In just over one month, our City has undergone a cataclysmic transformation. The disease caused by the novel coronavirus, known as COVID-19, has wreaked utter devastation upon the social and economic order of this vibrant City, and will cost thousands of lives before it is quashed. Like you, we did not imagine any of this at the start of the year. Like you, we grieve the destruction COVID-19 has caused in our lives. Like you, we wake up wishing it will end soon—and wondering when life will return to normal.

Our fellow New Yorkers, these are not normal times. They are, instead, times filled with uncertainty, pressure, loss, and stress. But they are also times of unity and of commitment to the public good. As New Yorkers, we have and always will come together to sacrifice for each other, triumph over adversity, and overcome even the greatest losses. We have done it before, and we will do it again. But we need everyone’s help. As representatives of our City’s Emergency Departments, along with many hundreds of our colleagues across the state who are working tirelessly to save lives, we want to impress upon each of you what this pandemic truly looks like on the frontline, and what you can do to help our City.

1. This disease spreads more easily than we initially knew. COVID-19 can infect anyone. You may not know you have COVID-19, but you can still spread the virus. Many who are infected only feel very mild or no symptoms.

2. Stay home, even if you do not feel sick. If you must leave home, protect yourself and others. Practice physical distancing – maintain at least 6 feet of distance between you and others. Wear a face covering (any well-secured paper or cloth that covers your mouth and nose), do not touch your face with unwashed hands, and wash your hands often with soap and water for at least 20 seconds.

3. The symptoms of COVID-19 can feel like the flu, and symptoms can be variable. When people get sick with COVID-19, they can expect symptoms that might include fever, chills, cough, shortness of breath, sore throat, loss of smell or taste, headache, nausea, diarrhea, abdominal upset, and other flu-like symptoms. Not everyone has exactly the same symptoms, but most people will fully recover within days to weeks.

4. If you feel sick, you need to self-isolate and stay home. If you feel any symptoms, immediately isolate yourself from others! Protect your friends and family; stay by yourself, eat alone, use a separate bathroom (or clean after each use), and avoid touching the same objects (e.g., refrigerator, remote)—or use gloves if you do. Cover your mouth and nose with a tissue or your sleeve when sneezing or coughing. Do not use your hands to cover your sneeze or cough. Immediately throw out tissues and wash your hands afterward. Wear a face covering if you cannot maintain at least 6 feet of distance from others. Do not leave your home unless you need medical care.

5. Take care of yourself and stay in touch with your doctor. Most people who have COVID-19 experience mild symptoms and can safely recover at home. Take acetaminophen (Tylenol), ibuprofen, or other fever-reducing medicine, get rest, and drink lots of fluids. If you have any of the symptoms described above, assume that you have COVID-19. Going outside to obtain a COVID-19 test is not necessary; it only exposes others to the illness. If you are 50 years of age or older or have an underlying health condition (including lung disease, moderate to severe asthma, heart disease, a weakened immune system, obesity, diabetes, kidney disease liver disease, or cancer), call your doctor. They may want to monitor you more closely. If you do not have a doctor call 311.

6. Watch for warning signs. If your symptoms get worse or do not go away after three to four days, consult with your doctor. Call, text or use your patient portal before visiting your provider. Use telemedicine instead of an in-person medical visit, if possible. Go to the emergency room if you develop any of the following severe symptoms: trouble breathing, chest pain, new confusion or the inability to stay awake, bluish lips or face, fainting, feeling winded when talking or walking short distances, or have severe weakness. This list is not all inclusive. Call 911 if you need help right away.

7. Self-isolation is hard, but temporary—and it can save lives.
If you had or may have had COVID-19, you can leave your home when all the following are true:
• It has been at least seven days since your symptoms started.
• You never had fever OR you have not had a fever for the prior three days without use of fever-reducing drugs such as Tylenol or ibuprofen.
• Your overall illness has improved.
Remember, even when you feel better, stay home as much as possible and only go out for essential supplies like groceries. This type of isolation is difficult, but we assure you it will save others. Don’t cut corners.

Many of you have taken the steps above to protect yourself and others and we thank you. You are literally saving lives. But many of you have not—or continue to cut corners. This virus does not respect what we do "most of the time." Fellow New Yorkers, we need to do more!

Every day, our emergency departments are overflowing with patients newly infected with COVID-19, many starving for oxygen and on the brink of death. Many are older, but some are young. Many have pre-existing medical problems, but some do not. While we're constantly searching for new treatments and better ways to care for our patients, too many are dying despite our best efforts. These patients are also our friends, families, and colleagues. We grieve for them, even as we care for them. It is difficult work, but it is our job. The hardest part about it, truthfully, is that we have no control over stopping the spread. That’s where you come in, New York.

