Now, more than ever, it’s important to tell stories that connect the UB community, inspiring others to help, cope, understand and work to strengthen the ties that bind us.
Together we can make a difference and persevere during this time of crisis.
We want to hear about—frontline experiences; behind-the-scenes support; the challenges of couples in healthcare; lives lost, lives saved; creative solutions; coping strategies; expressions gratitude… and more.
Providing care, lending insight and offering expertise, faculty in the Jacobs School of Medicine and Biomedical Sciences are working in UB-affiliated teaching hospitals throughout Buffalo to treat patients with Covid-19.
J. Maurice (Mo) Hourihane, MD, clinical assistant professor, neurology, Jacobs School of Medicine and Biomedical Sciences, pictured at Buffalo General Medical Center, Kaleida Health, a UB teaching affiliate. Photo by Joe Cascio/Kaleida.
Kristin Lythgoe, MD, assistant professor of emergency medicine, foreground left, talking with emergency medicine residents and Robert F. McCormack MD, professor of clinical emergency medicine, Jacobs School of Medicine and Biomedical Sciences; UBMD Emergency Medicine, at Erie County Medical Center, a UB teaching affiliate. Photo by Joe Casio/ECMC.
James Lukan, MD, clinical associate professor, General Surgery Residency Program Director, Department of Surgery, Jacobs School of Medicine and Biomedical Sciences; UBMD Surgery, at Erie County Medical Center, a UB teaching affiliate. Photo by Joe Cascio/ECMC.
Alberto F. Monegro, MD, assistant professor, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences; a physician with both UBMD Internal Medicine and UBMD Pediatrics in the divisions of Pulmonology, Critical Care & Sleep Medicine and Pediatric Pulmonology, respectively. Pictured at Buffalo General Medical Center, Kaleida Health, a UB teaching affiliate. Photo by Joe Cascio/Kaleida.
Samuel D. Cloud DO, assistant clinical professor, Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences; UBMD Emergency Medicine, at Erie County Medical Center, a UB teaching affiliate. Photo by Joe Cascio/ECMC.
Marc Maller, MD, is a geriatrician and faculty member in the Department of Medicine’s Division of Geriatrics and Palliative Medicine. In March 2020, he was infected with the Covid-19. The following is an account of his experience.
It was early March of this year on an otherwise routine day for me as medical director of a 64-bed long-term care facility in the suburbs of Western New York. The chief nursing officer and I had just completed visiting each of the three neighborhoods in our facility in order to provide general information to the nursing home residents and staff as to the recently implemented visitor restrictions due to the impending Covid-19 crisis. One week prior, our residents had been told that they could no longer leave their respective neighborhoods and move about the different areas of the facility freely. This was just at the time when it had been announced that several residents in a long-term care facility in Washington State had contracted a new and unusual virus: novel Coronavirus (Covid-19).
During this week, I had begun to notice some mild gastrointestinal symptoms primarily consisting of increased borborygmi and an increased urgency to move my bowels; also, of note is the fact that my stools were significantly looser than normal, and at times explosive in nature. My instinct was to attribute this to a typical viral gastroenteritis, which I assumed would resolve in several days. Unfortunately, it did not. I managed to continue working through the week but recognized that the diarrhea was worsening in frequency and I was slowly become weaker and weaker.
I decided not to make the half-hour drive into work on Monday, as I knew I needed to rest. However, feeling somewhat better the following morning, I drove to work and managed to finish out the week, albeit knowing that this gastrointestinal illness had not completely resolved. While at work I became aware of my normal high-strung tempo and level of stamina diminishing to sub-par levels. In addition, several staff members with whom I interact on a daily basis made note of my facial color, labeling it anywhere from pale to “yellow.” And, although these same staff members felt compelled to ask me if I was alright, my responses to them were tempered a bit, as deep down I felt that something was definitely amiss.
Because my diarrhea worsened dramatically over the weekend, I asked my daughter to drive me to the local university-affiliated hospital emergency room on Sunday morning. I had showered first, and that activity enervated me to such a degree that I had to lie still for 30 minutes even before I dressed. When I arrived at the emergency department, I was escorted past the tent constructed exclusively for suspected Covid-19 patients and into the emergency room proper. I was triaged appropriately and quickly brought to a room. I was seen by a nurse, an emergency room resident and, eventually, an attending physician. Since the Covid-19 pandemic had already taken a strong foothold in the community, every patient’s initial history-taking was focused on that issue. Neither the emergency room resident nor the attending physician considered my history of progressive weakness associated with protracted diarrhea even close to their expectations of what a conventional Covid-19 presentation would entail. Although, they both did believe that I was suffering from mild dehydration. I was examined and laboratory tests were obtained. My results indicated hypokalemia (2.9) as well as hypomagnesemia. Both electrolytes were replaced and I received one bag of intravenous fluid. Over the next several hours, I improved slightly, but in no way was my energy level back to normal.
