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Students, Postdoctoral Fellows, and Faculty Team Up to Advance Immunology Research on COVID-19

Updated on Jun 30, 2022 | COVID-19, Featured, Research, School

Members of the Sinai Immunology Review Project. From left to right: Matthew Spindler; Louise Malle; Berengere Salome, PharmD, PhD ; Miriam Merad, MD, PhD ; Luisanna Paulino; Verena van der Heide, PhD; and Nicolas Vabret, PhD. Via Zoom, left to right, top row to bottom: Alvaro Moreira, MD; Robert Samstein, MD, PhD; Rachel Levantovsky; Matthew Park, Conor Gruber; and Emma Risson.

The unprecedented generation of non-peer-reviewed scientific information about COVID-19 in just a few months helped galvanize more than 50 members of the Precision Immunology Institute at the Icahn School of Medicine at Mount Sinai into forming a group to parse through the data.

The effort, called the Sinai Immunology Review Project, is composed of faculty, postdoctoral fellows, and graduate students. By sharing their knowledge and expertise, project members evaluate the quality of the research being posted to the bioRxiv and medRxiv preprint servers and help advance the most significant findings that are related to their field. Peer review is quality control provided by a panel of experts who evaluate whether a study has used proper research methods and is scientifically valid.

“Reviewing the preprinted studies benefits the authors and the scientific community, provides the public with access to what is being discussed, and helps reinforce scientific credibility,” says one of the project leaders, Nicolas Vabret, PhD, Assistant Professor of Medicine (Hematology and Medical Oncology) and a member of the Precision Immunology Institute at the Icahn School of Medicine. “To help pick the best treatments for COVID-19 you need to have a strong understanding of the pathology of the disease and we are able to help with this.” Many of the researchers who are working from home during this pandemic welcome the collaborative opportunity to contribute to the field.

Since mid-March, the project’s participants have ranked more than 2,000 studies according to their immunological relevance and written 130 reviews that are then posted alongside the corresponding study on the preprint servers. To ensure that the best science is elevated, each summary is written by a fellow or student specializing in a specific area of the immune system and then reviewed by a faculty member. A website built by Nicolas Fernandez, PhD, a computational scientist at Mount Sinai’s Human Immune Monitoring Center, hosts all of the reviews.

Recognition of this work recently led the editors of Nature Reviews Immunology to reach out to Miriam Merad, MD, PhD, Mount Sinai Professor of Immunology and Director of the Precision Immunology Institute, to form a unique collaboration. Mount Sinai is now publishing three short commentaries in the publication each week on the most promising immunological findings on COVID-19. Within a few days of launching the collaboration with Nature Reviews Immunology, Mount Sinai’s work was viewed more than 10,000 times.

Project co-leader Robert Samstein, MD, PhD, Assistant Professor of Radiation Oncology, and a member of the Precision Immunology Institute, says, “This has been a massive effort. It’s been a great opportunity for Mount Sinai’s trainees to integrate all of their knowledge and provide a summary for the scientific community,” so quickly and efficiently. “The huge flurry of output on COVID-19 by the scientific community is unprecedented and this effort is responding to that.”

While speed and the open sharing of information are vital to enhancing further understanding of the COVID-19 health emergency, the peer-review process is an essential part of scientific advancement and the preprint servers that are now publishing all of this new information were never meant as a replacement. In the absence of the peer-review process, members of the Immunology Project are stepping in to provide their expertise in the best way they can, says Dr. Samstein.

“By doing this we can really help make it easier for policy makers, physicians, and scientists to see what the best information is as it evolves and have a direct impact on treatments,” adds Dr. Vabret.

As time goes on, the medical and scientific community is learning more about the disease and calling into question some of its earliest hypotheses about possible treatments. This makes the need to highlight quality science to inform decision-making a continued priority, according to Dr. Vabret.

Mount Sinai Medical Students Graduate Early, Some To Join a Special Medical Corps

Updated on Jun 30, 2022 | COVID-19, Featured, School

Katleen Lozada, MD, one of the first Icahn School of Medicine at Mount Sinai students to sign up for early graduation.

Seventy-seven Icahn School of Medicine at Mount Sinai students earned their medical degrees early on Wednesday, April 15, at a time when Mount Sinai Health System hospitals are experiencing extraordinary and unprecedented demands brought on by the COVID-19 public health crisis. Among them are 19 graduates who matched at Mount Sinai for residency and volunteered to join the Mount Sinai Medical Corps, helping to relieve a strained medical system while answering the call by New York Governor Andrew M. Cuomo for “all hands on deck” to assist in any way.

