BOSTON — Dr. Mark Poznansky of Massachusetts General Hospital invoked a principle from the Talmud during a recent virtual discussion about the COVID-19 pandemic.
Asked what has guided him the most during the year or so of the pandemic, Poznansky replied, “That fundamental belief that to save one life is [to save] the world.”
“It’s a very important thing,” said Poznansky, who is a member of Temple Emanuel in Newton. “Every life that could be saved is incredibly important to every doctor and every health care worker in the hospital in the battle we engage in against disease.”
“A Day in the COVID Unit,” the March 1 panel event sponsored by Boston’s Vilna Shul, included a surprise guest with a particularly remarkable lifesaving narrative: Jim Bello, the first patient to test positive for COVID-19 at the MGH ICU and the subject of the New York Times profile “32 Days on a Ventilator” by Pulitzer Prize winner Pam Belluck.
On the panel, Bello joined one of the doctors who cared for him – Dr. Paul Currier, the director of MGH’s Respiratory Acute Care Unit – as well as Poznansky, who is the head of the hospital’s Vaccine and Immunotherapy Center.
“I don’t have a ton of memories,” Bello said. “What I take away from it is how Paul and everybody at MGH treated my family … the doctors, nurses, CNAs, respiratory therapists.”
Bello was admitted to MGH during what Currier said was an atmosphere of dread following the COVID-19 surge in New York City.
“I just remember the intense fear of what was going to happen,” Currier said, “the way we tried to get ready for a thing that we had no idea exactly what we were dealing with.”
Currier described coming into the ICU at 1 a.m. to care for the new patient. He put on PPE, a practice known as donning. Wearing gowns, gloves, masks and eye protection, he and a resident trainee went through two sets of double doors to examine Bello.
“Originally, when [Bello] came in, he started getting better,” Currier said. “We felt things were going really well. Very soon thereafter, he took a turn for the worse. We were very, very worried about him.”
Currier and his team used a technique called proning to turn Bello onto his stomach in an attempt to improve his oxygen situation.
“The next morning, things were looking worse again,” Currier said. “Once you flip somebody over with proning, there’s really only one step after that, a few other tricks.”
This time, Currier and his team used a technology called extracorporeal membrane oxygenation or ECMO to try to improve his oxygen supply.
“It’s very specialized, difficult-to-run technology,” Currier said. “It’s available in very few institutions,” and it was used “in order to be able to keep him alive.”
Currier and Poznansky both reflected on what it is like to care for people as medical professionals.
The beginning of the pandemic, Currier said, was a moment when he and his colleagues “took a chance to also examine why we went into medicine in the first place, the idea of why it was important. In good times and bad, we were actively working to try to help people in the context of illness. It was a time of a lot of soul-searching early on.”
“It’s actually a tremendous privilege to look after patients,” Poznansky said. “You take their lives in your hands along with your colleagues, trying to restore the patient to full health again. It’s undoubtedly a privilege that you’re entrusted and trained to do this and work with inspiring teams of doctors and nurses to achieve this greater good.”
As doctors worked to treat patients in the hospital, they also encouraged the public to follow public health measures that might keep others out of the hospital.
At the beginning of the pandemic, Poznansky said, “we knew that COVID-19 had a capacity to mutate and change. We were not sure a vaccine might be possible at that particular point all those months ago … Despite this, masks and social distancing along with other public health measures definitely worked well to contain the pandemic during that first year.”
Since then, there has been a rollout of multiple COVID-19 vaccines in the U.S. from Pfizer/BioNTech, Moderna and most recently Johnson & Johnson.
Poznansky leads a team with Dr. Patrick Reeves and Dr. Jeff Gelfand at the Vaccine and Immunotherapy Center (VIC) at Massachusetts General Hospital on the development of a second-generation COVID-19 vaccine. VIC is working in partnership with a new biotechnology company called Voltron Therapeutics Inc. which builds on the Department of Defense-funded VaxCelerate program.
“Where we are, one year on and now going forward, we now know that the first generation of COVID-19 vaccines can work and prevent the most serious forms of disease and death caused by COVID-19,” Poznansky said. “We have great data from Israel,” including that “they vaccinated [over] 50 percent of the population.”
One questioner asked whether pregnant women should be vaccinated.
Poznansky said, “The CDC advises pregnant women to be vaccinated. There should be a joint decision between the mother-to-be and her obstetrician … Israel is a great example. A large number of people have been safely vaccinated, including pregnant women.”
In the future, Poznansky said, “We should remember all the things we learned – masks, social distancing, now the vaccines … carry all of this knowledge forward into the next six months to a year as data and science informs our next steps to combat this pandemic.”
“There will be a new normal,” he predicted, “but it will not be the old normal.”
Bello said he has no long-haul COVID symptoms. He has returned to an active lifestyle, and his family includes a recently adopted dog named Blake.
“For me, things could always be worse,” Bello reflected. “You can’t change the past. You can control the future.”