Where Is the Federal Government?

Jahan Fahimi, an emergency-medicine doctor at the University of California, San Francisco, feels the same. “New York is the canary in the coal mine,” he told me. “We can see what’s going to happen.” Like other health professionals, he is using the limited time before the anticipated surge to prepare. He said doctors are developing work groups and doing dry runs, so that if a surge hits, they won’t be “caught flat-footed.” They are rushing to repurpose the hospital and are changing inpatient wards into negative pressure isolation wards to accommodate the needs of COVID-19 patients. He praised San Francisco Mayor London Breed and California Governor Gavin Newsom, who implemented stay-at-home policies “in the nick of time,” which bought them crucial weeks and helped flatten the curve.

Fahimi, though, is distressed by the unevenness of the national response. He cringes at the packed beaches in Florida. “It’s insulting to the health-care professionals who will have to deal with the consequences and irresponsibility of everyone who said this was business as usual,” he said. Florida Governor Ron DeSantis finally ordered a statewide shutdown on April 2. He kept the beaches open for more than two weeks after Trump declared a national pandemic.

Kris Okumu, the chair of orthopedic surgery at Seton Medical Center in Daly City, California, told me that even though community physicians have been “banding together” like the Avengers and communicating with the local academic centers, such as UCSF and Stanford University, they are still not fully prepared.

Okumu is originally from Uganda, which he described as the “the country known for having viruses,” such as Zika, Ebola, and HIV. He’s long dealt with death, but the coronavirus is uniquely frightening for him. “It’s ironic to come to the U.S., the most developed country in the world, and deal with a pandemic, with a virus, affecting my life here and not in Uganda,” he said with a sigh.

His hospital, which has been leased by the state to treat COVID-19-positive patients, has a shortage of PPE. His wife is a physician who worked in Milan, Italy, and has kept in touch with her Italian colleagues over the past three months. She had been warning him that the U.S. was not prepared for the virus. He said his hospital currently has less than a week’s worth of isolation gowns, “which we should have for every health-care professional treating a COVID-positive patient or person under investigation.” He also said they don’t have enough N95 masks.

He told me the crisis is forcing them to ask difficult questions, such as “Who is going to be treated when we don’t have enough space to treat everyone?” If an older patient breaks her hip, will he still be able to help her? Where will she stay? He is still searching for the answers.

In Boston, Mary Ann Dakkak doesn’t have time to ask questions. She’s busy trying to save lives at Boston University’s medical center, where she’s an assistant professor and a family-medicine physician. Her state is expecting its peak caseload in the next two weeks.