When we face extraordinary difficulties, we are called to tap reservoirs of talent that we have stored for times like this. Even as we have idled activities in the classrooms and laboratories and suspended many elective clinical procedures on our physical campus, the Anschutz Medical Campus community has mobilized in ways that demonstrate courage and compassion, dedication and intelligence. I would like to recognize members of our campus community who are demonstrating these skills in abundance and are preparing us to meet the challenges we will face in the days ahead.
Marc Moss, MD, professor of medicine and head of the Division of Pulmonary Sciences and Critical Care, did an outstanding job representing the University of Colorado School of Medicine at a news conference Monday, March 30, with Colorado Gov. Jared Polis. Marc was called by the governor’s office to offer the expertise needed to emphasize the gravity of the pandemic we are facing.
The extensive media coverage of Marc’s comments hopefully will resonate, particularly with those who haven’t been as conscious of the social distancing advisories. “The COVID patients we are treating are on average in their 40s and 50s and some are as young as 19 years old,” Marc said. “Many of these patients were healthy with no other preexisting conditions. This pandemic can affect anyone.” Thanks to Marc and everyone in the critical care work force who are on the front lines facing the demanding increase in the number of patients who need our care now. As providers of care and as employees of the state of Colorado, we are fulfilling our commitment to serve the needs of our community by responding to state officials when they ask us for help and guidance.
Tyler Anstett, DO, assistant professor of medicine in the Division of Hospital Medicine, and Kasey Bowden, MSN, FNP, assistant professor of medicine and associate clinical director of hospital medicine, have been helping in efforts to prepare providers who mostly work in outpatient clinics for shifts in the hospital. More than 100 physicians and advanced practice providers have heeded that call to serve. Richard Altman, MD, an assistant professor of medicine who usually works in a primary care clinic, told Colorado Public Radio that it’s like “getting back on the bike and riding it.” The team already has the solid clinical skills they need, they are brushing up on workflows and technology to be able to pedal the bike efficiently. Thanks to all who are joining the effort and to Tyler and Kasey for helping to steer.
Members of the CU Anschutz Campus community from near and far have been making significant contributions to meet the equipment needs of our clinicians. Tyler Johnson, a second-year student in the School of Medicine’s Modern Human Anatomy program, jumped to action when our campus laboratories closed. Using printers that he took to his home from the lab of Caley Orr, PhD, assistant professor in the Department of Cell and Developmental Biology, Tyler has produced headbands for 35 protective face shields as part of the make4covid consortium. Caley said, “We’re just one of the cogs in the wheel doing our little part.” Kudos to Tyler and Caley for their resourcefulness and to all who have joined the make4covid effort.
In another example of the CU Anschutz community coming together, Richard Spritz, MD, professor and director of the Human Medical Genetics and Genomics Program, said one of his former trainees, Mao Li, PhD, who is now an associate professor of dermatology at a hospital in China, recently purchased and shipped a case of 500 sterile surgical masks for use here. Last week, Mao emailed Rich and said he was shipping another 4,000 masks to our campus at his own expense.
Seventeen medical students and seven members of the School of Medicine education leadership team met the challenge of teaching during this crisis by creating a new elective course about the COVID-19 pandemic response that is now listed in the resource collection posted at the iCollaborative website of the Association of American Medical Colleges (AAMC). Course modules focus on virology, epidemiology, and clinical management. Materials consist of select readings, videos, podcasts, websites, and key resources. To ensure medical students are active participants in responding to the pandemic, community service is a required portion of the course. A full description and list of the authors is posted at the University of Colorado School of Medicine COVID-19 Pandemic Response Elective Course page at the iCollaborative. Shanta Zimmer, MD, senior associate dean for education and professor of medicine in the Division of Infectious Diseases, and Chad Stickrath, MD, associate professor of medicine in the Division of Internal Medicine, are the course directors, and Aimee Bernard, PhD, assistant professor of immunology and microbiology, made sure our team’s work was shared by the AAMC. I would encourage you to check out the iCollaborative site to see the impressive roster of authors.
Several of our faculty are working on the standards of care to guide providers through potentially difficult decisions. Matthew Wynia, MD, director of the Center for Bioethics and Humanities, explained to The New York Times last month, it is a critical duty to prepare now for an awful predicament – critical shortages of equipment such as ventilators in a time of overwhelming need. “It would be irresponsible at this point not to get ready to make tragic decisions about who lives and who dies,” Matt said.
