Ob/Gyn Dispatches During COVID-19: Arnold Advincula, MD, Part 2

April 23, 2020

Each day during the COVID-19 crisis, we'll share an update from a member of our team in the Department of Obstetrics and Gynecology at Columbia University Irving Medical Center. Today's note is from Arnold P. Advincula, MD, Chief of the Division of Gynecologic Specialty Surgery. Today, Dr. Advincula talks about his experience procuring supplemental personal protective equipment (PPE) for the department.


Arnold P. Advincula, MD
Arnold P. Advincula, MD

In its simplest form, the surgical mask is a piece of personal protective equipment  (PPE) that we as healthcare workers have always taken for granted. Lately, in the context of COVID-19, the mask has taken on the identity of a precious commodity. As the person responsible for procuring supplemental PPE for our department, sometimes it feels like I’m competing for a highly-desired apartment in New York City and hoping not to get out-bid by the next buyer. If that isn’t hard enough, the marketplace is also full of counterfeit masks and price gouging. The words “broker,” “distributor” and “supplier” now readily roll off my lips like I’m a dealer looking for contraband. I never realized a mask could come in so many forms and I don’t just mean surgical versus N95. Ear loops, ties, elastic, anti-fog, shielded, or moldable nasal bridge? The list goes on and on. If the healthcare system collapses after this pandemic, I think I will be able to get a job on the black market.

No matter which iteration or where from, the mask is replete with symbolism, signifying an amalgamation of politics, psychology, racism, and democracy. Given the lack of centralized leadership for procurement, federal, state, and local governments are all competing for these coveted masks. The disorganization of our pursuits makes us question our Constitution and Bill of Rights. How is it American to pit state against state? How can the federal government seize PPE legally purchased by the states? How is it possible that in the United States of America, the most powerful country in the world, our healthcare workers are not outfitted to maximize their safety on the front lines of this war? There are no Blue masks or Red masks. The virus doesn’t discriminate between political affiliation, North or South, East or West. Country of origin does not matter. 

A variety of PPE
A variety of PPE

Nonetheless, the mask is now associated with racism. It triggers feelings of xenophobia. As an Asian-American wearing a mask in public I have witnessed first hand the racial slurs. It had been a long time since I heard the word “chink,” but its resurgence is real. The circumstances of this viral pandemic bolstered the smoldering racism in our country. The naming of COVID-19 as the “Chinese virus” was just the beginning. Next KN95 masks sent from China to help make up for deficiencies here were deemed inadequate. Healthcare workers were initially denied the right to wear these masks despite insufficient supplies resulting in protracted reutilization of old N95 masks. The Chinese KN95 mask was reflexively deemed inferior. Ironically, most of our PPE, including the N95 masks come from China -- with or without the K, these masks are mostly one and the same.

Psychologically speaking, the mask represents our fears. The very sight of one can make us wonder whether it is being worn to prevent the spread of illness from an infected person or to avoid contracting it. For me, wearing a mask makes me feel safer, but it is also a constant reminder of the risk I take to care for patients. Literally every time I don the mask, I wonder what my future holds -- will I get sick? if so, will I be one of the lucky ones to make it through unscathed? Or alternatively, will my worst fears be realized?

Even though the ubiquitous use of masks has made us somewhat of a faceless society, it has redefined us in ways that go beyond the surface. Black or white, brown or yellow, healthcare provider or average citizen, I believe as humans we should be united, not divided, behind our masks, like superheroes going into battle against a common nemesis. Our strength is in realizing the importance of sticking together and recognizing our individual roles in advancing the common good. With our masks we will win this war and I for one will never again look at a mask the same way.