Q: Can you describe your current employment?
A: My name is Jay Das. I’m an interventional cardiologist, and I’m part of a private practice medical group.
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Q: How was your workplace and medical specialty affected by COVID-19?
A: A lot. In a number of ways. Now, one of the things that was easy for cardiology was, you know, we deal with a lot of acutely ill patients, so a lot of practices where most of the procedures are elective were certainly hit hard from a financial aspect, because basically everything elective was canceled. Everything was just emergent. But because we’re cardiology, we were still able to move on. There were a lot of different things we had to think about—how do we keep our staff employed, how do we keep our patients from getting infected, are we at risk, how do we keep ourselves safe, and then how do we kinda go about this. So we adopted telemedicine pretty early, and we did a lot of tele-visits and got the software together and made sure things were privacy-compliant and whatnot. And then basically we just kept going to work. It was pretty scary, early on, as far as like ‘what do we do about our families?’ and ‘what’s our risk of getting infected?’ A lot of the older physicians in the group—early on, the reports said that the elderly were the highest at risk for passing away—they obviously didn’t want to do patient care. There were a lot of exposures, and then ‘what do you do with these acute heart attacks coming in when you don’t have enough time to test them?’ and things like that. So, there was kind of a lot going on early on, and then all throughout. Adjusting what we did, and the unintentional side effects of shutting down—everything it did for other major health problems.
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Q: Was there a particular patient or day or week that stays with you? I know you work in cardiology—is there a lot of patient-to-doctor interaction?
A: Yeah, there’s a ton of it. Basically, my job, a lot of the time, is if someone comes in with the type of heart attack that they’re going to die from, I have to take them to surgery and try to get that artery that’s blocked off open within 90 minutes. So, not only am I taking them immediately to surgery, I don’t know much about their exposure history. You can talk to them about their medical history if they’re stable enough.
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One of the things that was happening pretty frequently was people were afraid to go to a hospital, and understandably so. Basically, they were worried about overloading the hospital, they were worried about getting sick themselves by getting exposed. So people were not coming in for the chest pains they would normally experience. And so I would say, the thing that sticks with me the most about the pandemic is the number of people that came in and died, or came in on death’s door. Meaning, basically, these people normally would come in, we would evaluate them, get them figured out, electively do an open-heart bypass surgery. That didn’t happen. I mean, these people came in and were so sick, the surgeons felt they were too sick to operate on, so we would have to go in and bring them back. So, in addition to the exposure stuff, what was happening was that a lot of people came in dying from other medical illnesses that had nothing to do with COVID because they were waiting too long to come in. It’s a big issue for healthcare everywhere, but in the United States, it’s preventative medicine—where people are looking at the risk factors and staying on top of things. If you’re not seeing your doctors a lot—it’s kind of like anything else. If you have a home, and you do regular maintenance on your home, the problems are not as big. If you wait 40 years and then decide to look into the problems, you’ll find major issues.
Q: How were you or your family personally impacted by COVID-19?
A: Well, my wife is a pharmacist and my son is four years old. We were pretty lucky—I mean, lucky in a sense. Obviously we were concerned that I was going to come home with COVID all the time. In fact, a bunch of people in my office did get infected. And, you know, when that happens, the ones who were working had to continue to work and cover things. What was nice was that my wife was able to come home and do a lot of her work from home with telemedicine. I mean, telemedicine made a big difference as far as still safely conducting evaluations. My son, fortunately, was young enough that we were able to keep him in his daycare, even though so many of the schools had shut down. I was really thankful for that—that he was still able to go to school and interact with his friends. So, in a sense, he kind of missed COVID versus—you know, I can’t imagine, if you were a senior in high school, or a junior or senior in college. I mean, those are—they’re just very memorable parts of your life, and to have that interrupted by this whole thing was kind of devastating. So, I have to say we were pretty lucky with it all. One of the things I figured out early on was that I didn’t really listen to a lot of what was said about this-and-that with masks. And I was wearing an N-95 way early. We had a trip planned to go to Hawaii in February—which we obviously canceled—so in December, when we started hearing about this, I started buying a bunch of N-95 masks online so that we would have them for the trip. And then we were just fortunate enough that we ended up having them at the time that everything happened. So what I would do is, even though you’re only supposed to wear it for a day, I would keep a mask on for, like, 10 days, or a week, and then trade it in for another one. And then I would wear a regular mask over it, to try and keep it from getting contaminated, and three or four months in, I started wearing my surgical goggles all the time for protection.
Q: How have things progressed in the last few months? Are you receiving fewer patients with COVID-19?
