Tag Archives: Covid-19

400,000 lives lost – finally a national strategy

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On December 14 with the first frontline workers in the U.S. starting to receive the vaccine there was great optimism and hope that we had entered a new chapter of this pandemic. But six weeks later over 100,000 more people have died of COVID-19 and only 16.5M of the total 36M vaccine doses distributed have been administered. 5% of the U.S. population has been vaccinated though only 2.1M people have received the full two doses.

On Tuesday night, on inauguration eve, the new administration held a National Moment of Unity and Remembrance. A simple ceremony in front of the Lincoln Memorial to mourn and honor the over 400,000 people who have lost their lives to COVID-19 in less than a year. President Joe Biden and Vice President Kamala Harris spoke briefly, an ICU nurse from Michigan sang Amazing Grace, and 400 beams of light were lit up along the reflecting pool in front of the Washington Monument – one for every 1000 lives lost. Across the country bells tolled and buildings were lit up. It was a simple yet moving and much needed moment for all of us.

Five hours after President Biden took the oath of office on Wednesday, he was signing his first set of executive orders. Three of them including the very first were directly aimed at the pandemic – “100 days masking challenge”, rejoining the World Health Organization (WHO), and creating the position of COVID-19 response coordinator. Dr. Anthony Fauci is the U.S. representative to the WHO executive board and joined his first call on Thursday. Jeff Zients, who served as chief performance officer under President Barack Obama and led the rescue of HealthCare.gov, has begun his work as the COVID-19 response coordinator. Zients is “ready to manage the hell out of it”, as Biden said last Friday.

The new administration is getting right to work, and the pandemic is a top priority. A National Strategy for the COVID-19 Response and Pandemic Preparedness was released yesterday. Continue reading →

8 health experts to follow

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In past years, I’ve used the end of the year mark as a way to highlight my most read blogs of the year and encourage you to check them out if you missed them. But who cares about my most read blogs? Instead, I want to amplify the voices of health experts who have educated us throughout this pandemic and who will continue to for many months to come. If you aren’t already following them on social media or listening to their podcasts, I encourage you to do so. They are often interviewed on the major news programs.

Trusting the science, knowing the facts, and maintaining objectivity are critical for all of us to do our part and get safely to the other side of this pandemic.

Here are the experts I recommend you follow in alphabetical order:

Esther Choo, MD, MPH, Co-Founder, Equity Quotient, is an emergency physician and professor at the Oregon Health & Science University. She has been speaking from the front lines of the pandemic since the beginning. She did a podcast series called Doctors’s Log – A Covid-19 Journal in the early months of the pandemic. Twitter: @choo_ek

Laurie Garrett is a Pulitzer Prize winning science journalist and author of several books including “The Coming Plague: Newly Emerging Diseases in a World Out of Balance” and “Betrayal of Trust: The Collapse of Global Public Health”. In 2007, she did a TED talk “Lessons from the 1918 Flu”.  Twitter: @Laurie_Garrett

Ashish Jha, MD, MPH, is an internationally respected expert on pandemic response and preparedness. He recently left his position as faculty director of the Harvard Global Health Institute and became dean of the Brown University School of Public Health.  His recent interview on In the Bubble with Andy Slavitt, “The Next Three Stages of COVID-19”, is worth checking out. And as I just learned, he also has his own podcast series, “COVID: What Comes Next”. He is a frequent contributor on all the major news outlets. Twitter: @ashishkjha

Vivek Murthy, MD, MBA, has been nominated as the next U.S. Surgeon General, a role he also served in during the Obama Administration.  He is the co-chair of the Biden COVID Task Force. His recent interview on in the Bubble with Andy Slavitt, “Inside the Biden COVID Task Force”, is worth checking out. Twitter: @vivek_murthy

Michael Osterholm, MS, MPH, PhD, is the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota and is a world-renowned epidemiologist who has spent his career investigating outbreaks. He is a member of the Biden COVID Task Force. Continue reading →

V-Day – With the vaccine comes hope

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The UK administered the first fully tested and approved COVID-19 vaccine this week. The U.S. could be administering the vaccine as early as next week. There is hope!

Projections are that by summer 2021, most everyone in the U.S. who wants a vaccine will be able to get it. There is hope!

The Biden Administration’s health team has been announced. There will be a new reliance on clinicians, scientists, and public health experts. There is hope!

And yet, the challenges are many. To name just a few: overall supply vs demand, distribution logistics and storage, logistics of administering the vaccine, establishing guidelines for prioritized groups to receive it, ensuring both doses are administered at the right time interval, and of course public trust in the vaccine.

As I have read and listened the past week, I have learned how the free market impacts the availability of key components for the manufacturers, that each state can decide on their group priorities after the CDC publishes the guidelines, and that only about 60% of the population say they are willing to take the vaccine.

On a more encouraging note, I have heard how provider organizations have been developing their vaccine administration plan for months and how a leading pharmacy chain is planning to scale administration across their 10,000 locations and has an app ready to go for tracking patients, scheduling appointments, and sending reminders for the second dose.

