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

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
Mar 14
Hey my medicine and public health people!

How much do you know about eugenics?

Just old pseudoscience, you say?

Any idea how much it continues to influence us?

Answer: A LOT.

I taught a class on the history of eugenics and public health today. Here's what we covered: 🧵 Image
Eugenics is Greek for 'well-born'. But it wasn't coined by the Greeks. It's a late 19th century term made up by Francis Galton. He LOVED data. We will come back to that.

Eugenics had the biggest impact on the approach to mental illness, immigration, and reproductive justice. Image
We will dig into each.

But first, you gotta know the background and key players.

For background, eugenics arose in an environment obsessed with progress, but also frustrated with economic and social realities.
Read 44 tweets
Oct 21, 2023
Having worked in conflict zones, I want to share a bit on humanitarian response in Gaza, as aid starts to trickle in.

This isn’t a thread on how to end the war, or hostages, or any of the other very important things. Those are critical too. But they’re not at all my expertise 🧵
Over the past week, shortages in food, water, and electricity have exacerbated the humanitarian and health challenges.

This creates new problems, as well as worsening chronic issues.

Without gas, generators can’t run. Newborns on life support in intensive care can’t survive.
Without electricity, patients can’t receive dialysis. Insulin for diabetes can’t be kept refrigerated, as it should be. These chronic health issues worsen, quickly.

Without water, infectious diseases like cholera (and others) become increasingly likely.

cnn.com/2023/10/18/mid…
Read 12 tweets
Sep 20, 2023
Today I spoke in a colleague’s class about the COVID-19 pandemic.

He asked me to talk about what it was like in NYC’s emergency rooms in March and April 2020. Seemed easy enough.

But revisiting the trauma was really hard and painful.

I’m still not sure we’ve fully processed.
It really hit me when I described how we strung oxygen tubing from the wall outlets up through the ceiling so it reached patients in the middle of the ER who were suffocating when the canisters under their bed ran out…

We all normalized something that just wasn’t normal, at all
It had been years since I thought about how my colleague avoided my gaze as I examined her.

Struggling to breathe, she was looking over my shoulder as her mother was intubated across the emergency room.

It seemed so routine then.

But retelling it today felt so sad, surreal.
Read 4 tweets
May 19, 2023
You know why we intubated people for Covid in March 2020?

Because otherwise they were going to die. Full. Stop.

I remember a patient rolling in with an oxygen saturation of 42%, breathing twice as fast as normal,struggling on a face mask with oxygen all the way up.

What to do?
I’m sick of seeing people trying to relitigate 2020 through the eyes of 2023.

If you miraculously know everything now, why didn’t you tell us so then?

So over a million Americans didn’t have to die of Covid.

So we didn’t have to put ourselves at risk every time we went to work
I don’t care about the narrative you want to create, from the safety of where you stand now.

Do not try to reimagine the environment and the challenges so many of my colleagues felt on the frontlines, 3 years ago, when we knew almost nothing.

My colleagues died.
Read 4 tweets
Mar 7, 2023
3 years into the pandemic, it’s incredible to see the revisionism, lamenting how we ‘over-reacted’ to Covid.

In March 2020, many of my patients died every single day. No matter what we did. 4 one shift. 6 the next.

Often more than when I worked in West Africa treating Ebola.
This isn’t an apologists take on medicine or public health over the past 3 years.

Every field and every person whose had something important to say about Covid has made mistakes along the way.

But don’t confuse initial transmission dynamics for political dynamics.
Maybe ‘blue’ cities weren’t more concerned about Covid early on because they—and public health more broadly—are generally “left-leaning”.

What if it was just because more of their people were dying at rates not seen from an infectious disease in nearly a century?
Read 5 tweets

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