On that day, a number of the early graduates participated in an informal ceremony—from the safety of their homes and conducted on Zoom—reciting the modern Hippocratic Oath and marking this milestone with faculty, staff, and friends and family, all in virtual attendance. Led by Staci Leisman, MD, FASN, Associate Professor of Medicine (Nephrology), and Medical Education, each graduate made a commitment to “respect the hard-won scientific gains of those physicians in whose steps I walk,” to “respect the privacy of my patients,” to “tread with care in matters of life and death,” and to “prevent disease whenever I can, for prevention is preferable to a cure.”

Staci Leisman, MD, FASN, Associate Professor of Medicine (Nephrology), and Medical Education, led students and faculty in reciting the modern Hippocratic Oath during a virtual ceremony.

The opportunity to graduate from the Icahn School of Medicine a month early—as well as the decision to begin clinical work in the Health System through the Mount Sinai Medical Corps—was strictly voluntary. The Medical Corps is a newly formed training program that gives these newest MDs an opportunity to provide vitally needed support services to an overburdened staff—entering orders, for example, scribing, relaying updates to patient families, and facilitating discharge planning. Also joining Mount Sinai graduates in these efforts are 12 graduates from other medical schools who have matched at Mount Sinai for residency.

“We are extremely proud of the dedication and altruism of our students and their passion for helping our patients and communities at this historic time,” said David Muller, MD, Dean for Medical Education, and Professor and Marietta and Charles C. Morchand Chair in Medical Education at the Icahn School of Medicine at Mount Sinai.

Katleen Lozada was one of the first Icahn School of Medicine students to sign up for early graduation. “This is definitely not how I envisioned my graduation, but I just really want to help alleviate the intense pressure on clinical staff working on the front lines. What lies ahead is somewhat unknown, but most of all I am looking forward to helping in whatever capacity is needed,” said Dr. Lozada, who matched in the Emergency Medicine residency. The program has training sites at The Mount Sinai Hospital and Mount Sinai Beth Israel—and at Elmhurst Hospital, which is part of a New York City integrated system of health care facilities that has been particularly hard-hit with COVID-19 cases.

“I would much rather be working and helping during this crisis than sitting at home and watching other able-bodied medical professionals take the brunt of the disaster,” added Dr. Lozada, whose mother is a pediatrician.

Olamide Omidele, MD

Also among the early graduates was Olamide Omidele—now Olamide Omidele, MD—a native of Nigeria who was matched to Mount Sinai as a urology resident. “The health care system is currently strained, and I am hoping that I can provide relief in whatever way is needed,” said Dr. Omidele. “I draw my strength, optimism, and comfort about joining the workforce from my parents, who are the main reason I chose to go into medicine.”

For Dr. Lozada, who is a first-generation New Yorker raised in the Bronx, the opportunity to assist the city she loves was also a motivating factor. “What’s even more exciting is that I’ll have the honor of serving the New York City community I grew up with and am awed by every day,” she said. “I can’t wait to get started!”

Students, faculty, staff, family, and friends participated in the virtual ceremony.

Mount Sinai’s Antibody Test for COVID-19 Receives Emergency Use Authorization from FDA

Updated on Jun 30, 2022 | COVID-19, Featured, Research

A renowned team of virologists, pathologists, and clinicians at the Mount Sinai Health System developed, validated, and launched a blood test for COVID-19 antibodies that received the U.S. Food and Drug Administration’s (FDA) emergency use authorization late Wednesday.

The blood test determines whether individuals have antibodies to the SARS-CoV-2 virus that causes COVID-19. It is used for the qualitative detection of human IgG antibodies in serum and plasma that is collected from individuals suspected of having been infected with SARS-CoV-2.

Early development of the assay, led by Florian Krammer, PhD, Professor of Microbiology at the Icahn School of Medicine at Mount Sinai, enabled Mount Sinai to become the first health system in the nation to undertake a convalescent plasma program that transfers the antibody-rich plasma from recovered COVID-19 patients into those who are critically ill.

To date, Mount Sinai has identified more than 1,900 donors who are eligible to provide their antibodies. A total of 141 patients have received the protocol, and the results are being evaluated clinically.