I encourage you to check out these resources to understand the issues involved:

In the Bubble with Andy Slavitt podcast – Toolkit: Where and When Can I Get the Vaccine? He talks about the science with Dr. David Agus and the logistics with CVS Health’s Tom Moriarty. Together they answer questions from listeners.

Interview with Dr. Atul Gawande in the New Yorker by David Remnick – Atul Gawande on Coronavirus Vaccines and Prospects for Ending the Pandemic. It covers a lot of ground and Dr. Gawande is as insightful here as he is in his regular New Yorker pieces and many books. Continue reading →

Well past time to support our healthcare workers – Part 2

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I knew that Governor Gina Raimondo had announced a two week pause starting November 30th and that there were growing concerns about hospital capacity here in Rhode Island. But when I got this alert pushed to my phone Monday morning like everyone else in the state, it became very real again.

I knew there was discussion about opening a field hospital in Rhode Island. But when I saw that the lead story on one of the national morning news shows was an interview with the field hospital director on opening day December 1st, it became very real again.

I knew that our ED at the largest hospital in the state was at a breaking point as I have been following Dr. Megan Ranney closely on social media in recent weeks. But when I heard her describe what it is like in the ED on this week’s In the Bubble podcast with Andy Slavitt – “Following One Shift in the COVID-19 Unit”, it became very real again. Listening to her describe mentally getting ready for her shift, donning and doffing layers of PPE that is worn the entire shift, assessing and admitting very sick patients, calling families with updates, and heading out the door with her physically exhausted co-workers at the end of a long shift, I came to appreciate even more what our frontline healthcare workers are doing 24×7 in hospitals across the country.

I am not a denialist. Quite the opposite. I have taken this virus seriously since the start. I wear a mask whenever I’m out and can’t be socially distanced. I keep a journal of all our outings and contacts. I have the Crush Covid RI app that includes a location tracker diary for the past 20 days on my phone. I have watched many news stories, read many articles, and listened to many podcasts in the past 9 months. I feel very educated and informed. And at times, I feel very sad – so many stories have brought me to tears.

When I hear about new restrictions in my state, I typically tell my husband no change for us, we’re already living that way.

But it hit me different this week. Continue reading →

With gratitude – yes, even in 2020

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Difficult as 2020 has been, it is my hope that each of us can find something to be grateful for this Thanksgiving. If you have lost a loved one to COVID, I know that no words can take away your pain and grief. If you are a “long hauler”, I hope that you are finding support from others as you navigate your ongoing health issues. If you have lost your employment due to the economic downturn, I hope you are finding support from your network to find a new job.

Many times, during the past 9 months I have said to my family and friends – I can’t complain, I’m healthy and alive. I never really felt my age, but since March I have been reminded that I am an “elder”. I am overall healthy with no underlying conditions but I’m in that over 65 group. My husband is 4 years older than me and does have some medical conditions. We have been mask wearers since mid-March and do our best to minimize our risks.

I have much to be grateful for. Healthcare workers caring for COVID patients on the front lines and scientists working to develop a vaccine. All those who support them in ways we see and don’t see. And yes, that includes the IT and HTM teams in every health system who provide solutions and systems that the clinicians depend on.

I am also grateful for all the essential workers – at the grocery store, providing public transportation, delivering packages, and the police and firefighters who protect us.

My family are my big rocks. And that has never been truer than this year. I am eternally grateful for them. Continue reading →

Well past time to support our healthcare workers

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Any graph or heat map you look at, one thing is obvious – the coronavirus is out of control and spreading rapidly. New coronavirus cases have jumped by more than a third in the U.S. over the past seven days, according to data from Johns Hopkins University, the fastest pace since late March. Every day since Election Day, more than 100,000 people in the country have tested positive for the virus with a daily record of over 187,957 new cases last Friday per Worldometers.info. We went from 10 million new cases to 11 million in just one week. And we have lost over 250,000 lives.

We saw heartbreaking stories on the news from ICUs in the Northeast during March and April. Then stories from southern states. And now from hospitals in the Midwest. But when you look at the heat maps, the virus is everywhere now.

Listen to any healthcare worker and one more thing is obvious – they are exhausted and burning out. They tell story after story of how hard it is to work 12- and 18-hour shifts caring for COVID patients only to drive home past crowded bars.

We have seen exhausted physicians and nurses share their stories for months. I cannot tell their stories, but I can share them. And I can encourage you to do the same. But more importantly, I can encourage you to take the basic steps needed at this point – messages we have all heard for nearly 9 months now – wear a mask, socially distance, and wash your hands frequently.

This virus is not a hoax. It is not something you can ignore or deny. A story from a nurse in the Dakotas is the latest to go viral. She describes patients who yell at her and say she does not need to wear PPE because they don’t have COVID, right up until they are intubated.