A: Oh yeah, no question. My take is going to be different from a lot of other physicians, I think. I’ve been around medicine long enough to know that a lot of the time, people that are convinced they know what’s going on have absolutely no idea what’s going on. Anecdotally, I mean, the vaccines are miraculous. Basically, it takes a long time to come up with any new medication, any new surgery or procedure. The United States is very—and appropriately so—into safety. So basically, they make sure that everything is extremely safe before we give it—the FDA is always on top of medications. You hear about all these meds that come out with issues as far as contamination, and they take them off the shelves. I mean, for us to have a vaccine nine months out, where the mortality risk of COVID after getting vaccinated is almost negligible—I mean, that’s amazing. You know, I’m specifically speaking about the Moderna and Pfizer vaccines, the two-injection vaccines. And people get knocked out, they feel fatigued, there’s certainly young people that come in with mild elevations and heart damage and inflammation. But they’re pretty easily treated, versus COVID, in which you could get a fever for three days or you could die—it was kind of all over the place. There’s no question that the number of patients has reduced. At this point, we are still seeing COVID patients; they’re almost entirely a non-vaccinated group. And there has been a lot of impact. I guess, the question is, as these variants come out, what exactly do they particularly mean, but it seems like even with them, the protection that’s given by two-dose vaccination appears to be pretty impressive. I mean, I assume that by this time of year, in the next couple months there would be booster vaccinations needed.
Q: What are your hopes for a post-pandemic world?
A: I mean, my hope is that it goes back to normal. Another thing you probably won’t hear a lot is that one of the concerns I had with this is, when I was a little kid, I had a walnut allergy. A nut allergy. And basically, I was the only kid, in three school districts, to have a nut allergy. And one of the things that happened was I got a third-degree burn when I was a child, so I think after that, my parents were worried about me getting sepsis, so they kept me clean. Like, very clean. And that was not a thing, in the 1970s or 1980s, the way it is now. So, there are a lot of children—and I don’t know if this is a hundred percent true, but I think there’s some thoughts that the fact that we keep everything so much more sterile than we did before may be affecting kids’ development as far as their immune responses. So, my worry with everything is, there’s a price to be paid for keeping yourself completely clean and away from everything. So, my hope is that there’s no major consequence of that. I think that, you know, as far as the effects of the shutdown, most of the people who held off on seeing the doctor and had really severe blood-clots in their lungs or heart attacks or had multivessel disease and didn't go in for a bypass—a lot of them have already passed away. So hopefully, as we go along, we end up doing better with it. I would say those are my main things.
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The other thing is that there’s a lot of finger-pointing that's gone on about the causes of this, and everything is our response, but it does bother me that the explanation for COVID that we all just took at face value was that it came from a wet market. That's the same explanation given—you won't know this, but basically 20 years ago there was something called SARS. And SARS was a viral infection; it was nowhere near as infectious as COVID, but it was a lot more dangerous. Like, regular people were dying at a rate of 30 percent. I had a good friend who was in law school in Hong Kong at the time, and had to basically escape the city because of it coming out. And 20 years ago, the explanation was that it came from a wet market, so the fact that you got two major viral pandemics—I mean both of those have occurred—we’ve said it's the wet Market that caused it. And the wet markets are still open; they’re not closed. So why the whole planet is ignoring this fact is pretty insane to me, but my hope is that we learn from this. There were a lot of surgical advances in all the trauma and tragedy of World War II, a lot of technical advances—hopefully we learn quite a bit from this and get better as a society afterwards.
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Q: Is there anything you want future generations or future doctors to know about handling another pandemic?
A: Yeah, I mean, it comes about once in a hundred years. Nobody really knows what they're doing—cut them some slack, and we'll figure it out as we go along. Basically, people need to understand. There’s hundreds of thousands of deaths with the flu, you know. There are just some things that are hard and are not going to be easy to figure out, and we’ll continue to get better and better at them. But people do need to listen to the general advice as far as what's probably protective, and just be smart about things. You know, there were a whole lot of problems with the pandemic. We have a society—as far as healthcare right now, it’s very expensive. Very expensive. You got to pay for all the equipment, and the nursing staff, and the physicians, and the hospitals, and all the administration that goes along with keeping people's data safe and following all the guidelines and everything like that. And so, because hospitalization is expensive, our whole medical system is focused on trying to get people out of the door as possible. And COVID-19 was certainly a disease process that didn't allow for that. When people were really sick, we kind of needed to monitor them and figure out what was going on; it was kind of the antithesis of the way that we direct medicine at this point. So, I don't know, so many things are pushed by finance that it's kind of hard to say what the benefits there would be, but yeah, I don't know, I'm rambling.
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Q: Are you planning to continue with your field?
A: Oh, with cardiology? Yeah, I mean, I’m not quitting anytime soon. We’ll see. My dad worked ‘till he was 69—I'm not planning on doing that. I think I'll probably retire earlier. Medicine’s a tough field. It’s easy to get burnt out.