Make no mistake. This disease spreads silently, but it kills mercilessly. Even as we help you, we need you all to help us. Stay home, wash your hands, stay smart, stay on your guard. Protect your fellow New Yorkers. Call your doctor or 311 if you have questions about COVID-19, and only if you feel very sick, come see us in the ER. We are here for you, doing our part. Thank you for doing yours.

Signed,

Karin Rhodes MD, MS
Professor, Emergency Medicine and Psychiatry
Zucker School of Medicine at Hofstra/Northwell
NSUH/LIJMC, Northwell Health
NYC Health + Hospitals
ED COVID Action Team

Eric Wei, MD, MBA
Vice President
Chief Quality Officer
NYC Health + Hospitals
ED COVID Action Team

David Silvestri, MD, MBA, MHS
Director, Care Transitions and Access
Office of Ambulatory Care
Office of Quality and Safety
ED COVID Action Team
NYC Health + Hospitals

Shaw Natsui, MD
Director, Emergency Medicine Innovation
ED COVID Action Team
NYC Health + Hospitals

Brendan G. Carr, MD MS
Professor & System Chair
Department of Emergency Medicine
Icahn School of Medicine at Mount Sinai

Michael P. Jones, MD
Vice Chair for Education
Associate Professor of Emergency Medicine
Albert Einstein College of Medicine
NYC Health + Hospitals | Jacobi /// Montefiore Medical Center

John P. Marshall, MD, MBA, FACEP
Chair, Department of Emergency Medicine
Maimonides Medical Center

E. John Gallagher, MD
Professor & University Chair
Albert Einstein College of Medicine
Montefiore Medical Center

Barry Geller, MD
Chair, Emergency Medicine
Phelps Hospital/Northwell Health

Michael Bouton, MD
Chief Medical Information Officer
NYC Health + Hospitals
ED COVID Action Team

Livia Santiago-Rosado, MD FACEP FAAEM
Chair, Emergency Medicine
Vassar Brothers Medical Center
Poughkeepsie, NY

Corita Grudzen MD
Vice Chair, Research
Ronald O. Perelman Department of Emergency Medicine
Associate Professor of Emergency Medicine and Population Health
NYU School of Medicine

Salvatore R. Pardo, MD, MBA, FACEP
Chair, Emergency Medicine
LIJ-Valley Stream
Northwell Health

R. James Salway MD, MScDM, FNYAM
Director, Emergency Management
Clinical Affairs and Quality
NYC Health + Hospitals
ED COVID Action Team

Joshua Moskovitz, MD, MBA, MPH, FACEP
Associate Director of Operations
Department of Emergency Medicine
Jacobi Medical Center

Frederick Nagel, MD, MPH
Chief of Emergency Services
North Central Bronx Hospital
Assistant Professor
Albert Einstein College of Medicine

Gregory Almond MD, MPH, MS, FACEP
Chief of Service NYC H&H Metropolitan
Chairman & Professor of Emergency Medicine
New York Medical College

Stu Kessler, MD
Director Dept. of Emergency Medicine
Elmhurst Hospital Center
Vice Chair and Associate Professor
Dept. of Emergency Medicine
Icahn School of Medicine at Mount Sinai

Nicholas Gavin, MD, MBA, MS
Vice Chair of Clinical Operations
Assistant Professor
Department of Emergency Medicine
Columbia University
Vagelos College of Physicians and Surgeons/New York-Presbyterian Hospital

Robert M. Bramante, MD FACEP
Chairman/Director, Emergency Medicine
Mercy Medical Center
Progressive Emergency Physicians, PLLC

Tom Perera MD
Program Director, Emergency Medicine
Zucker School of Medicine at Hofstra/Northwell
Northshore University Hospital & Long Island Jewish Medical Center
Northwell Health

Rachel T. Moresky, MD, MPH, FACEP
Director, sidHARTe - Strengthening Emergency Systems
Associate Professor, Population and Family Health Department - Columbia University Mailman School of Public Health
Director, Columbia University Global Emergency Medicine Fellowship
Emergency Medicine Department - Columbia University College of Physicians and Surgeons

Shellyann Sharpe, MD
Assistant Director, Department of Emergency Medicine
North Central Bronx Hospital | NYC Health + Hospitals
Assistant Professor of Emergency Medicine, Albert Einstein College of Medicine
Associate Residency Program Director, Department of Emergency Medicine
Jacobi Medical Center/// Montefiore Medical Center

