UCSF Division of Geriatrics Weekly Updates (4/17/2020) from Chief Dr. Louise Walter
It is hard to believe we are ending our fifth week of sheltering-in-place with our fifth Geriatrics Division Weekly Update about Division happenings. The heartening news for the Bay Area is that models suggest our early social distancing saved over 44,000 lives in the 6-county Bay Area. The number of COVID-19 cases in CA is peaking this week (see link https://covid19.healthdata.org/projections) assuming social distancing continues. Conversations are beginning about what the next phase might look like and next steps. Below is a summary of the updates that have been shared with me this past week.
UPDATES ACROSS THE DIVISION
UCSF outpatient programs: Care at Home continues with mostly telemedicine visits as well as mobile COVID-19 testing at home and at assisted living facilities. Carla is leading a collaboration with our skilled nursing facility (SNF) partners, discussing the most up-to-date guidelines and identifying SNF PPE needs. Also, several Care at Home and Inpatient Geriatrics faculty will be helping to staff a new COVID unit at the San Francisco Campus for Jewish Living (SFCJL) over the next couple months. The details of this UCSF-SFCJL agreement are still being finalized but Geriatrics faculty are taking the lead and Hospital Medicine will fill in any gaps in coverage. Carla was a featured speaker at the 4/14 UCSF COVID Townhall discussing these initiatives. You can listen to this Townhall recording here: https://ucsf.app.box.com/v/Covid19TownHallRecordings
UCSF inpatient Programs: Our inpatient workforce remains healthy. Mobile ACE continues to provide Geriatrics Consultations for all adults age 80 and older on all units of Moffitt-Long hospital. Mt Zion Hospital will open April 29th as a COVID Respiratory Unit, which hopefully means 15L will revert from a COVID Respiratory Unit back to our ACE unit in the not-too-distant future. Todd James is on the UCSF Committee for COVID-19 mass screening. Already there are plans to conduct COVID-19 screening of all surgical patients and those undergoing invasive procedures who receive their pre-operative evaluation at UCSF, with likely plans to expand screening to more patients in the future.
San Francisco VA: Anne Fabiny has started a conversation about how our Geriatrics clinical programs will address Governor Newsom’s six critical indicators that form his framework for thinking about when to modify California’s stay-at-home order. Here is the link to his press release which provides a rough outline of the parameters we will be operating within as we plan for next steps over the coming weeks: http://www.oesnews.com/governor-newsom-outlines-six-critical-indicators-the-state-will-consider-before-modifying-the-stay-at-home-order-and-other-covid-19-interventions/ VA Geriatrics Clinic and HBPC continue primarily telephone and VVC visits. IMPACT continues to collaborate with Primary Care to develop criteria and protocols for home visits for COVID+ or presumed + patients. Eric Widera and Alex Smith have started providing palliative care telemedicine consults to patients in the New York Presbyterian (NYP) Emergency Department as part of a new UCSF Professional Service Agreement with NYP. Other Division faculty (Rebecca Sudore, Ashwin Kotwal and Lynn Flint) are also in the process of getting emergency credentials at NYP to do this. Similar agreements with other New York hospitals are still pending. The CLC continues to be COVID negative.
ZSFG: ZSFG continues to have the greatest number of hospitalized patients with COVID-19 (~25 patients) but the number has decreased from a peak of ~35 patients. Inpatient teams are doing well and the ZSFG ACE unit is full as usual. There are no COVID-19 patients on the ACE unit as an early decision was to not put them on our unit with the most vulnerable patients.
EDUCATION: Fellows’ clinics continue via telemedicine and all our didactic learning continues on Zoom. Evie Kalmar gave Division of Palliative Medicine Grand Rounds on 4/16 titled “Caring for Seriously Ill and Older Patients with COVID-19.” Her talk focused on pro-active advance care planning followed by a panel discussion, including Kana McKee and Natalie Young. Also on 4/16, Carla Perissinotto gave a presentation about COVID-19 in older adults to a national group of assisted living operators who are part of Welltower.
RESEARCH: Mike Steinman, Laura Perry and Carla Perissinotto published a commentary in JAMA Internal Medicine on “Meeting the Care Needs of Older Adults Isolated at Home During the COVID-19 Pandemic.” Here is the link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2764748
Rebecca Sudore is part of a national advance care planning campaign “Be Prepared: Take Control” in collaboration with national leaders. This campaign encourages people to have “hospital go bags,” designated medical decision makers, and conversations with loved ones about what matters most. Please spread the word to your family and friends and read the press release here. Rebecca Sudore is also part of a CTSI webinar on 4/17 10-11am about how to set up a recruitment website with a focus on health literacy. Here is the link:
https://recruit.ucsf.edu/events/recruitment-website-templates-zoom-webinar
Carla and Ashwin have launched their study of the impact of social distancing on well-being and whether needs of elders in SF are being met during this pandemic.
