For Millerton doctor: a second plague in one career and one lifetime

This is the second of two articles on Dr. Kristie Schmidt; the first ran in the March 26 Lakeville Journal and Millerton News.

MILLERTON — It will get better, but not before it gets worse. That message from global health experts describing COVID-19 is eerily familiar to Kristie Schmidt, a Millerton internist who several decades ago found herself on the frontlines of a pandemic the likes of which the world had never seen: HIV/AIDS.

The then-unknown disease — which brought with it pneumonia, cancer and other killing illnesses — confounded doctors and devastated the gay community.

Back in the mid-1980s, as a  young woman, Schmidt traveled east from her home in California to attend New York Medical College, a private biomedical health sciences college in Valhalla, N.Y., from which she graduated in 1989.

She next landed at St. Vincent’s Hospital in New York City’s West Village, which had one of the first and largest AIDS wards on the East Coast at the time; and later at a clinic in the East Village focusing on primary care and HIV medicine.

Dangers for doctors

As a med student and then medical resident, she found herself at ground zero of the AIDS epidemic, treating patients who were dying in alarming numbers from an unknown infection. It took about a year before they uncovered its cause: the human immunodeficiency virus, HIV.

Despite the fear of exposure to HIV she and her peers faced — from needle pricks and fluids — today’s health care workers, said Schmidt, face a “much higher” risk of infection with COVID-19, “especially with the shortage of appropriate personal protective equipment.”

However, the consequences of infection, said Schmidt, are much different. “AIDS was a death sentence in the 1980s and up to the mid-1990s. It is now treatable, although essentially not curable, and there is still no vaccine.”

COVID-19, on the other hand, said Schmidt, “is what we call ‘self-limited,’ meaning if it doesn’t kill you, your immune system will eradicate it.” An estimated 20 percent of COVID patients will become sick enough to be hospitalized, said the internist, who now has her practice in Millerton. And, she said, an estimated 1 to 3% will die.

“This mortality rate is about 10 times higher than influenza.”

HIV/AIDS and COVID-19

The two plagues do share similarities, she said.

“Our governments and health care systems at the time both failed to respond to the crisis proactively in a way that could have averted significant suffering and death,” said Schmidt.  “Both Reagan and Trump could have advocated for better public health measures like education about prevention” on issues like safe sex and use of condoms during the AIDS crisis; and social distancing, hand-washing, and use of gloves and masks for COVID-19 prevention.

Both administrations also used the epidemics to stigmatize, rather than focus on solutions, said Schmidt, by referring to them as “the gay plague” and “the Chinese virus.”

Furthermore, she added, “President Trump is only now, at least two months too late, offering medical advice that he is not competent to give. He is providing such a wealth of misinformation that he is going to increase the damage and suffering that we will have to endure.”

The death toll from AIDS, said Schmidt, remains significant. In 2018, about 1 million people died of AIDS-related illness worldwide and 32 million have died since the onset of the epidemic, according to UNAIDS statistics. And while the infections can be prevented, an estimated 38,000 new HIV infections still occur in the U.S. annually, according to www.HIV.gov.

Dr. Anthony Fauci

Although Schmidt never worked directly with noted immunologist Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a respected member of the White House Coronavirus Task Force, his presence at televised briefings brings echoes of the past for Schmidt.

Fauci played a critical role in identifying, and ending, the global AIDS crisis.

“I think he’s doing a good job,” she said of his work on COVID-19. “But at some point I think he is going to have to more aggressively defend his belief system based in epidemiology and evidence-based medicine.”

As deadly as the AIDS epidemic was, the internist said she believes COVID-19 will have a greater impact on the psyche of the general public because it doesn’t discriminate.

“It is an equal opportunity infector, and it’s much easier to catch. If the exponential curve of COVID infections continues to double every three days in the U.S. as it has, there would be 100 million cases by July, according to the Washington Post,” said Schmidt.

“Strict social distancing will reduce the numbers of infected people and will save lives if it will keep our health care system from being overwhelmed until perhaps a vaccine is available.

“But I feel that as Americans we are not very good at accepting limitations on our freedom, and therefore we may be hit hard.”

COVID-19 test was negative

In Part One of this article, which ran in the March 26 edition, Millerton physician Kristie Schmidt said she had been ill with a fever and was working from home while awaiting her COVID-19 test results.

Those results have since come back negative, she said via email on Sunday, March 29. She will, however, continue to see patients primarily via telemedicine.

Schmidt said despite the confirmation that she had not contracted COVID-19, she does not find the news totally reassuring. “The sensitivity of the test is 50 to 80 percent, so it’s kind of a coin toss. I feel fine, but my practice will be mostly remote at this point. My office is actually being closed temporarily due to staff shortages elsewhere and if I need to see a real live human in the office it will probably be in Sharon, not sure where. The situation is changing by the day.”

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