VC Notes - A weekly word from Dr. LouAnn Woodward
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Friday, April 24, 2020

The End of the Beginning

This is the last Friday of April, so normally I would answer questions you have submitted during the past month. But we’ve answered a lot of questions during the last two weeks in our virtual town hall meetings (the most recent one can be watched here) and in VC Notes on April 10, so today I’ll focus on the one question that is probably on everybody’s mind: When are we going to begin getting back to normal operations?

VC_Apr_24_Derm_Telehealth.jpgThis pivot point has been variously labeled by other entities as the “reopening” or the “restart,” but those terms don’t quite capture our experience, since we didn’t “close” and we didn’t “stop.” I prefer to think of it as a gradual ramping up that will take some time to accomplish, and that will be contingent on what is happening with the coronavirus in the community and with case counts in our hospitals. Expressed as a graph, this ramping up will have more of a stairstep pattern toward the resumption of activities in our mission and support areas as opposed to a straight line.

Gov. Tate Reeves’ shelter-in-place order expires Monday, April 27. Even if that date stands and there is no extension, I expect and hope many citizens will still be exercising caution and remaining sheltered to the extent possible, so we can avoid a surge of new cases. According to guidelines issued by the White House, the “reopening” should be considered state-by-state, contingent on a downward trend in cases and the development of more robust testing capability within the health care system, among other things.

If conditions on the ground don’t erode significantly over the weekend - and we are watching closely as our confirmed COVID-19 inpatient census continues to inch up - we are tentatively planning to begin scaling up our clinical operations in our adult settings on Tuesday, April 28, and in Children’s of Mississippi settings on Monday, May 4. This initial activity will include the scheduling of urgent or semi-urgent surgeries and procedures. As public health guidance allows, we’ll gradually schedule more elective appointments and procedures. Planning for this resumption of services includes provisions for physical distancing in waiting rooms and PPE allocations to currently inactive clinical sites. Migration of certain services to a telehealth platform will continue to be a very big and important part of the equation.

In our education mission area, preclinical classes have shifted to online instruction or some alternative to in-person education for the duration of the summer. Each school will make its own decision as to the resumption of clinical instruction. Since commencement has been canceled, each school will determine when its students will officially graduate, in consultation with the Office of Academic Affairs.

In our research mission area, activities will begin ramping up a bit next week but mainly during the first week of May, with an initial focus on externally funded research activities. To maintain social and physical distancing, employees may be divided into shifts.

Finally, as we resume greater activity in each of our three mission areas, our administrative support functions, which have been operating but at lower levels, will gradually come back to full strength in coordination with the mission areas. We currently have more than 2,000 employees engaged in some level of telework, so some of that may need to remain in place to achieve appropriate physical distancing in the office setting. In any case, the ramp up for these employees won’t begin before May 4 and will be highly contingent on the status of pandemic containment within the state.

I’ll emphasize a few specific points here:

  • As we begin to ramp up, it’s going to be vitally important that all of us – individually and collectively – maintain good habits to avoid COVID-19 transmission: physical distancing, hand hygiene and continued use of masks in all settings while on campus. Do not come to work if you feel ill or have symptoms associated with respiratory illness. We will continue to refer employees and students for screening and testing where indicated.

  • A number of you have asked if we will be testing all employees and students. There’s no scientific reason to do that and, in any case, there’s not enough testing capacity to test everyone. As we ramp up, we’ll focus our testing where it will provide the most benefit, for example, on all hospital admissions or on select patients who pose the highest risk to providers. Antibody testing that attempts to determine who has had the disease and therefore might be immune is still not refined enough to provide practical benefit.

  • Heavy on my mind is the large and significant negative financial impact this pandemic will have on our Medical Center and our Mississippi community. Many of us have family and friends who have lost their jobs. The headlines are full of reports of layoffs and pay cuts. Know that we are looking at every opportunity we have to manage this impact in the most responsible manner possible. I have asked both HR and finance to analyze all options in a timeline that is close to unreasonable. Just as all of you have responded, they are doing the same. I pledge to you that we will look at every viable possibility to address our challenges and come out on the other side stronger, leaner and more effective. We are facing a projected $100 million negative swing attributable to the pandemic. While we will pursue any and all relief funds we can identify, there is no question UMMC will suffer a financial loss unprecedented in its history.

These are hard times, and even though the demands on our health care teams have not been as extreme as initial models predicted, these days have been challenging and taxing. So many people say to me, “You must be exhausted.” The truth is, I am, as I know many others are. So many of you have put in long hard hours during this time and that is noticed and appreciated.

But I am also energized. I am energized by the creativity, the positive spirit, the “get it done” attitude that I have witnessed time and time again. I am inspired by the way you have taken care of each other, our students and our patients. As we take the first careful steps toward some semblance of normalcy beginning next week, carefully monitoring the environment for resurgence, we will experience continued uncertainty for the foreseeable future. We have a steep mountain to climb. But one step at a time, we will climb it together. I have confidence in you and in the work we can all do when we pull together. #UMMCStrong
Signed, Lou Ann Woodward, M.D.

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