GWEP: We continue website updates to our COVID site. Anna Chodos continues to work closely with San Francisco Department of Public Health to support senior site hubs with case-by-case guidance, education and webinars about COVID-19 in older patients. GWEP is also brainstorming about developing webinars to meet the education needs of our community partners in the North Bay, Contra Costa and Alameda counties.
POLICY: Brie Williams continues to develop COVID-19 policies for prisons and jails. Her team is creating a Professional Service Announcement video about COVID-19 that will be played on TVs in several prisons to educate prisoners about COVID-19. The plan is to expand the reach of this video to prisons in multiple states. Here is the link to COVID-19 correctional health education resources developed by Brie’s team: https://amend.us/covid/.
STAFF: All Division staff continue working from home unless they are providing direct patient care. Sarah Ngo and UCSF Maker’s Lab held a seminar on Tips and Tricks for Making Your Own Fabric Mask ranging from no-sew techniques to those requiring sewing machines. Also, everyone is encouraged to join our second Virtual Pilates workout on Monday 4/20 from 5pm-5:45pm
CLINICAL UPDATES FROM OUR HEALTH SYSTEMS
San Francisco VA: 1 hospitalized cases of COVID-19 at SFVAMC.
UCSF Health: 17 hospitalized cases at UCSF; https://coronavirus.ucsf.edu/
ZSFG: 25 hospitalized cases at ZSFG.
SF Chronicle COVID-19 Dashboard (CA, County and SF#s)
OPTIONAL WEEKLY GERIATRICS DIVISION CHECK-INS
We will continue our optional division-wide check-ins next week.
Next Check-In Meeting: Wednesday April 22nd from 2:30-3:30pm on Zoom
Geriatrics Half-Day is April 29th: 1-4pm (everyone is encouraged to attend)
MAXINE’S WEEKLY TIPS
There is a Webinar Series on Emotional Well-Being During the COVID-19 Crisis for Health Care Providers, which is held on Thursdays from noon-1pm via Zoom. Register for the upcoming “Supporting Our Youth: How to Survive and Thrive,” featuring Daniel J. Siegel, MD. This webinar is focused on providers who are trying to balance childcare while working from home.
UCSF Clinical Research Coordinators who are looking for ways to connect with other CRCs and stay informed can subscribe to the [email protected] by sending a one-line email with no subject to [email protected]. The one-line message should read: subscribe CLINRESCOORD firstname lastname (enter your first & last name). This group has been holding a weekly happy hour via Zoom on Tuesdays from 6-7pm. Details are sent out every week via the CRC listserv. Click here to learn more.
SUPPORT OUR AWESOME UCSF STAFF
Nominate our UCSF Staff for an Achievement Award and/or SPOT Award. Nominations are due TODAY Friday April 17th. Submit your nominations through this website: https://starawards.ucsf.edu/or contact Maxine if you have any questions.
MORE GUIDANCE TO COME
- The University of California has instituted a hiring freeze through June 30, 2021 (see 4/7/20 email from Chancellor Hawgood). This is because of the dire financial situation resulting from the pandemic. The goal is to have a unified approach across the UC system that allows us to ride out this storm. There will be exceptions to the hiring freeze but the principles for implementing this freeze are still being worked out. We should have more guidance later today.
- Construction on the Wayne and Gladys Valley Center for Vision (WGVCV) at Mission Bay is on hold, which means our anticipated move there from Laurel Heights is also on hold. Once shelter-in-place has been lifted and we are able to return to work, we will need to consolidate our paper documents (scan, store, move to UCSF archives, or dispose). If you are out on leave when the shelter-in-place has been lifted, our core admin team will help pack up your office/desk items to move to Mission Bay. If you have any questions, please contact Caroline.
If you have other suggestions for maintaining our social connectedness during this time, please email me. Thanks for all you are doing!
Louise
PS: Since we are on Zoom so much lately, I appreciated trying out the Monterey Bay Zoom backgrounds: https://www.montereybayaquarium.org/animals/wallpapers
Ashwin sent me this link to a free Digital Concert Hall with has been lovely to listen to in off hours (or in the background): https://www.berliner-philharmoniker.de/en/titelgeschichten/20192020/digital-concert-hall/