Craig Spencer MD MPH Profile picture
Mar 31 9 tweets 2 min read Read on X
Four years ago today, I walked into the apocalypse.

Crossing the line in the ER felt like entering a whole other world.

Frenetic alarms.

Patients strewn about, struggling to breathe.

Too few staff. Too many deaths.

Covid was everything.

It had completely taken over our ER
Covid inundated NYC a week prior.

And many of our staff fell ill.

Especially the nurses.

We had only a fraction of those we needed.

Too few to notice when the oxygen tanks under patients’ beds ran out.

So we did something kinda insane.

Actually unbelievable
We ran tubing from the oxygen outlets on the wall

up, up, up

then through the ceiling

and then dangled it down to the middle of the ER

All over the ER

So everyone could get a reliable oxygen supply

And not suffocate when their tank ran out

It saved lives.

A lot.

A lot.
But not all

“Hey, who has the guy in room 7”

—“Oh, me”

“He’s dead”

Keep going.

Others would die the same shift.
Hundred died that day in NYC from Covid

The worse was still in front of us

A week later, 815 died. In one city.

Morgues were over capacity.

Walk by trucks set up outside the hospital for the overflow.

More staff fell ill.

They couldn’t get tested. Still.
Four years ago, we had no idea what would happen next.

How long it would last

Or who would be next

Would it be as bad in Chicago?

LA?

Detroit?

Phoenix, Cheyenne, or Pensacola?

We know how it played out now

We knew nearly nothing then

We didn’t know
Today, many will tell you we overreacted then

But you’ll never hear that from someone, anyone who worked in the hospital then

Covid scarred a generation of healthcare workers

Many watched their colleagues suffer.

Struggle to breathe.

Then die.
Mistakes were made.

Politics became paramount.

We all paid the price.

But until the day I die

No one can tell me…

The things I saw

The things we

All those on the frontline

Witnessed and endured

We’re not real

We’re not the worst things we will

EVER see
The past is being rewritten

But none of us who witnessed those early days can scrub our memories of the pain, and horror

We’ll never forget finding young, otherwise healthy people dead in a chair

And we’ll never forget our colleagues who died

You might.

But we won’t.

• • •

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More from @Craig_A_Spencer

Dec 6
"What's happening with this mystery illness in the Congo"

I've gotten this text dozens of times in the past few days.

Here's what we know. What we don't.

And what really matters 🧵 Image
Since the end of October, there have been just under 400 cases of an 'unidentified' illness in the Kwango Province of Southwest DR Congo.

And 79 reported deaths.

Symptoms include "fever, headache, coughing, breathing difficulty, and anemia".

Kids under 5 appear most affected. Image
Breathing difficulties and other signs suggest a respiratory disease and likely respiratory transmission.

Epidemiologists have been sent to the area.

Testing is in process, with results expected in the next few days.

BUT we don't know anything for certain...
Read 11 tweets
Nov 12
10 years ago today I walked out of the hospital after surviving Ebola.

Back then I begged the world to strengthen our response to that crisis and prepare for others.

I’ve been reflecting on what we’ve learned over the last decade.

And the role of the U.S. in global health🧵 Image
The international response to Ebola in 2014 was way too slow and weak.

Too many people died because we didn’t have the experience, coordination or willpower to address the crisis quickly and head on.

In the aftermath, we focused on lessons learned. We made changes.
We created new ways to fund outbreak response at the global level.

The Africa CDC was created to help the continent better prepare for and respond to disease threats.

And changes were made in U.S. government to allow better coordination among agencies.

africacdc.org/about-us/our-h…
Read 15 tweets
Sep 30
As news of the Marburg cases in Rwanda spreads, I want to share some thoughts on where the outbreak stands, what will likely come next, and why this outbreak may (hopefully) end up being unlike other viral hemorrhagic fever outbreaks in the past 🧵
For those just tuning in, Marburg is a viral hemorrhagic fever, very similar to Ebola.

This is the 18th Marburg outbreak since 1967.

Most outbreaks fizzle out fast. This one, despite being just announced days ago, is already among the largest.

Although the incubation period, symptoms, and spread are very similar to Ebola, there are some really important differences.

Most importantly, we have FDA/WHO approved vaccines and treatments for Ebola.

But we only have experimental therapeutics and vaccines for Marburg.

fda.gov/emergency-prep…
Read 15 tweets
May 22
I teach a class on the history of humanitarian response.

We talk about how a field full of dead soldiers in 1859 in Solferino led to the ICRC, Geneva Conventions, & international humanitarian law.

Every year, my students always ask “the ICC seems useless, why do we need it?” 🧵
In the aftermath of World War II, the Nuremberg Trials was the first international war crimes tribunal.

I think we can all agree that prosecuting those responsible for the atrocities of the Holocaust was an important endeavor.

There were calls for a more permanent tribunal…

cfr.org/backgrounder/r…
But the ICC wasn’t established until 2002.

In the last 22 years, it has indicted 40 people and convicted only 10.

Given that it seems like bad guys get away with doing bad things with impunity all the time, many will question the ICC’s role and impact.

icc-cpi.int/about/the-court
Read 13 tweets
May 12
I can’t stop thinking of a baby girl I treated, just minutes after grenade shrapnel tore through her brain…🧵
I was in Burundi working as a trauma doctor in 2016.

Civil conflict enveloped the country. I was training local physicians to treat and stabilize life-threatening injuries.

Most of our patients had gunshot wounds

or had been pierced by grenade shrapnel

Sometimes both.
When violence erupted, we’d hear a furious bang at the hospital entrance

the large doors would open

then 60-70 people wound stream in, some walking, some carried.

Many bleeding. Some already dead.

We’d start to triage. We had trained for this. We had a system.
Read 12 tweets
Mar 20
How much do you know about food and drug safety?

Where did our current regulations come from?

And what were some of the greatest scandals that forced change?

We covered everything from swill milk, patent medicines, and thalidomide in our class today.

Here's what we covered 🧵 Image
We started with smill milk.

This was a massive problem that few—including in public health—have ever heard of.

In New York (and elsewhere) in the mid-19th century, milk was a big part of the daily diet, especially for children.

But people didn't realize how deadly it was.
Image
Image
Usually marketed as 'pure milk' with depictions of happy cows and happy kids, the reality was WAY different.

A lot of milk—estimates are 60-80% of ALL milk at the time—was actually 'swill milk'.

Swill milk came from cows fed solely on a diet of distillery slop (aka 'swill').
Image
Image
Read 52 tweets

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