Somehow I expected a pandemic to be louder

Somehow I expected a pandemic to be louder. Explosions, screaming, sirens ? dramatic sounds to let everyone know that Something. Bad. Is. Happening.

But this pandemic is silent.

The streets of New York are eerily quiet. I hear the sounds of birds chirping as I make my way to work ? I am a doctor in the NYU emergency department. The subways are nearly empty. I look around at the remaining passengers and note that few are wearing masks or other protective clothing. They sit quietly, almost serene.

People who are struggling to breathe do not talk. They do not make noise.

I arrive at the hospital and am again struck by the lack of noise. Gone are the crying children and loud sounds of chatter. The usual trauma, headache, and abdominal pain patients have virtually disappeared. No one who can avoid the emergency room comes here now. Only the respiratory patients come. One after another ? all with the same symptoms.

?Fever and respiratory distress.?

People who are struggling to breathe do not talk. They do not make noise. Each day more of the emergency department is converted into respiratory isolation units to care for them. The remaining patients with broken bones or chronic illness get shuffled to smaller and smaller sections of the department to make space for the expanding colony of those with respiratory distress.

The doctors and nurses caring for them quietly discuss whether and when to intubate. The sickest among them get quickly sedated, intubated, and sent to intensive care. Transport teams whisk them away in silence. There are no family members to talk with or comfort them. Visitors are not allowed in the isolation units.

The medical staff who get sick develop symptoms after they?ve gone home ? invisibly. I hear about who is ill from the remaining nurses and doctors. We whisper about it at the work stations. We hear rumors of which colleagues have been admitted to the hospital for ?fever and respiratory distress.?We scroll through the boards and remark in hushed voices about which of the patients admitted yesterday are still there and which ones have been taken off the ventilators.

It is now spring.

The sky is blue, trees are budding, and the parks fill with blooming flowers. As the weather gets warmer, I am reminded of years ago when I first learned to recognize a person who is drowning. Drowning is silent. There is no splashing. No cries for help. Every breath is precious. None can be spared.

This pandemic is silent.