getting sicker. All of these things that we need to do are things we’ve needed to do from before the pandemic started, and have been exacerbated by it — by making sure everyone has access to a primary care provider that is affordable, accessible in real time, don’t have to wait months for, and having a public health system that isn’t subservient to the pharmaceutical system here in the U.S., public health where we’re able to focus on preventative health, on social determinants of health, on recognizing that it’s not just about whether you have good insurance or no insurance at all, so that people are coming to the healthcare system with everything else that they bring, you know, their access to employment, their understanding of their illness, their access and their previous history of education. And we just, unfortunately, have not been able to meld those things over the past few years, the past few decades, in this country, because we have a model where in the U.S. medicine is unfortunately a business, and it’s an incredibly strong and powerful one.
AMY GOODMAN: Finally, children, Dr. Spencer. You’re a New York City emergency room doctor. What about children and Omicron, the whole debate around the country around schools being such a major vector of COVID?
DR. CRAIG SPENCER: Yeah, it’s really hard to say. You know, up until now, we’ve known that schools can and should be safe and that we should be doing everything that we can to keep schools open. We know the mental health impact of having them open is profound. And by all means, schools should be open, and bars should be closed, if we need to take any type of intervention, right? And it’s the exact opposite here in many places in New York City and all around the country, where you have bars open and schools closed.
Now, we need to do everything we can to make sure that our students are safe. And we can do that with ventilation, with masking. We need to make sure that all of our providers, our teachers, everyone else that is working in those places is safe, as well. And we have access to vaccines, but still other people have underlying medical issues.
You know, we know that, thankfully, for the most part, Omicron and at least other COVID variants, COVID strains, haven’t tended to impact children in the same severe way as it has older adults, for example. But that doesn’t mean that it hasn’t been impactful and that kids don’t or potentially can’t get infected at school and bring that home to loved ones, to parents, to grandparents, who may be living with them. So, I think the point of this needs to be that the safest way that we can keep kids in school is to take those measures, to get them vaccinated if they’re eligible, and, if not, make sure all the people that are around them are vaccinated, as well.
AMY GOODMAN: Dr. Craig Spencer, we want to thank you for being with us, New York City emergency room doctor and director of global health and emergency medicine at Columbia University Medical Center. He’s been treating coronavirus patients since the pandemic began.
Coming up, three protesters are killed in Sudan, bringing the total to around 60 killed since October’s military coup. We’ll go to Khartoum for the latest.
AMY GOODMAN: “Limaza” by Abdel Karim al Kabli. The Sudanese singer, composer and humanitarian died last month at the age of 89.