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Nat Geo’s The First Wave is an unflinching look at the early days of the COVID-19 pandemic, as seen through the eyes of the doctors and nurses at Long Island Jewish Medical Center in Queens, New York, during the first four months of the crisis.
Director Matthew Heineman is no stranger to dangerous filming locations — his Oscar-nominated and Emmy-winning Cartel Land examined the drug trade at the Mexico-U.S. border; his Emmy-nominated follow-up City of Ghosts documented ISIS activity in Syria. But nothing prepared him for the chaos of the COVID-19 front lines.
After the film’s nomination for the Producers Guide of America award for best documentary, Heineman spoke to THR about the difficulties he faced making The First Wave and how he hopes it serves as more than a historical document of COVID’s early days.
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What was the spark that made you say, “I need to make this movie right now”?
Like everyone else [in early March 2020], I was terrified by this potential tsunami that was about to wash over us. We were inundated with stats and misinformation, and I felt this enormous need to try to humanize this issue, to try to put a human face on it. We reached out to hospital systems all across the country, and I finally got access to a hospital in our hometown here in New York. I didn’t want to tell this story from the outside. I want to put people on the front lines, in the shoes of doctors and patients and nurses, to feel what this was [like] up close. One of the biggest tragedies of COVID is the fact that we as an American public were so shielded from the realities of what was happening in hospitals. I think that’s a big reason why the issue became so politicized.
You’ve made films in tense and violent settings before. How did this compare?
It was by far the hardest thing I’ve ever made. It was absolutely terrifying. Having made films in war zones, in foreign conflict zones, there are spurts of danger and terror, but there’s also a lot of boredom, and when you come home, you can somewhat detach yourself. With The First Wave, it was our experience for a long period of time. We were living the same thing we were documenting. You could never ever turn it off. All the things you sort of take for granted about making a documentary, — you know, putting a lav mic on somebody, putting the camera down on the counter; eating, taking bathroom breaks — these are all ways to get the virus and spread the virus. It was, logistically, emotionally, physically … just unbelievably difficult.
When watching the movie, it’s important to realize how far we’ve come. At that point, we knew so little about the virus, how it spread and how it was contracted. We used the best available science at the time to develop safety protocols, but at the end of the day we were still filming in an ICU, in an ER, as people were getting intubated. We basically mimicked what doctors and nurses were doing. We didn’t walk in the hospital with big hazmat suits. We wore scrubs and tried to blend in.
How did you manage to get so intensely close to the subjects without feeling like you were in the doctors’ and nurses’ way?
I want [all my films] to be as intimate and visceral as possible. And this was no exception. With The First Wave, we needed a very, very small footprint. We operated in shifts and two-person teams, often just one camera in a room at a given time. We tried to be part of the fabric of the daily lives of our participants in the film, and obviously the hospital itself. There’s no question that there were some growing pains in the first week. Trust is an access that is earned, not given. Once we got the green light from the hospital itself, we still needed to obviously gain the trust of the participants in the film — and, each day, renew that trust with the hospital itself.

People always ask, “Why do people take part in documentaries?” I think it’s the same common denominator, no matter what the situation is. It’s generally that people want to be understood [and have people understand]what they’re going through. The participants in the film were both the doctors and the patients. For the family members, we were filming on the razor-thin line between life and death. The stakes couldn’t have been higher. We owe so much to them for opening their lives to us. It was such an incredibly difficult time, but I think they felt this needed to be documented. Especially in those early days, we knew that no one had the access that we had. The doctors and the nurses, we found, thought [so many people were] talking about them or talking for them, but no one was actually seeing how they were actually being impacted. People talk about doctors and nurses on the front lines, using sort of wartime verbiage, but we weren’t experiencing that with them. I think that’s a big part [of why these] health care workers decided to partner with us, because they wanted to speak for themselves. They wanted the world to understand what they were going through.
Considering how much information was changing at the time — and how much we have changed in the past year and a half — how do you see this film as a historical document?
I didn’t know exactly where this film would go, or where the journeys of other participants in the film would go. I knew that this is a sort of once-in-a-lifetime story, and that on some level this is a historic record of that time. It was unbelievably difficult, but the weight and the pressure of trying to document this moment, and also the love, compassion and fortitude that we witnessed every day, is what drove us to make this film. Despite the terror of it all, despite the amount of death that we saw every single day, what a privilege it was to be able to document how human beings come together in the face of crisis. As Americans, we have such a tendency to want to move on past things and to try to forget things. Every single person on this Earth has been touched by COVID. We’ve all been changed forever. I really hope this film provides a way in which we can reflect on all that we’ve been through and to meditate on what we’ve learned, and how can we apply that to now and to the future.
Interview edited for length and clarity.
This story first appeared in the Dec. 15 issue of The Hollywood Reporter magazine. Click here to subscribe.
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