Many other experts are also putting in extra effort and thought into what we should do if the course of COVID-19 proceeds as projected. Two of those experts are Darlene Tad-y, MD, associate professor of medicine, and Stephen Cantrill, MD, an emergency medicine specialist at Denver Health and visiting associate professor of clinical practice of emergency medicine for CU School of Medicine. In 2018, Stephen helped write the Colorado Crisis Standards of Care. Darlene, who serves on the Governor’s Expert Emergency Epidemic Response Committee in her role as vice president of clinical affairs for the Colorado Hospital Association, explained in a Denver Post article: “There may be dire circumstances where our resources are unable or are insufficient to provide optimal care to everyone. Should we reach that moment, I hope community members will feel we have done our due diligence in using the utmost sense of fairness and ethics in what we write.”
The Institute for Health Metrics and Evaluation (IHME) at the University of Washington released COVID-19 projections for hospital resource use in the United States and for each individual state, based on social distancing measures continuing until the end of May 2020. While precise peak dates and mortality rates of such projections are certain to be off target, the modeling forecasts show that the path will continue to challenge our health care system and requires continued vigilance to mitigation efforts to keep the rates as low as possible. The Colorado Department of Public Health and Environment yesterday released its COVID-19 modeling data, which was produced by a team led by the Colorado School of Public Health. Those models offer a range of numbers that are based on different rates of infection and multiple scenarios of effectiveness of social distancing.
The Department of Medicine Grand Rounds last week offered a snapshot of where we are now in terms of the modeling, clinical understanding, treatment, and research into understanding the virus and potential therapies. The speakers were Jonathan Samet, MD, MS, dean of the Colorado School of Public Health; Eric Poeschla, MD, head of the Division of Infectious Diseases; Steven Johnson, MD professor of medicine; and Thomas Campbell, MD, professor of medicine. To watch the presentation, the department has posted a video link.
ECHO Colorado has developed COVID-19 Just-In-Time ECHO For Primary Care to provide up-to-the-minute information and to answer questions about COVID-19 to support primary care practices and safety-net practices across Colorado. Three times each week, a panel of public health, clinical, and pharmacotherapy experts provide updates on testing locations, offer assistance on transitioning to telehealth, discuss de-identified patient cases, and debunk myths around medication management. The sessions include time for a Q&A and case review discussions. These free hour-long sessions will be held on Mondays, Wednesdays, and Fridays at 7 a.m. ECHO, which stands for Extension for Community Health Outcomes, is a significant way that the University of Colorado reaches out to provide care in communities across the state. All Colorado health providers are eligible to participate. ECHO Colorado is presenting the COVID-19 Just-In-Time ECHO For Primary Care sessions in collaboration with the Department of Family Medicine, the Division of General Internal Medicine, the Skaggs School of Pharmacy and Pharmaceutical Sciences, the Colorado Academy of Family Physicians, Denver Health, and CU Medicine. Registration is available online.
Coloradans can have confidence that the Anschutz Medical Campus community is putting all skills to work to that provide comfort and care for the people we serve and to explore better ways to treat COVID-19. We trained to face difficult times and we are ready to meet this challenge.
The MSGratitude project was launched by medical students at the CU School of Medicine to focus on medical student wellness during the COVID-19 pandemic. Students are invited to share pieces of gratitude, reflection, and art on a Twitter account @GratitudeMS created last month. Last Friday, the MSGratitude project posted a video of medical students from schools across the country expressing their thanks to intensivists, advanced practice providers, lab techs and phlebotomists, security services, hospitalists, social workers, nurses, respiratory therapists, janitors and custodial staff, volunteers, physical therapy and occupational therapy staff, specialists in infectious disease, emergency department staff, pharmacists, palliative and spiritual care providers, and dining services. It is an excellent reminder of how big the teams are and how we must depend on one another. CU medical students Vincent Fu, Ryan Friedman, Andrew Isaac, and Andrew Tannous are among those in the video and Joe Fuchs worked behind the scenes on the script and format.
To manage the stress that we face, three of members of our Department of Psychiatry, Helen L. Coons, PhD, Steven Berkowitz, MD, and Rachel Davis, MD, offered advice that is posted by the American Psychological Association. The Department of Psychiatry also has posted on its website many resources to provide support.
There are several websites with information and resources for members of the CU Anschutz Medical Campus community:
School of Medicine COVID-19 Informational Resources: https://som.ucdenver.edu/COVID-19
Coronavirus Research Guidance: https://www.cuanschutz.edu/coronavirus/research-guidance
Anschutz Medical Campus updates: https://www.cuanschutz.edu/coronavirus
Division of Infectious Diseases: https://medschool.cuanschutz.edu/infectious-diseases/information/ncov
As we face the mounting pressure and continuing demands of the pandemic, we should remember to rely on one another for support. Focus on the greatest good you can do and don’t waste effort on distractions. Trust your colleagues, ask for help, take a break when you need one. Do your part.
Have a good week,
John J. Reilly, Jr., MD
Richard D. Krugman Endowed Chair
Vice Chancellor for Health Affairs and
Dean, School of Medicine