Diagnoses of COVID-19 among patients hit an all-time high for the Department of Ob/Gyn this week, and the reverberations of the pandemic are being felt. Radical and unprecedented changes, like the closure of the fertility center, the consolidation of the Allen Hospital and Morgan Stanley Children’s Hospital Labor and Delivery Unit, and staff redeployment, send shock waves through the department. The pandemic has fundamentally changed how we deliver care to our patients.
April 06
Doctors and staff from our department are redeployed to support our obstetric service and to assist with the medical center’s COVID-19 testing sites. This effort includes having our gynecologic surgeons assist with cesarean deliveries and members of our research and women’s mental health teams supporting patients and nurses on the postpartum units.
April 07
Research With all fertility treatments put on pause during the pandemic, 85% of our fertility patients found this experience moderately to extremely upsetting, with 22% rating it emotionally equivalent to the loss of a child, according to a survey conducted by our fertility team on the emotional impact of the ASRM guidelines on fertility care patients during the COVID-19 pandemic.
Research One-third of pregnant women with COVID-19 presented with no known symptoms, according to a landmark study published by our team examining a series of 43 confirmed cases of COVID-19. “COVID-19 Infection Among Asymptomatic and Symptomatic Pregnant Women: Two Weeks of Confirmed Presentations to an Affiliated Pair of New York City Hospitals” reports that 10 of the 14 initially asymptomatic women developed symptoms over the course of their delivery or shortly after postpartum discharge.
April 08
Our Allen Hospital Labor and Delivery Unit is consolidated with our unit at Morgan Stanley Children’s Hospital in order to create more ICU space for COVID-19+ patients at the Allen. This consolidation requires significant teamwork and reveals a need for tools to identify doctors and nurses that not only don’t usually work together but are also wearing face-obscuring PPE.
For the first time in my 10 years as a reproductive endocrinologist, our office is closed. Large fertility clinics like ours don’t close, ever. I’ve driven to work through a blizzard and stayed in a hotel for the weekend so that we could complete time-sensitive IVF cycles. I’ve worked during Hurricane Sandy, when patients risked running out of gas to get to the clinic for monitoring and embryologists wore headlamps to see in a dimly lit lab with limited power from an emergency generator.
I usually wake up every morning (sometimes in the middle of the night) excited to see how our patients’ cycles are going. But there are no cycles now. No patients waking up extra early for an ultrasound to monitor their progress. No couples nervously struggling to figure out how to do their injections.
What remains, however, is our patients’ burning desire to start their treatment. That desire is stronger than ever. They’re nervous that their chances dwindle the longer their treatment is delayed. Patients have offered to sleep on the street or in our lobby so they could continue their treatment. Despite a global pandemic, their desire to grow their families cannot be quenched.
Eric J. Forman, MD, HCLD, Medical and Laboratory Director at Columbia University Fertility Center and Assistant Professor of Obstetrics and Gynecology at NYP/CUIMC