Starting daily update of big issues I'm seeing @ucsf / @UCSFHospitals:
a) Getting more pts; not yet a deluge (7 COVID+ pts in hosp, 2 ICU)
b) We have dedicated inpt unit, ~30 beds w/ COVID & r/o COVID patients. & dedicated resp clinic & ED space. Setting up COVID-only ICU
(1/7)
a) Getting more pts; not yet a deluge (7 COVID+ pts in hosp, 2 ICU)
b) We have dedicated inpt unit, ~30 beds w/ COVID & r/o COVID patients. & dedicated resp clinic & ED space. Setting up COVID-only ICU
(1/7)
c) Shortages real: have enough PPE now but may run out soon. Testing: doing ~100/d now, but big shortage of reagent & swabs may force cuts. Beds, ICUs, vents OK for now but seeking more if we need, including at other SF hospitals. Blood shortage looming (2/7)
d) Workforce: ok now but Italy/China show how we could be overwhelmed later. As we dial down outpt visits (now down by ~50%, tho tons of televisits) & surgeries, may free up people to do other stuff. But a heavy lift to track & redeploy clinicians/staff to new sites/roles (3/7)
e) New change in our workforce rules: Consistent w/ CDC, our HCWs exposed to COVID+ patient but who have no sxs (or mild sxs; eg runny nose) can keep working (w/ mask). But if returned from Level 3 country & are well, still must be out for 14 d (per CDC). Latter seems off (4/7)
f) Nice to see fed policy changes, incl. new $s, relaxation of HIPAA rules (allows FaceTime for telemedicine visits; note at UCSF we're sticking w/ approved tools like Zoom). Feds need to push/promote ramp up of manufacturing (of PPE, ventilators, testing materials...) stat (5/7)
g) Marked limits on pt visitors (per @sfgov rules) which allow only rare exceptions (end of life; kids) make sense but are brutally hard for everyone – patients, families, & our staff. Working on new ways for pt-families to communicate. If someone could donate 500 ipads... (6/7)
h) Awed by @ucsf colleagues, working 24/7. Remarkable teamwork: clinicians, leaders, folks in areas from ED to ID, from occ health to finance. I know this is true elsewhere too. Particularly inspiring when everyone's life has been disrupted & fear is real (7/7). More tomorrow...