When the attending physician visited me, he explained that my clinical picture was not congruent with the typical scenarios encountered by providers from patients who eventually test positive for the virus. Nevertheless, he suggested I be tested primarily because of my role as a healthcare provider. A nasopharyngeal swab was taken and I was given the standard written information describing test result notification and my need to remained quarantined until released by the local health department. Of course, I followed their recommendations.
Of note: I had started to use Gatorade as my go-to method of hydration, and each time I was able to drink a small amount, I felt a tiny bit stronger.
After being driven back home, I lay in bed pondering this whole clinical situation: in my mind I was convinced that no ordinary virus could weaken someone to this degree with this speed. I was sure my test would be positive. And approximately 36 hours later, my instinct was confirmed.
Of course, I let my family know and I notified the appropriate individuals at my job site of this result.
My symptomatology was augmented by a newly developing dry, hacking cough that seemed difficult to control voluntarily. There was never any associated shortness of breath, air hunger, chest pain, wheezing, or true respiratory distress. The cough usually subsided at nighttime so I was able to fall asleep. Again, the cough was not part of the initial presentation either at home or at the emergency department.
Each day this week became more and more taxing and threatened my stamina. It became increasingly difficult to move about my apartment, to walk to the refrigerator to hydrate, to speak on the telephone. I also slept for many hours at a time feeling utterly drained physically. Colleagues and friends were telephoning me to check in and I spoke to them for as long as my wakefulness would hold out. My appetite was completely shot: the only foods that I could swallow and derive any pleasurable taste from were ice cream and other selected sweets. In general, the thought of food (which normally excites me) absolutely turned me off.
I was contacted fairly routinely by the chief medical officer at my parent institution, who asked whether I would be amenable to undergo a second COVID-19 nasopharyngeal swab, which would be tested at a laboratory in Albany. She and other clinicians, as well as the chief of infectious diseases at that facility, strongly believed that my original positive test could have been a false-positive test. I agreed and the swab was obtained from a nurse at that facility; two days later I received the second positive result.
On a more surrealistic note, thoughts kept invading my mind that this could be the beginning of the end. I was afraid to fall asleep at night. Would I suddenly be awakened at night by paramedics attempting to intubate me because I had gone into acute respiratory failure? Would I suddenly be awakened to find myself hooked to a ventilator?
I continued to rest in bed, drink as much fluids as I could tolerate and wait for my appetite to return.
April 10 was a milestone: I literally turned the corner on that date. How did I know? My appetite, including normal taste and smell and the desire for food, returned. When I awoke that morning, I convinced myself that I had a tad more energy than on previous days. I was able to shower without becoming completely enervated afterward. I wanted breakfast. I was better able to ambulate within the apartment without having to stop and rest.
The remainder of that day and the days to follow carried with them the same feeling that ‘I had made it!’ I finally believed that I might have licked this virus plague. And with each day this week and weekend I continue to grow stronger, to feel more and more like my normal self, to want to resume working at my job, to want to eat at meal time, and so on.
And with all that said I still ponder a number of issues related to this illness:
Has my viral load truly declined to subclinical levels?
Have I produced sufficient antibodies to this virus to afford me immunological protection should I be re-infected?
Assuming my plasma now contains anti-Covid-19 antibodies, is it now useful to others who might be struggling with the same or similar acute Covid-19 illness?
All this remains to be seen.
I am totally better; however my nasal swab is still positive. It will take another week or so to convert.
“My first exposure was March 19 and the patient is still in the ICU (as of March 29). Goggles and faceshield with surgical mask and cap for everyone. N95 only permitted for suspected POI with no aerosolized procedures planned. PAPR for intubation only per hospital protocol.”
“We have enough PPE for now [March 29], but we will run out in the next two weeks, I’m thinking. We are reusing to try to conserve right now. Lots of Covid-19-positive admitted hypoxic on the floors and about seven in the ICU. Am getting rest but my kids are home, so I’m trying to nap after overnight shifts and watch them.”
Gonzalo Bearman, MD, ’97, MPH, is chair of the Division of Infectious Diseases and the Richard P. Wenzel Professor of Medicine at Virginia Commonwealth University (VCU), where he also serves as hospital epidemiologist.
Like all infectious disease specialists worldwide, Bearman and his colleagues at VCU have been on a steep learning curve since they began seeing Covid-19 patients in February. “The past six months have been incredibly challenging,” he says.
Bearman’s responsibilities related to the pandemic include overseeing VCU’s Covid-19 Command Center; and serving as co-investigator for remdesivir and sarilumab clinical trials at VCU and as senior investigator of the university’s Covid-19 Healthcare Worker Seroprevalence Study. He also is the university’s point person for internal and external media requests and is a member of the Virginia Disaster Management Advisory Committee as well as a member of committees advising VCU and the Atlantic 10 Conference on reopening the school and resuming athletic programs.
