COVID, Hurricane Sandy and a future without ‘health care heroes’

The cheering would begin promptly at seven o’clock each night. It was early in the COVID-19 pandemic, and New Yorkers had started a nightly ritual of clapping, yelling and singing outside to thank health care heroes. It was loud and chaotic. And it was incredible.

I’m an infectious disease physician, and while I never felt much like a hero, I would crack open my Brooklyn apartment window each evening and smile thinking that a tiny bit of that cacophony outside was meant just for me.

Those were dark days in New York. The streets were typically quiet except for the wail of ambulance sirens. Hospitals swelled with the sick, and the health care system nearly buckled under the weight of their collective struggle to survive. 

Back then, masks and other protective equipment were in short supply, and staffing seemed impossible as health care workers themselves fell ill. Even some essential medications and supplies became scarce. Two hospitals in Queens ran out of oxygen when too many people inside were gasping for air all at once.

A hero is commonly defined as one who shows great courage in the face of adversity and danger, particularly in the service of others.

So, there’s no question that health care workers in the early days of COVID-19 were heroes, not only because they risked their own safety to help others, but because they endured the psychological toll of witnessing so much concentrated suffering and death.

And there’s no question that we should celebrate and thank our health care heroes.

But, as we thank them, we should also recognize that heroes are only really needed when our systems fail and our safeguards break down. If we had been better prepared for COVID-19, would we have needed health care heroes? Can we plan to withstand the next pandemic without relying on the heroics and sacrifice of front-line workers? 

The last time I heard of large-scale heroism in New York was a decade ago, when Hurricane Sandy slammed into the Atlantic coastline.

On the evening of the storm, my Brooklyn window was firmly shut against the violent wind and rain. Outside, trees bent at impossible angles in the wind, and water was everywhere. At one point, an electrical transformer in the distance exploded sending a blue-orange fireball into the night sky, and I understood that I was in the midst of real danger.

Luckily I survived that night unharmed, but other New Yorkers fared far worse, as Hurricane Sandy caused more than 40 deaths and over $19 billion in damage in New York City alone.

Reports of heroism during Sandy abound. In Staten Island, neighbors in small boats pulled each other from rising waters, while in Queens firefighters battled a hellish blaze in blistering winds. There were even health care heroes, like the staff at NYU hospital, who evacuated patients down stairwells when backup generators (and elevators) failed. 

In the years since Sandy, New York has heavily invested in preparing for the next superstorm. Work is underway to fortify lower Manhattan against rising waters, and a massive $ 52 billion network of sea walls has been proposed to protect the city from future hurricanes. 

With these storm preparations, New York is protecting not only its infrastructure and citizens but also its first responders and neighborhood heroes. After all, we won’t need to ask heroes to rescue us during the next storm if the floodwaters never reach our doorsteps.

As we mark the third anniversary of COVID-19 in the United States, we should similarly be investing in fortifying our health care system so that, when the next pandemic arrives, frontline workers won’t need to become heroes.

To prepare for future pandemics, we must dedicate more federal research funding to the study of viruses and other emerging pathogens to advance our understanding of these diseases and develop new ways to prevent, diagnose and treat them. We must also commit more funding to our public health institutions, so that they can effectively track outbreaks, assist with diagnostic testing and provide real-time pandemic guidance. And we need to secure the supply chain of essential medications and protective gear, so that health care workers have the supplies to safely do their jobs.

And, most importantly, we must invest in the health care workforce itself, to ensure that enough frontline workers are employed that they are not overwhelmed during future times of crisis. The recent nursing strike in New York City highlighted that low pay and stressful working conditions have resulted in thousands of vacant nursing positions across the city. One recent study projected that by 2030, New York State may have a shortage of over 39,000 nurses.

Meanwhile, physicians in my specialty, infectious diseases, may be slowly disappearing due to relatively poor compensation within a system that undervalues their important contributions. Supporting the salaries of frontline workers is fundamental to being ready for the next outbreak.

Hospital conditions are much better today than during the nightmarish early days of the pandemic, and New Yorkers aren’t cheering in the streets for health care heroes anymore. But health care workers are still treating sick patients with COVID-19, and we should continue to celebrate and support them for doing this important work.

We should also begin to invest in a future in which health care heroes are no longer required. Perhaps the best thanks that we can give to those willing to risk their own safety to help us is to not need to ask them to do it.

Timothy Sullivan is an infectious diseases physician in New York.