Lance B. Becker, MD
Chair, Emergency Medicine
Zucker School of Medicine at Hofstra/Northwell
Chair, Emergency Medicine
Northshore University Hospital and Long Island Jewish Medical Center
Northwell Health

Edward Chew, MD
Chief of Emergency Medicine
NYC Health & Hospitals/Harlem

Jolion McGreevy, MD, MBE, MPH
Medical Director, Department of Emergency Medicine
Mount Sinai School of Medicine
New York, NY

Anjali S. Hulbanni, MD
Patient Safety Officer
Harlem Hospital Center
Clinical Assistant Professor of Emergence Medicine
Columbia University College of Physicians and Surgeons

Jeremy Sperling, MD, FACEP
Chair, Department of Emergency Medicine
Jacobi Medical Center & North Central Bronx

Jason D’Amore MD
Vice Chair, Department of Emergency Medicine
Jacobi Medical Center & North Central Bronx

Andrew Wollowitz, MD
Emergency Department Medical Director
Montefiore, Wakefield Campus

Rajesh Verma, MD, FAAEM
Chief, Emergency Medicine
NYC Health + Hospitals/Kings County

Adrienne Birnbaum, MD, MS
Chair, Emergency Medicine
NYC Health + Hospitals/Lincoln

Mark Kindschuh, MD, MBA, FACEP
Chairman, Department of Emergency Medicine
NYC Health + Hospitals/Coney Island

Neal Shipley MD, MBA, FACEP
Zucker School of Medicine at Hofstra/Northwell
Emergency Medicine GoHealth Urgent Care
Lenox Hill, Northwell Health

Dave A. Holson, MD, MPH
Director, Emergency Medicine
Department of Emergency Medicine
NYC Health +Hospitals /Queens

Michael Redlener, MD, FAEMS
Medical Director EMS Quality, Mount Sinai, NYC
Associate Medical Director, Emergency Department, Mount Sinai West
Department of Emergency Medicine
Icahn School of Medicine at Mount Sinai

Arlene S. Chung, MD, MACM, FACEP
Residency Director
Department of Emergency Medicine
Maimonides Medical Center

William Paolo, M.D.
Residency Program Director
Associate Professor
Emergency Medicine
SUNY Upstate

John Colletta MD
Chairman,
Glen Cove Emergency Department
Northwell Health

Alan Kaplan MD, FACEP
Chair, Emergency Services
Plainview & Syosset Hospitals
Northwell Health

Abbas Husain, MD
Assoc. Residency Director Emergency Medicine
Staten Island Emergency Department
Northwell Health

Penelope Lema, MD
Vice Chair, Faculty Affairs
Director, Emergency Ultrasound
Associate Professor
Columbia University Vagelos College of Physicians & Surgeons

Rajneesh Gulati, MD
Chief of Service, Dept. of Emergency Medicine, Bellevue Hospital Center
Chair, ED Council, Health + Hospitals Corporate Office
Co-Director, Healthcare Leadership and Operations Fellowship (HCLO)
Ronald O Perelman Department of Emergency Medicine, NYU School of Medicine

Lynne D. Richardson, MD, FACEP
Professor & System Vice Chair of Emergency Medicine
Icahn School of Medicine at Mount Sinai

John D’Angelo MD, FACEP
Executive Director & Senior Vice President
Emergency Medicine Service Line
Northwell Health

Jim Dwyer, MD, FACEP
Chair of Emergency Medicine
Northern Westchester Hospital
Northwell Health

Catherine Jamin, MD
Chief of Service
Perelman Center for Emergency Services
Vice Chair of Operations
Director of Emergency Critical Care
Ronald O. Perelman Department of Emergency Medicine

Eric Cruzen, MD, MBA, FACEP
Chairman, Emergency Dept, Lenox Health Greenwich Village
Chief Medical Informatics Officer, Emergency Medicine Service Line
Northwell Health

Angela M. Mills, MD
Chief of Emergency Medicine Services
New York-Presbyterian/Columbia
University Irving Medical Center

Laura Iavicoli, MD, FACEP
Associate Director
EMS/ Emergency Management Director
Department of Emergency Medicine
NYCHH Elmhurst
Assistant Professor
Icahn School of Medicine at Mount Sinai

Marc Kanter, MD
Associate Chief, Emergency Medicine
NYC Health + Hospitals/Lincoln

Konstantinos Agoritsas, MD, MBA
Associate CMO – Hospital Operations
Associate Chief, Emergency Medicine
Director, Pediatric Emergency Medicine
NYC Health + Hospitals/Kings County

ALL NYC EM
Nonprofit Organization of NYC Emergency Medicine Educators
Dedicated to the education of emergency medicine residents