Under the leadership of Peter Palese, PhD, Horace W. Goldsmith Professor and Chair of the Department of Microbiology, Mount Sinai has built one of the world’s leading academic institutions for the study of viruses and emerging pathogens. “The COVID-19 antibody test is not only helpful in identifying individuals who could be donors for the convalescent plasma program but also identifies persons who can safely go back to work now that they are immune to the virus,” Dr. Palese says. This important step would allow the nation to return to economic productivity.

“We are grateful to the FDA for granting this expanded authorization so that we can deploy this vital test to the community at large,” says Carlos Cordon-Cardo, MD, PhD, Irene Heinz Given and John LaPorte Given Professor and Chair of Pathology, Molecular and Cell-Based Medicine. Dr. Cordon-Cardo oversaw the validation of the test that is produced by the Mount Sinai Laboratory, Center for Clinical Laboratories. The Mount Sinai Hospital’s Clinical Laboratories are certified by the Clinical Laboratory Improvement Amendments and accredited by the College of American Pathologists.

According to Dr. Krammer, the antibody test can, in some cases, pick up the body’s response to infection as early as three days post-symptom onset and is highly specific and sensitive. “We have shared the toolkit needed to set up the test with more than 200 research laboratories worldwide to help mitigate this global crisis,” Dr. Krammer says.

David L. Reich, MD, President of The Mount Sinai Hospital, and Judith A. Aberg, MD, Chief of the Division of Infectious Diseases and Immunology in the Department of Medicine, have led Mount Sinai’s convalescent plasma program. “The exchange of ideas between clinicians and scientists and our intense drive to innovate is the catalyst that led to this achievement,” says Dr. Reich. “Mount Sinai will continue to advance the science and medicine in the fight against COVID-19.”

Preliminary Case Series Leads to New Questions About the Disease Progression of COVID-19 in Patients with Blood Clots in the Lung

Updated on Jun 30, 2022 | COVID-19, Featured, Research

Hooman D. Poor, MD, Assistant Professor of Medicine (Pulmonology, Critical Care and Sleep Medicine, and Cardiology)

A small, preliminary case series led by physicians at the Icahn School of Medicine at Mount Sinai found that five severely ill patients with the SARS-CoV-2 virus responded to the blood-clot-busting drug tPA when it was introduced as a life-saving measure. This response, and the large number of critically ill COVID-19 patients who have blood clots in their lungs, have raised new questions concerning the course of the disease and may present new possibilities for treating it.

“This case series pushes us to consider avenues of clinical investigation that are different from what they are now,” says the paper’s first author, Hooman D. Poor, MD, Assistant Professor of Medicine (Pulmonology, Critical Care and Sleep Medicine, and Cardiology). “Perhaps we should be looking at the disease from the standpoint of clots that form in the blood vessels and travel to the lungs.”

Dr. Poor says that more testing will be needed to determine whether the clots are the “inciting events in a subset of patients,” and not a complication that develops after these patients develop acute respiratory distress syndrome (ARDS). “ARDS looks the same, but it’s not,” he says. It requires “dramatically different treatments.”

According to the paper, the critically ill COVID-19 patients had relatively well-preserved lung mechanics, and did not develop stiffness of the lungs, despite severe gas exchange abnormalities. This feature is more consistent with pulmonary vascular disease and not with classic ARDS. The COVID-19 patients also demonstrated markedly abnormal coagulation with elevated D-dimers—small protein fragments present in the blood after a blood clot—and higher rates of venous thromboembolism, a condition where blood clots that form in the deep veins of the legs or groin travel and become lodged in the lungs.

Click here to read the paper titled “COVID-19 Critical Illness Pathophysiology Driven by Diffuse Pulmonary Thrombi and Pulmonary Endothelial Dysfunction Responsive to Thrombolysis.”

Mount Sinai’s paper cited autopsy studies from the SARS outbreak in the early 2000s, which revealed that patients had “pulmonary thrombi, pulmonary infarcts, and microthrombi in other organs.” SARS-CoV-1, the virus that caused SARS, and SARS-CoV-2, which causes COVID-19, belong to the same family of coronaviruses.

With mounting evidence that a consistent pattern of COVID-19 patients are presenting with blood clots, front-line clinicians at the Mount Sinai Health System and throughout the United States are reassessing and modifying existing guidelines that incorporate anticoagulation therapies.

Mount Sinai has provided treatment guidelines for its eight hospitals that address the significant role microthrombi—tiny clots composed of platelets—may play in patients with severe cases of COVID-19. The new guidelines help to inform clinical decision-making on administering anti-coagulation therapy for critically ill patients throughout the Health System. They call for patients who require hospitalization to be assessed for blood clots in their lungs by measuring their oxygen levels, testing for markers of clotting in their blood, and assessing their difficulty breathing or shortness of breath. Patients in intensive care units may also be eligible for a clinical trial at Mount Sinai that will examine the use of thrombolysis in respiratory failure due to COVID-19.

