The COVID-19 pandemic through eyes of a NYC fertility center: a unique learning experience with often unexpected results

Abstract

Affecting basic tenets of human existence such as health, economic as well as personal security and, of course, reproduction, the COVID-19 pandemic transcended medical specialties and professional disciplines. Yet, six months into the pandemic, there still exists no consensus on how to combat the virus in absence of a vaccine. Facing unprecedented circumstances, and in absence of real evidence on how to proceed, our organization early in the pandemic decided to act independently from often seemingly irrational guidance and, instead, to carefully follow a quickly evolving COVID-19 literature. Here described is the, likely, unique journey of a fertility center that maintained services during peaks of COVID-19 and political unrest that followed. Closely following publicly available data, we recognized relatively early that New York City and other East Coast regions, which during the initial COVID-19 wave between March and May represented the hardest-hit areas in the country, during the second wave, beginning in June and still in progress, remained almost completely unaffected. In contrast, south western regions, almost completely unaffected by the initial wave, were severely affected in the second wave. These two distinctively different infectious phenotypes suggested two likely explanations: The country was witnessing infections with two different SARS-CoV-2 viruses and NYC (along with the East Coast) acquired during the first wave much better immunity to the virus than south western regions. Both hypotheses since have been confirmed: East and West Coasts, indeed, were initially infected by two distinctively different lineages of the virus, with the East Coast lineage being 10-times more infectious. In addition, immunologists discovered an up to this point unknown long-term anti-viral innate (cellular) immune response which offers additional and much broader anti-viral immunity than the classical adaptive immunity via immobilizing antibodies that has been known for decades. Consequently, we predict that in the U.S., even in absence of an available vaccine, COVID-19, by September–October, will be at similarly low levels as are currently seen in NYC and other East Coast regions (generally < 1% test-positivity). We, furthermore, predict that, if current mitigation measures are maintained and no newly aggressive mutation of the virus enters the country, a significant fall-wave of COVID-19, in combination with the usual fall wave of influenza, appears unlikely. To continue serving patients uninterrupted throughout the pandemic, turned for all of our center’s staff into a highly rewarding experience, garnered respect and appreciation from patients, and turned into an absolutely unique learning experience.

Investigating the impact of asymptomatic or mild SARS-CoV-2 infection on female fertility and in vitro fertilization outcomes: A retrospective cohort study

“…The psychological impact of fertility treatment suspensions during the COVID-19 crisis should also be considered [41] . Numerous fertility centers worldwide were forced to be out of service because of the uncontrolled pandemic [42] . In the post-COVID-19 era, vaccinations against SARS-CoV-2 are likely to become general and essential [43] .…”

COVID-19 infection control protocol and acceptance in an ART in vitro fertilization hospital

“…Such measures have yielded success in infection control comparable to those achieved as a result of our policies. Conversely, some others have experienced difficulty in achieving reasonable protection with their protocols, such as advocating avoidance of travel by public transportation, changing medical staff hours to avoid peak travel times, and prohibiting hospital visits except for the patients requiring ART treatment [ 10 ].…”

The prevalence of SARS-CoV-2 antibodies in triage-negative patients and staff of a fertility setting from lockdown release throughout 2020

“…Most of them are susceptible to the virus and must be shielded even more so as vaccination programs have started to roll out worldwide ( ASRM, 2021 ); it is also possible that vaccine hesitancy will play a role in the ART population ( Dror et al , 2020 ). Risk mitigation strategies in the fertility units must be held in place in the foreseeable future ( ESHRE, 2021 ), alongside constant surveillance of the pandemic and of the growing body of literature in the field ( Gleicher, 2020 ).…”