“The major issue we face right now is communicating to people in a convincing way that they need to change their behavior,” he emphasizes. “We must wear masks, practice social distancing, wash our hands and not get together in large groups.”
Bearman, who grew up in Argentina, has found it helpful to collaborate with infectious disease specialists around the world—to share data and to give and receive support during these stressful times.
In addition to participating in media interviews and recording podcasts, he has spoken on virtual Covid-19 panels in Argentina and in the U.S., and has presented to a number of professional organizations.
Throughout the pandemic, Bearman has stayed in contact with his UB medical school classmate and fellow infectious disease specialist Usha Stiefel, MD. She is on faculty at Case Western Reserve University, where she serves as interim vice dean in the Office of Faculty Development and Diversity in the school of medicine and sees patients at the Louis Stokes Cleveland VA Hospital Medical Center.
At UB, Bearman maintains contact with Thomas Russo, MD, professor and chief of infectious diseases in the Department of Medicine; and SUNY Distinguished Professor Timothy Murphy, MD, senior associate dean for clinical and translational research and an infectious disease specialist. He says other infectious disease faculty at UB who influenced his education and career include Alan Lesse, MD; John Sellick, DO; John Crane, MD, PhD; and Joseph Mylotte, MD ’73.
When asked how he is coping after six months of intensive effort on the frontlines of the pandemic,
Bearman reports that initially he was working with little rest and no time off, even on weekends. More recently, he has been able to take a vacation and to work less hours on weekends, although he continues to average 10-hour days during the week. “Unfortunately, things will not improve until people are willing to change their behavior and an effective vaccine or treatment is available,” he says.
Lynn Aronica, MD ’99, an obstetrician who practices in West Seneca and Buffalo, writes: As you know Covid-19 is especially aggressive in the older and vulnerable populations. As statistics and information began to trickle in from Italy and China, it seemed that pregnancy was not included in the vulnerable category (although it usually is). Obstetricians took a deep breath because one patient at time is hard enough, but two?
Well, fast forward to April 22, when a very sick patient with Covid-19 pneumonia who was 33 weeks pregnant required ventilator support at Mercy Hospital—terrifying to all teams involved.
Obstetricians, ICU team members, and NICU teams worked together to not only have a safe delivery after the mother was stabilized, but a healthy, albeit premature, baby whose mother is improving one week later.
Andrew I. Soiefer, PhD ’84, is a national expert in chemical safety in the workplace. After graduating from UB, he trained in neurotoxicology at Albert Einstein College of Medicine and went on to work in the petroleum, chemical and pharmaceutical industries.
On April 9, he wrote: “We are fine and self isolating in Hoboken, NJ, which is practically the global epicenter for Covid-19, so it’s plenty scary, of course. This is a nasty and contagious virus that is particularly dangerous for folks like us in our sixth decade of life. Our son, Leland, and his girlfriend, Marleigh, are both on the front lines in medicine. He is a second-year internal medicine resident at New York Hospital, and she is a first-year resident at Mt. Sinai. Both have been admitting and treating Covid-19 patients for weeks now, so we are proud and concerned. So far, everyone in our immediate family is well despite the lack of PPE supplies, which is outrageous. Nancy and I were lucky to have spent most of February in New Zealand to celebrate our 30th wedding anniversary, so that is making isolation a bit better. It was a fantastic trip; New Zealand really is paradise from my point of view. Being there on the other side of the globe gave us a ring-side seat to the start of this pandemic. We were receiving news from Asia frequently. I spent my career in Risk Assessment. Nancy and I spent 15 minutes at least sanitizing our aircraft seat and surround to start our return flight to the U.S. on February 25. When we arrived in Los Angeles (LAX) on the 26th and no one from CDC met our flight or was visible in the customs area, I knew we were in deep trouble as a nation. That morning thousands of people were arriving and mixing in the airport with little guidance or safeguards. I took extreme precautions immediately upon returning to New Jersey (at least they seemed extreme at the time) and now folks are dying in somewhat large numbers across the NY/NJ area. I watch Andrew Cuomo’s briefing every morning. In my opinion, he’s one of the few politicians in the U.S. demonstrating leadership.”
Sarah Gueli, MD ’08, an anesthesiologist at Animas Surgical Hospital in Durango, Colorado, recently volunteered for 10 days at Elmhurst Hospital in Queens, New York. Her local paper, the Durango Post, reported on her experience, which was also featured in the American Society of Anesthesiologists’ daily newsletter.
Find David's full story about his eleven days in a COVID-19 hospital in Brooklyn, NY here.