The recommendation was made by a panel of expert clinicians within Mount Sinai, and was based on published and rapidly emerging data, international and local experience, and autopsy reports.

Recently, the International Society on Thrombosis and Haemostatis recommended that all hospitalized COVID-19 patients, even those not in intensive care units, should receive prophylactic-dose low molecular weight heparin—a blood thinner—unless they have contraindications, such as active bleeding.

“If patients with COVID-19 show a small problem with their lungs, perhaps we should start them on blood thinners to prevent the clots from reaching the point where we have to administer tPA,” says Dr. Poor. “However, this treatment paradigm with early anticoagulation will need to be evaluated with well-designed clinical trials.”

A Snapshot of the Extraordinary Contributions of Mount Sinai Students in COVID-19 Efforts

Updated on Jun 30, 2022 | COVID-19, Featured, School

From left: Shravani Pathak (MS3), Samuel Paci (MS3), and PhD candidates Mark Roberto and Sindhura Gopinath, members of the PPE Task Force, inventoried PPE stock, coordinated with different floors, and distributed PPE across Mount Sinai West based on need.

In an extraordinary effort across the Icahn School of Medicine at Mount Sinai and its Graduate School of Biomedical Sciences in New York City, 200 students and postdoctoral fellows have volunteered more than 6,100 hours during a three-week period and continue to assist the Mount Sinai Health System during the staggering challenges of the COVID-19 crisis. As members of the Sinai Student Workforce, they have made an impact in a wide range of areas, from sourcing, acquiring and assembling personal protective equipment (PPE), to supporting clinical trials. An additional 450 student volunteers have since joined the effort.

Students are organized into task force teams working in the following areas: PPE, pharmacy, telehealth, administrative, operations, labs, and morale. The six-member COVID-19 Student Volunteer Leadership Team—Alexandra Agathis (MS3), Ben Asriel (MS4), Rohini Bahethi (MS3), James Blum (Scholarly Year), Zina Huxley-Reicher (MS4), and Shravani Pathak (MS3)—meets regularly with administration leadership to receive, triage, and coordinate requests from throughout the Health System. “Our students have become an essential part of the support system Mount Sinai needs to save lives and care for the communities it serves,” says David Muller, MD, Dean for Medical Education, and Professor and Marietta and Charles C. Morchand Chair in Medical Education.

“We know we’re making a huge difference because we can see it.” — Christopher Park (MS3), Icahn School of Medicine at Mount Sinai

Following is a snapshot of what they have accomplished.

The PPE Task Force, led by Annie Arrighi-Allisan (MS3) and Stephen Russell (MS3), sourced and acquired nearly 3,000 N95 masks, nearly 9,000 surgical masks, and 400 gowns. They assembled more than 1,500 durable, reusable face shields from 3M and distributed them to front-line health care providers, fitted staff with protective masks, and played an instrumental role in the distribution of 750,000 single-use face shields. Students worked in around-the-clock shifts to assemble more than 200 PPE go-bags for residents working at Elmhurst Hospital—which is part of a New York City integrated system of health care facilities that has been particularly hard-hit with COVID-19 cases, and with which Mount Sinai has an affiliation. In addition, the group trained more than 50 students to help fit clinical staff with new models of N95 respirators.

The Operations Task Force, led by Alexandra Capellini (MS2) and Christopher Park (MS3), delivered vital equipment, a task that requires unloading deliveries and assembling IV poles. One team assisted in rapidly engineering a method to transform 200 ResMed VPAP ST machines as a donation from Elon Musk, Chief Executive Officer of Tesla, Inc., as patient ventilators. They additionally helped write the assembly guide and operation instructions and assemble hundreds of units. Other teams provided support on clinical trials and promoted blood donations among their eligible classmates and peers.

From left: Jeremy Nussbaum (MS3), Marc Casale (MS3), Meygan Lackey (MS4), and Rebecca Rinehart (MS3) took inventory of COVID-19 medications, alerted staff of shortages, and distributed critical medications to hospital floors at Mount Sinai Beth Israel.

