UCSF Division of Geriatrics Weekly Updates (3/27/2020) from Chief Dr. Louise Walter
As we reach the end of our second week of sheltering-in-place, here is the second Geriatrics Division Weekly Update to keep everyone more informed about what is happening across the Division. While things are constantly changing, it is heartening to see all the ways the Division is stepping up to help elders during this pandemic. Below is a summary of the updates we heard during our Geriatrics Division-Wide Meeting on 3/25/20.
UPDATES ACROSS THE DIVISION
UCSF outpatient programs: We are now admitting patients to Care at Home using telemedicine visits. However, many homebound patients are not telehealth capable. We are working to provide more Grand Pads to be able to do more telemedicine visits and keep people out of the hospital. We are conducting COVID-19 testing in the home and wellness checks on all Care at Home patients to make sure their needs are being met, collaborating with our community partners. The UCSF Center for Geriatric Care (UCGC) is conducting telephone visits first to decide who would benefit from an in-person visit. Pei Chen is working with UCSF medical students to call elders to help them learn how to use Zoom so they can receive telemedicine visits. Leah Witt is reviewing UCSF dot phrases and Laura Perry is reviewing clinical algorithms to enhance Geriatrics content. Carla Perissinotto is on the SNF/ALF/COB task force and the University of California Office of the President (UCOP) COVID Resource Scarcity task force.
UCSF inpatient Programs: Our ACE unit remains halted on 15L, which is now a closed COVID-19 unit. We continue to run Mobile ACE to assist older adults on all units of Moffitt-Long hospital. All adults age 80 and older are now getting Geriatrics Consultations. Todd James is on the UCSF Guidelines Task force, which provides guidance about algorithms, ethics, remote consultations, etc. Our inpatient workforce is healthy.
San Francisco VA: The Community Living Center (CLC) has no COVID-19 cases and is moving patients to prepare one wing of the CLC for the surge to off-load the hospital. Home Based Primary Care is using mostly telephone/tele-video visits with a few in-person home visits. Kathryn Eubank (representing the Ethics Committee) and Eric Widera (representing Palliative Care) are on the VA Scarce Resources Allocation Committee. Anne Fabiny and Michi Yukawa are on the VA Surge Planning Committee. The VA now has daily, 24hr turnaround COVID-19 testing. We also have new gel dispensers on the 2nd floor Bldg 1.
ZSFG: All specialty care clinics, including Geriatrics, have transitioned to telephone visits. Meredith Greene is providing telephone visits to older adults with HIV, many of whom have been triggered by this current pandemic, reactivating the trauma of the AIDS epidemic.
EDUCATION: Fellows’ clinics have shifted to telemedicine and all our didactic learning continues on Zoom. First-year medical students have been sent home and continue remote learning on Zoom. Third- and Fourth-year students remain part of the clinical workforce. Students are providing friendly visitor calls to Veterans at Colma Veterans Village. Anna Chang, Daphne Lo and Edgar Pierluissi are part of the leadership team for a new COVID-19 rotation in which medical students are connected to health system needs. No decisions have been made yet about summer students.
RESEARCH: In-person research activities are on hold. Database and telephone-based research continues. Carla Perissinotto and Ashwin Kotwal received quick IRB approval to study the impact on wellbeing and whether needs of elders in SF are being met during this time of social distancing. Ashwin is available to provide advice about IRBs for COVID-19 related studies. AGS will roll over most meeting content from this year to next year’s meeting but large scheduled plenaries will be available on-line. We are organizing a session to present our AGS research on 5/6 8-9:30pm on Zoom.
GWEP: Anna Chodos is the Geriatrics Lead for the SF Department of Public Health assisting In Home Supportive Services (IHSS) with policies and trainings to enhance safety while they continue to provide in-home caregiving services to vulnerable people, including those who test positive for COVID-19. IHSS is doing wellness checks on all clients, many of whom are disabled and/or have cognitive impairment.
POLICY: Brie Williams’ team is working closely with California Department of Corrections and Rehabilitation to provide guidance about COVID-19 policies and procedures. This includes early release protocols to reduce the size of the prison population. See their Health Affairs blog post: https://www.healthaffairs.org/do/10.1377/hblog20200324.784502/full/
STAFF: All Division staff are now working from home unless they are providing direct patient care. Staff have organized virtual social lunches and are finding ways to adapt to the routine of working remotely.
CLINICAL UPDATES FROM OUR HEALTH SYSTEMS
San Francisco VA: 2 hospitalized cases of COVID-19 at SFVAMC.
UCSF Health: 11 hospitalized cases at UCSF; https://coronavirus.ucsf.edu/
ZSFG: 7 hospitalized cases at ZSFG.
OPTIONAL WEEKLY GERIATRICS DIVISION CHECK-INS
At our Wednesday meeting there was a desire for weekly check-ins for those who are able to attend. These are optional check-ins until our next Geriatrics Half Day on 4/29.
First Check-In Meeting: Wednesday April 1st from 2:30-3:30pm on Zoom
Future meetings will be April 8th, April 15th and April 22nd at same time.
An Outlook email with Zoom details will be sent next week.
MAXINE’S WEEKLY TIPS
Here are 10 tips for dealing with the stress of uncertainty: https://www.apa.org/helpcenter/stress-uncertainty
STOCK UP ON COMPASSION
This is uncharted territory for us all. I thought this was a helpful article about stages of grief and encourages everyone to stock up on compassion for ourselves and others. Everyone has different levels of fear and grief. Please reach out if you need support.
RESOURCES ABOUT COVID-19 AND ELDERS
UCSF has developed a COVID 19 Resources for Older Adults webpage to share resources. Every day we are adding content. If you have content you would like to add to this webpage please send to Sarah Ngo.
If you have other suggestions for maintaining our social connectedness during this time, please email me. Thanks for all you are doing!
Louise
PS: I recently was sent the link to the Monterey Bay Aquarium live cams which are very peaceful to watch: https://www.montereybayaquarium.org/animals/live-cams/