Dr. Syra Madad is pretty used to pandemics. As one of the stars of the hit Netflix docuseries Pandemic: How to Prevent an Outbreak, Dr. Madad showed what life was like as a public health expert preparing healthcare workers for a potential outbreak. And then, COVID-19 came along, and Dr. Madad has been busier than ever. Dr. Madad spoke exclusively to Celebrity Parents Magazine about pandemics, how she only had an 8-day maternity leave, and why it’s so, so important to create your own new normal — safely.
It seems hard to remember life before the Coronavirus, but what were you doing pre-COVID-19?
Before COVID-19 came on my radar, I was working on Candida auris. There were ongoing issues, and it was holiday time, so the seasonal flu was ramping up, too. Flu season tends to peak sometime in January or February, so we were gearing up for that. Then we were doing a lot of other stuff in terms of general infectious disease. We had launched a global health center, so we were doing a lot of work with other international organizations, as well as the CDC, on various types of tools in the domain of disaster management and infectious disease. But the big thing was the flu, so we activated our emergency operations center; I’m part of emergency management within our healthcare system. Every year we do activation for seasonal flu, so we activated for it—and I was heavily pregnant at the time, too. I had just hired an assistant director underneath me to help take the torch during the time I was going to be on maternity leave. It was a very interesting time. She was concerned because my portfolio was so expansive, and she said, “I hope nothing happens during your maternity leave.”
Famous last words.
Yes, famous last words! But it was Murphy’s Law that anything that can go wrong will, and it did, big time. I delivered January 13th, and I officially went back to work January 21st. We put together our first system-wide meeting with leadership to talk about what was happening with COVID-19.
So you basically had an 8-day maternity leave.
I think so! [laughs] I don’t even know. I couldn’t even count — it was such a blur.
I’m with the entire system, New York City Health + Hospitals, which oversees all the 11 hospitals. It’s a huge healthcare system, and I’m part of the team at the system level that ensures for all the facilities that they have all the resources and serving as a subject matter expert.
What was life like during those first few months when COVID-19 really began to affect New York and we went into lockdown?
In March, I called my children’s school and told them that I was going to keep my kids home. I was seeing what was happening in our hospitals and around the world and I wanted to do my part to help flatten the curve. Of course, I’m an essential worker, so I’m going to go out and do what I have to do. At that time, they didn’t understand why I was pulling them out and I got a call from the principal and she said that she was happy to work with me, and for me to come once a week to pick up his school stuff, so we could have a game plan.
As for me, I was going to our facilities and doing behind-the-scenes training. I was at Elmhurst Hospital, which had a lot of COVID patients, about three weeks before the surge started. I helped train them, explained about the PPE and keep staff safe, and infection control procedures. I was doing that at multiple hospitals, giving trainings and gearing up our frontline workers on what to prepare for in case we start seeing a surge in cases. And once the cases started to come in, we quickly pivoted from doing just-in-time training to going to the facilities and doing environmental checks. We were also at the isolation quarantine hotels in NYC to train the staff so that they would have a good infrastructure — like a COVID floor and a non-COVID floor.
So has our first wave finished?
Yes, if you look at our Epi Curve, it’s beautiful. We obviously suffered a lot, and I think if we could all go back and see how we could have done a better job with the information we have and the resources we have, you always have room for improvement, on a state and federal level.
But you’re really learning on the fly, because you can’t really base this on the past experience of the Spanish Flu of 1918. Yes, some wore masks, and there was social distancing, but there’s no comparison with the way the world is now.
That’s exactly right. As public health professionals, we never have all the data that we need to make significant decisions that are going to impact the lives of everybody. And so when you’re thinking about shutting down schools, these are huge steps that have huge ramifications. So you don’t want to make a decision by throwing a dart in the dark. And sometimes, that’s what you were dealing with because you just didn’t have all the data, all the information, or all the testing to know how many cases you had in New York state.
Like the mask issue, which is something that has been highly politicized. Early on, public health officials said we don’t need to wear a mask, because we didn’t have the information on how common asymptomatic spread was. For us, when a patient comes into the hospital with a fever, cough or any hallmark signs of infection control, we do source control right away. The basics were already right there; we just didn’t have that information of how common the asymptomatic spread was, and as soon as we got it, public health said that everyone needs to wear a mask. And that’s how some of the guidelines changed, which is perfectly fine, because when you’re in the middle of a pandemic, as you said, you’re learning on the fly. You need to make sure that public health and clinical guidance changes with it, because if it doesn’t change then that’s a problem.
So let’s talk about the Netflix series, Pandemic. Will there be a season 2?
There is talk about a season 2 but it might not be on Netflix. When we were filming the Netflix docuseries, we were filming it in 2019, before COVID even existed. It really showcases the hard work that is happening around the world with so many people working in bio defense and bio preparedness. It really depicts that there are people who are focused on this and doing their best to try and prevent the next outbreak. But it’s so much bigger than the individual or even the community level, because you need buy-in from so many levels. I try to highlight that in the series; for example, you see me going to Senator Rivera’s office talking about the anti-vax movement. And you’ll also see me talking about budget cuts, and why we need more funding and political support.
Do you think there will be a second wave?
Certainly we are preparing for a resurgence of COVID-19. You always need to look at the data and be on your toes. Things can change very quickly and dramatically. We’re heading into the fall, and seasonal flu is going to ramp up. Temperatures will drop and people will stay indoors. What we know about COVID-19 is the three C’s—it likes confined spaces, crowded spaces, close contact. So when you put those three things together, you have a much greater risk of spread. I think we’re in a position where we need to prepare for the worst but hope for the best.
Since we are already social distancing, wearing masks, and doing hand hygiene, maybe the fall flu season might be a little better — or it might not be.
It might not be. A lot of people are comparing what to expect for the upcoming months based on the southern hemisphere. But we’re in a much different position because their flu season is during the warmer months; ours is during the colder months. We’re going to have more indoor gatherings and holidays where people are going to interact with each other. They might not do it safely, and so they need to learn how to merge social bubbles.
As parents, you know that we have sacrificed so much, including holidays this fall. As the mom of three young children, what will Halloween look like for your family?
Obviously being outdoors is better than being indoors, but when we talk about fomite transmission (like someone who is sick coughing on candy or they’re interacting with children), what’s the risk of transmission? And while it’s low and we don’t have any documented cases of fomite transmission causing an infection, at the same time there are so many unknowns. It’s just better to be on the side of caution. For me, I bought a bunch of eggs, and we are going to do a Halloween egg hunt around the house. They’ll wear their costumes and they’ll do the hunt, and in our social bubble, we have a couple of friends, so their kids will come over and be a part of it. That’s how we’re going to keep our Halloween spirit up.
You can’t have an absence-only approach. If you say that we’re going to stay home, we’re cancelling Halloween, we’re cancelling Thanksgiving and Christmas, no one is going to do that. In fact, it will actually drive the opposite and do things behind closed doors and risk contracting COVID-19. So the best approach is a risk-reduction approach. Give them tools on how to reduce their risk of transmission so that you can do things safely. The risk is never going to be zero, because if it is, you’re going to have to stay home, and you can’t interact. Everyone is trying to create their new normal, and their new normal doesn’t mean being home all the time. It’s just not realistic. So we need to make sure that we’re creating a new normal in which we can do some of the things that we love doing, but doing it safely.