“This has been an intense, eye-opening experience and, for the first time, I’ve felt I was doing my small part to help with the response to the pandemic,” says postdoctoral fellow Dan Filipescu, PhD. “Prior to this, I had no idea how the day-to-day operations of a clinical trial worked, or the amount of effort that goes into caring for COVID-19 patients.”

Approximately 300 student volunteers from the Telehealth Task Force provided and obtained patient information—calling them with test results, calling hospitalized COVID-19 patients to gather information regarding emergency contacts, and triaging the palliative care hotline. Students were trained to know when to answer questions and when to refer them to their superiors. Using an online chat platform, they triaged patients with potential COVID-19 symptoms—providing them with additional information about the virus and how to self-isolate, and arranging virtual appointments with physicians, or sending them to the emergency room if necessary. To date, students have had more than 2,320 triage chats and test result updates with patients. “As future physicians, we entered this profession in order to help people,” says Harinee Maiyuran (MS4) who, with Sidra Ibad (MS1) leads the Telehealth Task Force. “Though we are unable to engage in direct clinical care, coordinating Telehealth has allowed me to not only participate but feel useful in these weeks of uncertainty and fear, and it has allowed me to give back to the New York City community that has become my home.”

Pharmacy was the first task force to send volunteers throughout the Mount Sinai Health System. Led by Benjamin Liu (MS3), the team has been troubleshooting Pyxis loading to help resolve medication supply shortfalls. When students at Mount Sinai Beth Israel made pharmacy leadership aware of a dwindling supply of Azithromycin, pharmacists were able to recommend a different medication for some patients to conserve their supply. Volunteers in the leadership suite assisted the Health System pharmacy director in researching treatment guidelines and protocols, and in reviewing charts to understand the impacts of the COVID-19 protocols.

Members of the Administrative Task Force, led by Christopher Ferrer (MS3) and Phillip Groden (MS3), handled remote medical scribe work and assisted outpatient practices with transitioning patients to Telehealth appointments. Working with the Department of Clinical Innovation, they reprogrammed tablets in every room and unit to allow for teleconferencing between patients, families, and staff. They have also been fielding offers of vital supplies and PPE and acquiring them for the frontlines. A group of student volunteers working with Materials Management leadership developed a system of creating inventories of crucial PPE supplies, leading to improvements in efficiency.

More than 40 student volunteers on the Labs Task Force, led by Michael Fernando (PhD2) and Maddie O’Brien (PhD2), have triaged more than 500 incoming requests for serum antibody testing. Working with the departments of Microbiology and Pathology, they have contacted approximately 200 donors with their results, and scheduled approximately 300 new participants prioritized for potential plasma donation. Their most recent initiative has 50 volunteers screening COVID-19 patients to assist the Operations team to prioritize candidates for plasma treatment.

Melissa Hill (MS3), left, and Sarah MacLean (MS3), learned that “it is impossible to breathe when wearing N95s correctly—and staff have to do it all day long.” They were members of a team that brought N95s and other PPE to Mount Sinai West.

As staff and volunteers throughout the Mount Sinai Health System work long hours under increasingly stressful conditions, keeping up morale plays a key role in the fight against coronavirus. The Morale Task Force, led by Ms. Arrighi-Allisan, Ella Cohen (MS1), and Katie Donovan (MS3), is charged with boosting morale among student volunteers and the greater Mount Sinai community. They have coordinated meal deliveries three days a week to all students remaining in nearby apartments, with leftovers going to residents, nurses, and other staff at The Mount Sinai Hospital. They distributed health kits containing a thermometer, pulse oximeter, a mask, and acetaminophen to students who are ill. They also fostered a sense of community through social media and blogs that highlight the achievements of student volunteers and have created an initiative to write letters to residents of nursing homes and other skilled nursing facilities.

Collaboration among peers extends beyond the Mount Sinai community and includes medical students from around the country. Students from the University of California, San Francisco, tweeted a seven-minute video to health care workers in New York City, showing solidarity, thanking them for their heroic efforts, and offering words of encouragement. “I am in awe of the way everyone has come together to fight this pandemic and all the hard work my peers have put into volunteering,” says Ms. Pathak. “I love collaborating with students from other schools as they reach out to me about how they can develop structures like our workforce in preparation for when the pandemic affects their communities.”

Adds Mr. Park about his experience on the Operations Task Force, “I think a lot of us are learning about the real meaning of resilience and adaptability by living it. We know we’re making a huge difference because we can see it. I am both inspired but also unsurprised by the student response, because this is the standard I knew that our student body functioned at and would strive for.”

