By Stacey E. Rosen, MD
As a longtime practicing cardiologist in New York, I made it my mission to advocate for a new standard in women’s health.
Gender disparities in research, misconceptions and a lack of understanding of gender-specific risk factors, symptoms and treatment responses, coupled with societal factors, have caused women to be largely overlooked in the past when it comes to understanding how cardiovascular disease impacts us differently. And the reality remains, cardiovascular disease is the No. 1 killer of women annually. It claims more women’s lives than all forms of cancer combined1.
When I entered the medical field over 30 years ago, I knew it was time to change the antiquated system, which created disparities in health outcomes for women. I have taken a sex and gender-based approach to care for women, collaborating with patients to teach them how to become better champions for their health. We must never sit quietly when it comes to our wellbeing and we must always be educated advocates for our health, and the health of our families.
Yet we are not operating in normal times and need to listen to our bodies now more than ever. The coronavirus pandemic tilted the world, the healthcare system and my own life on its axis.
In March, I was splitting my time treating patients and otherwise working from home and knew it was time to bring my son home from his small New York City apartment so we could quarantine together. The city was on lockdown. Driving into the city was eerie and unlike anything I had seen. But that was only the start of our personal nightmare.
COVID-19 hit home shortly thereafter starting with my son; my initial instinct was to dismiss the warning signs. When he complained of body aches, I minimized the symptoms out of a maternal need to protect him, refusing to believe what might be going on. My son’s symptoms advanced from body aches to high fever. I sprang into action and urged him to be tested. That evening his swab came back positive for coronavirus.
COVID-19 then came for me. Five days after my son’s diagnosis, I woke up with fever and chills and tested positive. My husband tested positive for the virus after experiencing a sore throat, leaving only our daughter – a college senior mourning her loss of all that senior year had promised her.
My family was diagnosed with a virus unlike anything I have ever seen, and as someone who is self-diagnosed as a “Type-A” personality, it felt like our world was out of control. I could barely stand to take a shower and kept asking myself how this could be happening. We were miserable. It took over four weeks for us to fully regain our health. To add to my worries, our older daughter was working as a medical intern in a Brooklyn hospital overwhelmed with COVID-19 patients.
Dealing with COVID-19 was not only physically grueling, it was mentally exhausting and took a toll on all aspects of my life. I continued to put the health of others before my own as many women do, neglecting the time I needed to heal so I could better care for the people in my life: my husband, son and amazing patients.
As a mother and wife, like many women, we have this preconceived notion that we must be the “wonder women” for our families. COVID-19 prevented me from being the perfect caregiver to my son and husband while they were sick.
Professionally, it prevented me from treating my patients on a consistent basis until I was well enough. I knew my large patient population may be at a higher risk for contracting the virus and with overcrowding at the hospitals I worried about the potential catastrophes should anyone develop COVID-19. I tossed and turned at night thinking about the challenges they would face to effectively manage their health during lockdown as I was not there for them as usual. Looking back, I am relieved my family was sick during the onset of the New York outbreak when we did not know some of the terrible complications of COVID-19. Complications we still do not have answers for, and that researchers are continuing to study.
What I learned as a professional: COVID-19 is not influenza. This is an extraordinary virus and there is a frightening limit to what we understand at present.
While the data on gender and COVID-19 is still too limited to draw conclusions, my husband and son both experienced intense side effects that I did not. I was fascinated by the variety of symptoms we each faced. My husband’s night sweats were terrifying. My son had horrible headaches. Early data do suggest that men experience poorer outcomes than women.
COVID-19 energized my passion for research and my devotion to patient care – I am not going to take a back seat when it comes to learning more about this virus. We need more research focused on COVID-19 and its complications so we can enhance our gender-based science and empower professionals to find better solutions for women who have contracted or may be at risk for COVID-19 – especially women with chronic heart conditions.
Nearly 45% of women age 20 and older are living with some form of cardiovascular disease2 placing them at a potentially greater risk for serious complications from COVID-19. Women, especially women of color, are more likely to be caregivers for older parents, young children, and those who may be infected with COVID-19. Prevention and self-care for women is critically important and women living with heart disease and stroke should know and manage their risk. Not ignoring new symptoms or changes in how we feel is more important now than ever.
Most importantly, people must stop avoiding hospitals, emergency rooms and other health care facilities to ensure lives are not lost or profoundly changed due to lack of treatment, especially for emergencies such as heart attack and stroke as well as the management of chronic, underlying conditions that raise the risk of contracting COVID-19. If you are experiencing symptoms of heart attack or stroke, a hospital is the safest place for you to be. Heart attacks and strokes are still medical emergencies and you can safely access care by calling 9-1-1. Also, management of chronic conditions like high blood pressure and diabetes has to be a priority at this time.
I am proud to volunteer for organizations like the American Heart Association (AHA) during times of crisis to help spread valuable health information and reach women with the resources they need to empower them to take charge of their wellbeing and continue to care for their families. The AHA fast-tracked a special $2.5 million fund for rapid response scientific research projects to investigate the specific cardiovascular implications of COVID-19 that can demonstrate results quickly.
I implore women to take a more active role in unlocking the scientific solutions for COVID-19 through Research Goes Red. The AHA’s signature women’s initiative, Go Red for Women, and Verily’s Project Baseline launched a survey through Research Goes Red on COVID-19. This survey will assess the top concerns women have related to the health, social, economic, and emotional impact COVID-19 has had on their lives whether they have contracted COVID-19 or not. The survey results will be reviewed by the Go Red for Women Scientific Advisory Committee and will help determine future scientific research.
While this was not the year I anticipated, I did celebrate my 35th anniversary commemorating my graduation from Boston University School of Medicine. Reflecting on this milestone during graduation season, I am reminded of the countless young doctors in the U.S. facing the uncertainty of the medical education system, anxiety and concerns during the pandemic, even as they embrace the new opportunities that this major paradigm shift is providing.
I applaud the students who decided to graduate early and move onto the front lines to care for patients, perhaps sooner than they were prepared for or not on their planned career path. I want to encourage the young researchers, especially the female researchers, who have quickly pivoted to continue to explore and investigate the difficult questions that must be answered regarding sex and gender’s impact on health.
We need to empower more women to find health solutions for women amidst COVID-19. My journey with this virus reinforced my passion to inspire the next generation of female doctors and researchers to continue to study gender-based science so we can improve the health of all women. Women only account for 25% of jobs in science, technology, engineering, and mathematics (STEM) fields – and we cannot stand for that anymore. Even my own field of cardiology, continues to attract far too few women.
To the young female doctors out there, as you find yourself immersed in an unprecedented health crisis that is shocking to even veteran health professionals, like myself, take care and be safe. You are helping find solutions for the women of tomorrow so we can beat COVID-19 and its complications for heart disease and stroke patients. Thank you for all you do.
Stacey E. Rosen, MD, FACC, FACP, FAHA
Senior Vice President, Women's Health
Katz Institute for Women's Health
Partners Council Professor of Women's Health
Professor of Cardiology
Donald and Barbara Zucker School of Medicine
American Heart Association and Go Red for Women Volunteer Medical Expert
2Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics - 2019 update: a report from the American Heart Association. Circulation. E259. https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000659 Published January 31, 2019