After a three-decade career as an internal medicine physician and public health official, Dr. Jane Bedell decided to trade in her white coat and stethoscope for hiking gear and family time. But as she celebrated her retirement on Feb. 28, following 17 years as assistant commissioner and medical director at the Bronx district public health office, she knew she was in the midst of the calm before the storm.
So instead of her planned post-retirement trip to Wyoming with her partner, Sarah, to see their son, Bedell signed up for the New York City Medical Reserve Corps, so she could be drafted right back to the front lines of the coming public health battle.
Stories of physicians and other health professionals coming out of retirement to fight the coronavirus pandemic went viral, appearing on "TODAY," New York 1, The New York Times and many other news outlets in the early days of the crisis. Bedell was booked for over a dozen interviews about her decision to sign up for the corps, which she had assumed would result in her helping patients face-to-face.
But things didn’t go exactly according to plan. As a 63-year-old cancer survivor who has hypertension, Bedell is in a high-risk group for COVID-19 complications.
“I kept saying, ‘I don't want to clog up an emergency room spot,’” Bedell said, worried about being a burden to the health system should she contract the virus. “I mean, now we have a lot of ventilators in New York City and New York, but we sure as heck did not then.”
In the end, the medical reserve corps decided Bedell should keep doing what she was already doing: speaking to the public, civil society groups and journalists on the city’s behalf about its coronavirus response from the safety of a remote job — familiar now to millions of Americans.
Out on the Frontline: Dr. Jane Bedell is one of NBC Out's 2020 Pride Month honorees. To see the full list, click here.
As a member of the New York City health department’s COVID-19 speakers bureau, Bedell is using her platform and experience as a physician and health official to educate the public. This has included speaking out about the ways pandemics can create societies of haves and have-nots and how that impacts broader disease-control efforts.
“We have parts of the city where people feel that they can't get good quality medical care at the snap of a finger, and other parts of the city where a snap of a finger brings extraordinary amounts of medical care,” Bedell said.
That same disparity was present the last time a novel pathogen entered the city unnoticed and spread out of control.
“I grew up with HIV as a medical professional,” Bedell said. “In those early days, there was so much stigma and uncertainty, wild things that people proposed for its treatment ... a lot of misinformation, and a lot of a lot of a lot of suffering and a lot of deaths.”
Amid poverty and social stigma — and after AIDS destroyed the immune systems of countless New York City residents — tuberculosis came back with a vengeance and cases peaked in the early 1990s. During that time, the city instituted a world-renowned program for tuberculosis epidemic control, which involved testing, social isolation for treatment and directly observed therapy to avoid the widespread and growing issue of drug-resistant TB.
Bedell said that effort provided an early blueprint for a testing and tracing program that would, decades later, be operationalized for the coronavirus. Bedell said during that time “some of the best” health professionals were hired as part of the city’s TB program, and “many of them still work for the agency” today.
“The city has a long history of doing good on this topic,” she said of contract tracing amid a pathogen outbreak.
Bedell said New York’s TB control program is the best approximation for what to expect from its forthcoming COVID-19 contact tracing system. The city’s health department would isolate TB patients, trace and contact their associates and treat everyone who was exposed. Bedell said she learned some of her most important public health lessons while responding to New York City’s TB surge.
When she was completing her residency at North Central Bronx Hospital in the late 1980s, she recalled supervising a patient with active tuberculosis who was under a health commissioner’s order not to leave his isolation room, which had negative pressure and was where his TB treatment was being overseen.
”This man kept trying to leave,” Bedell said, so she asked the patient what was wrong. He told her he had a package that he needed to pick up at home, and he mentioned that he “really likes to read the newspaper every day.”
“I was like, ‘OK, this is easy.’” She called a social worker and had the package picked up and brought him a newspaper every day she came to the hospital. He completed his treatment and recovered.
“The patient, the person who’s positive — they're the VIP,” Bedell said, noting that this applied to people with TB then and people with COVID-19 now.
After this first wave of the coronavirus, the New York City Department of Health and Mental Hygiene envisions a surveillance system powered by thousands of contact tracers who will find, test and isolate people who test positive for COVID-19 and their contacts, Bedell said.
“We have to center those people in a very nonjudgmental way, take care of them, assure their close contacts that there's a really good reason why they're going to have to be quarantined for 14 days,” she said. “And then we’re going to dig our way out of this.”
“And then as we're digging our way out of this, how about we don't create the same city that brought us the overcrowded conditions, the difficult ways to access medical care, the work environments that put some people more at risk than others,” Bedell added. “I'd like to go back to a city that doesn't go back.”