Pandemic Expert’s COVID Journey: Doctor, Patient, Vaccine Recipient
Many healthcare providers have been stricken with COVID-19. But it’s unlikely anyone’s life has been more intertwined with the pandemic than that of Darren Mareiniss, MD, FACEP, an Emergency Medicine physician and pandemic expert at Einstein Medical Center Philadelphia.
Dr. Mareiniss warned that a pandemic was inevitable 12 years ago; he came down with COVID in March; he later helped Einstein determine how to treat the virus; he treated ER patients with it; he advised Einstein on how to allocate the vaccine; and he was among the first in the city to receive the Pfizer-BioNTech vaccine.
“It’s kind of full circle,” he says.
Dr. Mareiniss is the former Chair of Ethics at Medstar Franklin Square Medical Center in Baltimore and an expert in disaster response.
In 2009, he wrote an article in the American Journal of Disaster Medicine that said: “Although the exact moment of a calamity may not be foreseen, disasters, in general, are predictable events that occur with some periodicity. Pandemic influenza is such a menace on the horizon. A worldwide outbreak of influenza will occur; the main questions are when and how severe.”
As predicted, an influenza pandemic did come in 2009, but it was mild. However, Dr. Mareiniss did not foresee that the dreaded 1918-type pandemic would come in the form of a coronavirus pandemic instead of influenza.
Expected Problems, Unexpected Response
The rest of Dr. Mareiniss’s warning came true: the shortage of safety equipment, the strain on emergency departments, the ethical dilemmas of allocating ventilators and other life-sustaining interventions.
The other circumstance he didn’t foresee was the government’s response to the outbreak. He’d anticipated that the federal government would execute its pandemic response plan and utilize its Strategic National Stockpile and agencies to support the local pandemic response. He believed that a respected entity such as the Centers for Disease Control and Prevention would provide guidance to help contain the pandemic.
This had been the plan since the federal pandemic task force had been created under the Bush administration. However, the task force was disbanded in 2018 under the current administration.
Instead of a central response, “it turned out to be the Wild West,” he says. “It was crazy, disorganized, and much worse than it needed to be. The federal response was atrocious.”
Not to mention that if anyone had talked about the pandemic as a political conspiracy back then, “he’d have been laughed out of the room.”
Dr. Mareiniss didn’t necessarily foresee that he’d personally contract the disease, but he wasn’t surprised, given the high-risk exposure of working in the ED.
“I’m a healthy 47-year-old who actively exercises and I had no medical problems,” he says. “I wasn’t surprised to get it, but I didn’t think I’d get so sick. I had chills, fatigue, some fever. On the 10th day of my symptoms, I couldn’t stand up.”
From Doctor to Patient
Dr. Mareiniss got COVID so early that the loss of taste and smell – which he experienced – hadn’t yet been recognized as a symptom. On March 22, as the world was newly awakening to the pandemic, he became one of the first COVID patients in Einstein’s ICU.
Dr. Mareiniss was briefly hospitalized but out of work for nearly a month. And while he was home recovering, still short of breath and deeply fatigued, he participated in Einstein’s ED Incident Command conference call. “I could barely get through a sentence, and was working on protocols for allocating ventilators,” he says.
He chaired the Einstein committee on ventilator allocation and was a member of the allocation committee for the COVID drug remdesivir. Later, he was on the vaccine task force and a member of the subcommittee that developed protocols for dispensing the vaccine, including prioritizing who should get it.
Now, his experience helps create a rapport with patients.
“I always try to be empathetic, but I feel more of a personal connection to this disease process because I’ve dealt with it so personally,” he says. “I can build a rapport based on that. I try to say the things I wanted to hear when I was sick.”
He also tries to soothe patients with a little levity. “I tell them I love coffee and I couldn’t drink it for two months. It tasted like dirt. I was so angry. I love coffee.”
Dr. Mareiniss received his second dose of the vaccine on Jan. 10, “in order to protect myself, my family, my patients and the community,” he says.
If everyone who’s medically eligible will do that, he says, the rampage of COVID can be stopped. And his unusual journey with the pandemic, he predicts, can come to an end.