Our healthcare workers truly are heroes, but they are at a breaking point. Our hospitals are at or nearing capacity. There are over 73,000 people hospitalized with COVID, another record since the pandemic started. Field hospitals are opening again in many states. Continue reading →

COVID-19: The good, the bad, the different

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When it comes to COVID-19, there is little good. But every report that reflects progress is good news. Whether it is progress in how best to treat hospitalized patients, progress towards a vaccine, or the number of new cases, hospitalizations and deaths trending downward. I saw one of those reports just a few days ago when Shereef Elnahal, President and CEO, University Hospital in Newark, New Jersey shared their good news on social media:

“We made it.

For the first time since the #covid19 pandemic started, University Hospital has ZERO patients with coronavirus in house.

After over 1,000 discharges, leading northern NJ’s regional response, and folks in the City of Newark wearing masks, socially distancing, and getting tested, we hit a milestone that we’ve been hoping for since a time when almost every patient in our hospital had coronavirus.

So proud!”

There are probably many more hospital leaders in the Northeast who can finally report this same good news. And they have reason to be very proud of what they and their teams have done for their communities.

But there is plenty of bad. A health crisis with nearly 200,000 deaths and a projection that there could be over 400,000 deaths by the end of the year. An economic crisis with millions unemployed.

Another evolving bad news story is what we are learning about the “long-haulers”. These are people who had COVID-19 and months later report a variety of long-term symptoms. Continue reading →

A different kind of summer comes to an end

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If you were a fan of Downton Abbey and remember the Maggie Smith character, the Dowager Countess of Grantham, you may even recall how she said in her aristocratic way, “What is this thing you call a weekend?”. For the landed gentry of England who didn’t work, what did a weekend mean? For those of you working from home, dealing first with home schooling and then kids on summer break, and with vacation trips cancelled, you may ask the same question. But it’s because every day seems to run into the next during this pandemic.

As we approach the final summer holiday and three-day weekend we know as Labor Day, hopefully you won’t have to “labor” but can actually take a break. In the health systems I worked at, August was the big vacation month – especially in the academic medical centers. When I was CIO at Brigham and Women’s Hospital, one of my VP colleagues would remind us that after Labor Day it is a sprint until the holidays in December. He’d say let your family know how busy you’ll be and be sure to take a break in August somehow.

With a trip to Disney with grandkids and a European trip cancelled this year, my husband and I feel like one day just rolls into the next as I’m sure many of you do. I’ve written in the past about the importance of making time to reboot and the 6 R’s of summer. But this year is different. I only hope that all of you and especially those on the front lines of this pandemic have found time for a much needed and well-deserved break, somewhere, somehow.

If you are feeling overwhelmed at times, this article by Tara Haelle may resonate with you – “Your ‘Surge Capacity’ Is Depleted — It’s Why You Feel Awful”. It describes our personal “surge capacity” and how to manage through these times. Continue reading →

Healthcare leaders continue to learn and share lessons

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Virtual learning opportunities have increased significantly in the past few months as healthcare leaders are eager to learn from the experiences of others or share their own lessons during this pandemic. There are far more webinars, live sessions, and interviews than I have seen in the past. Most of these sessions are recorded so you can listen or watch when you have time. The trick is to register – if you end up not being able to join at the scheduled time at least you will be sent the archive link. And of course there are always podcasts – so many good ones as I have recommended in previous posts.

This week, there is yet another virtual learning opportunity that I am excited about joining – the HealthIMPACT Live’s Summer Forum. I have participated in their previous in-person forums and found them to be very thought-provoking programs with top-notch speakers on relevant topics. With limited attendance, there is always plenty of opportunity for dialogue. The forum organizers have pivoted and are promising a great virtual experience. The topics are very timely and divided into four parts over two afternoons:

Part I: Your People – Healthcare Workforce Reimagined – From Crisis Management to System-Wide Transformation

Part II: Your Processes – Sustaining Gains in Telemedicine and Virtual Care Delivery- Building on Successes and Lessons Learned Connecting Patients and Providers in Response to COVID-19 Continue reading →

Staying fit and informed

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If you are working from home during this pandemic, getting enough exercise each day can be a challenge. I spoke to a CIO colleague recently who said he used to get 10,000 steps a day just at work given the size of his office complex.

I recently decided that I needed to up my exercise routine to ensure I get 10,000 steps a day. A long dog walk at the end of the workday plus the steps inside my house from my home office to the kitchen and back are just not enough. While I have never been an early morning exerciser, I am now two plus weeks into a new routine. Instead of rolling out of bed and starting on email and work right away, I now go for a brisk walk. I try to do a minimum of 30 minutes but depending on the time of my first scheduled call of the day, I do anywhere from 20-45 minutes. The end of day dog walk rounds it out to ensure I hit my 10,000 steps.

Besides the physical and mental health benefits of more exercise, I also have more time to stay informed via podcasts. A few weeks ago, I wrote about my latest podcast recommendations. With my new exercise routine, I am ready to recommend two more:

The Osterholm Update: COVID-19 – If you had not heard of Dr. Michael Osterholm pre-COVID, you probably recognize his name by now. Continue reading →