Elmhurst Hospital During COVID-19, An Experience Like No Other

Updated on Jun 30, 2022 | COVID-19, Featured

Suresh K. Pavuluri, MD, MPH

The weekend of Saturday, March 14, marked a turning point for Suresh K. Pavuluri, MD, MPH, a second-year resident in Emergency Medicine at the Mount Sinai Health System, who was working in the Coronary Care Unit (CCU) at Elmhurst Hospital, a Mount Sinai affiliate. It was when the national discussion about the rising number of patients with COVID-19 became a deeply personal experience for him, and “everything just shifted quite dramatically,” he says.

Early that weekend, Dr. Pavuluri noted a couple of patients with suspected COVID-19 were being treated in the hospital’s Emergency Room and Medical Intensive Care Unit (MICU). That was consistent with his experience a week earlier, during his rotation at The Mount Sinai Hospital, where that hospital’s first COVID-19 patient had been treated and released.

But the trickle of patients at Elmhurst Hospital quickly changed into something very different as more patients started arriving. “It seemed to come out of nowhere,” he says. “Suddenly, everyone had COVID. It was as if this huge avalanche hit us and we were trying to dig our way out of it, trying to cope with all these patients. Initially, all the people who were under investigation for COVID were sent to the MICU. And that quickly changed because we didn’t have enough beds. So, then some of the floors were converted to handling these patients and others who had difficulty breathing.” The sickest patients, who required intubation to assist them with breathing, were sent to the intensive care units and what had been the CCU, where Dr. Pavuluri was busy tending to them.

Within days, the policy changed to not allowing any visitors or family members into the units with the sickest patients. “It was a way for us to protect the public, but it was also a way for us to protect our patients,” he says.

“So, all of a sudden, I could no longer have face-to-face conversations with family members, and we had to have discussions over the phone. It was difficult for the patients to not have their family members there because in intensive care there are so many nurses and doctors coming in and out. The lack of personalization was one of the hardest things about this. You can’t really comfort someone through a phone. The other part was that we spent a lot of time on the phone. We were receiving multiple phone calls a day from different family members. Obtaining consent to treat intensive care-level patients meant we had to track down family members as quickly as possible. Sometimes critically ill patients require multiple procedures. The patients were already intubated by the time they came upstairs. Some of the coronavirus patients were going into renal failure and needed dialysis. That is typical in the intensive care unit, but we never see the sheer volume of it. We never expected so many patients to require all of these things or this much attention. These were people in their 30s, 40s, 50s. We saw people in their mid-thirties with no prior medical problems. When this pandemic began, we thought it was going to be mostly elderly patients affected by this. Then we realized it’s anyone and everyone.”

During that turning point of a weekend at Elmhurst Hospital, Dr. Pavuluri says he began to hear the code “Team 700 to B4” on the overhead paging system more times than he could keep track of. It meant that a patient’s heart had stopped. At that point, Team 700 would rush into his unit and perform their assigned duties, from administering chest compressions to providing the medications needed to rescue the patient’s heart. “Before coronavirus took over our hospital, I may have heard this code once or twice a week,” he says. “But it became all too familiar. Sometimes, after several minutes, just when we felt defeated, the patient’s heart would start beating again and we’d sigh with relief and look at each other, acknowledging that it was just a matter of time until our next code.”

As the volume of patients entering Elmhurst Hospital increased, Dr. Pavuluri’s work schedule changed to meet the demand, from working every four days to 12-hour shifts. “We simply had to be resilient,” he says. “We had to be flexible and adapt to best serve our patients.”

More than a week later, Dr. Pavuluri developed COVID-19 too, and went home to nurse his splitting headaches, low-grade fever, exhaustion, chills, muscle aches, nausea, chest heaviness, congestion, and shortness of breath. He began to recover after five days. Eleven of his colleagues at Elmhurst Hospital also tested positive. By early April, Dr. Pavuluri was back at work, splitting his time in the Emergency Departments at Elmhurst Hospital and The Mount Sinai Hospital.

While he was home recuperating from COVID-19, Dr. Pavuluri had time to reflect.

“I can definitely say the experience will leave an impression on me and my colleagues for as long as we practice medicine. We did not anticipate this, and we were not prepared for this. I am really close to my family and they have been a great sounding board. My colleagues at work have been my great resource because they understand, they’ve been there. To be among the young doctors coming in and fighting the good fight—it’s been really gratifying. I am so proud to be among the nurses and doctors who are risking their lives every day in this pandemic. But there will be scars. It has been an experience like no other.”

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