‘This is Our Time, and This is Our Battle’

Today is National Doctors' Day, and the president of ColumbiaDoctors, Jack Cioffi, MD, shared this letter with the physicians of Columbia University Irving Medical Center:

Dear Colleagues:

At this time of unprecedented need amid incredible uncertainty, I want to applaud your courage, resourcefulness, and spirit. No matter where we come from, in this moment, we are all New Yorkers, and we are in this together. As a clinician, I certainly share your concerns about COVID-19 and potential impact on our personal wellbeing, the risk of infecting those we love, the increased risk due to certain personal characteristics, and the emotional toll that this takes on each of us, as well as our loved ones. I have immense respect for each of you who have continued to meet your patient care needs despite the risks. Unbelievably, today is Doctors' Day–and in the midst of this enormous challenge, allow me to begin by saying THANK YOU!

I am reminded at this time that we are clinicians and scientists. Like many of you, I look to the facts and numbers for comfort and a reality check. I believe that the practices (stopping elective surgery, restricting visitors, proper PPE use, decreasing outpatient clinical volumes, increasing the use of telemedicine, and others) that we rapidly put in place over the past month to protect our doctors and staff, while still meeting our patients’ needs, have made a tremendous difference–possibly lifesaving. The lesson is this: Smart protocols and practices afford us increased protection.

I also take some comfort in the knowledge that some 80% to 85% of COVID-19 infections are relatively mild, and that this number is likely to be artificially low due to a lack of broad-based community testing. Of the 15% of patients who require hospitalization, 75% to 80% are neither being treated in an ICU nor do they require a ventilator. Thus, the catastrophic scenarios that we all fear the most will happen in only a small number of cases. That said, the case numbers are also undeniably frightening in our city and state. New York now has over 60,000 confirmed cases, and New York City is the unfortunate epicenter of the world. I draw great comfort in knowing that I work at Columbia University Irving Medical Center and NewYork-Presbyterian, and if my family and I require care, there is no better place in the world for us to be.

The numbers from around the world tell us about the expected timing. COVID-19 will likely peak in the next several weeks. We cannot ignore the morbidity and mortality of this disease, but we must not falter. We will take every measure to save every life we can and to keep our fellow Columbians healthy so we can carry on caring for New York.

We all recognize that our national health care system has not been scaled to handle this sort of pandemic. However, our system (Columbia, Cornell and NYP) is up to the challenge. Our colleagues, particularly in emergency medicine and critical care medicine, need our help. The system as a whole is under extreme strain and many roles need to be filled. We are completely focused on increasing our hospital and ICU capacity to meet the challenge.

On behalf of our entire community, I would ask that each of you ask yourself, “What can I do? How can I contribute?” Our comfort zones are being stretched. We may not be intensivists or ER doctors, but your lifesaving skills, knowledge, and innovation are critically needed. We are physicians who bring compassion and intelligence to an overtaxed system that is gravely in need of both. Columbia is known for its excellence around the world, and I know that excellence is embodied in each one of you.

We are defined by our actions, especially in times of crisis. This is our time, and this is our battle. It is my honor to work with all of you. 

Be well,
Jack