Ob/Gyn Dispatches During COVID-19: Janice Aubey, MD

Each day during the COVID-19 pandemic, we'll share an update from a member of our team in the Department of Obstetrics and Gynecology at Columbia University Irving Medical Center. Today's note is from Janice J. Aubey, MD, Medical Director of the Postpartum Service at NYP/CUIMC.

Janice Aubey, MD

Janice Aubey, MD

Where do I begin? Was the beginning in mid-February when I was seated next to a passenger wearing an N95 mask on a flight to London? Clearly that was overkill, yet I paused to think about what am I getting myself into. So much has happened since then. Who would have thought that “Flatten the curve” would become everyday parlance, and that Dr. Anthony Fauci and Gov. Andrew Cuomo could become modern global folk heroes?

We met, strategized and shared more than I ever thought was possible. We rose to the occasion. Is there any more to say? The days are now longer and warmer, and there is a sense of optimism. As a nation and an institution, we are focusing on the next phase  – the phase marked by recovery, rebuilding, re-imagining. Yet, I am still fully present in phase 1 – the pandemic. The endless protocols with almost daily revisions, the donning and doffing, PPE conservation, the reluctance to wear anything but scrubs to the hospital, and the commitment to adhere to the principles of remaining socially distanced. So many people have moved on. Masks hang on one ear or below our chins, patrons gather on city streets seeking service from bars and restaurants, and parks are populated with people who want to re-connect. 

Is that it? Is it really over? What really happened?

I guess it is hard for me to think about moving forward, because I am still absorbing what happened:

More than 21,000 people in NYC died from confirmed and probable COVID-19 disease. Most of them were citizens of neighborhoods in Queens and the Bronx.

Blacks and Latinx represent 30 percent and 31 percent of New Yorkers who have died from this disease, yet only 24 percent and 29 percent of the City’s population identify as Black and Hispanic. Nationally, Black Americans represent 14 percent of the population and 30 percent of the cases. Similar statistics are found among ethnic minorities in the UK and Norway.

The NYC comptroller’s office estimates that 1 out of 5 working New Yorkers will lose their jobs by the end of June. Women are more likely than men to face unemployment. So far the greatest job losses have been reported in healthcare, social work, education, retail, the arts, and hospitality (restaurants and bars) in NYC, including some workers who, not long ago, were considered “essential.”

According to Census data, 21 percent of the 8.3 million New Yorkers are under age 18 – and on Monday, March 16the nation’s largest public school system closed. In NYC, 114,00 of these children are homeless. As schools around the country closed, it became clear how many families rely on schools for meals, shelter, clothing, and safety.

UNESCO estimates that global school closures have impacted 90 percent of the world’s learners – that’s almost 1.6 billion young people. How this has impacted student learning, and how it will impact the poorest and most vulnerable children, are some of the questions educators and large think tanks are now beginning to consider. How effective was distance learning?  I assume that this, too, will be unequal.

Fourteen point four percent of residents in NYC are food insecure – that’s over 1.2 million people – making the rate of food insecurity in NYC 12 percent higher than the national average, and 21 percent higher that the rate in New York State, according to aggregate data from The Food Bank of NYC, which uses data sourced from the US Department of Agriculture, Feeding America, and NYC and New York State.

The statistics are daunting. These are the numbers that I continue to sort through and have not been able to get out of my head. These are the numbers that keep me from moving forward. The numbers are linked by a common thread, which is poverty. We have learned so much in these few weeks about SARS-CoV2. However, we have so much to learn about the long-term consequences of the pandemic.

So as we prepare for the next phase, as we personally look forward to dining in restaurants with friends, getting haircuts, and celebrating graduations or professionally look forward to full OR schedules and normal outpatient schedules,  please don’t forget to wear a mask and think about these statistics. The tsunami may be over, and and we are better prepared for the next wave when it surfaces, but the landscape has been altered. We should stay conscious of the disparities that have been exposed. This is an opportunity for all of us to invest in equality for our future.   

As Martin Luther King said, “The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. The only measure of your worth and your deeds will be the love you leave behind when you're gone. The measure of a man is in the lives he’s touched.”

Janice Aubey, MD