Coronavirus Update March 17, 2020

thank you for joining us today we have
two experts here from UAB to talk to you the first is going to be UAB Provost Pam
vanillite who can talk about campus operations
the second is William curry he’s a doctor he’s assistant dean associate
dean excuse me for family and rural medicine here again he will comment on
the medical side but first we have UAB Provost Pam binoy good afternoon I’m Pam
binoy senior vice president for academic affairs and provost here at UAB as you
know the novel coronavirus code 19 situation continues to evolve throughout
the rapidly changing situation we’re continuing to put student faculty and
staff safety first since the last week we’ve made some changes with guidance
from Human Resources leaders across the university assessed work and staffing
needs and we move to a limited business model based on the latest covered 19
developments and the need to minimize in person contact UAB has reduced the
number of employees coming to campus during this time moving most of our
employees to work remotely if they can only employees whose jobs are essential
to campus operations continuing or on campus most of our staff are on work at
home status this model helps us to effectively manage the social distancing
that’s been recommended by health officials online and remote teaching
we’ll begin on March 25th and this week we’re providing daily zoom workshops for
faculty who are needing assistance with refining their remote teaching
techniques we have also developed resources and tips for students who will
be transitioning to online learning our students are still asked not to return
to campus and we only have students residing here who do not have any other
accommodations for those students we are providing meals on a pickup basis only
in our dining comments and Blaser kitchen continues to have groceries
available for food and secured students and employees we realize that we will
have to reevaluate students potential return to campus on a daily basis we
understand that the situation can bring a sense of fear and
increased anxiety to help our students faculty and staff we’ve listed some
mental health resources on our site UAB edu slash coronavirus the teams that
provide mental health services to our students and our employees are working
to be available remotely to support their health during this very trying
time thank you to everyone for their flexibility and understanding as we move
through this fluid situation these resources are also available to the
outside community check those for updates and additional resources I now
open it up to your questions we continue to make evaluations on Housing and
Dining as I said earlier we evaluate each day what we will do in the future
in terms of when classes might resume and that will be influenced by the
ability to prorate Housing and Dining charges again we’re continuing to
evaluate that daily we have already started to do some planning’s for
alternate arrangements if that becomes necessary now we have a dr. William curry he’s the
associate dean for primary care and Family and rural medicine excuse me
thank you good afternoon I’m dr. William curry I am a general internist here at
UAB and associate dean for primary care and rural health and senior vice
president for population health for the UAB health system part of what we want
to remind our own patients about today and for the general population everybody
no matter whose patient or whether you are a patient for two things one is the
general recommendation from public health that all of us reduce our
exposure to one another that we isolate more from one another
socially that we work from home if necessary we avoid public gatherings we
avoid travel and public spaces and particularly congregating with any
number of people now the number is down to 10 with whom we should congregate at
any one time and even then we need six feet of distance between us so that that
social distancing is important the reason for that is to decrease the
demand on the health system of the United States and of Alabama and of our
local communities and that brings us to the second reason that we want to bring
these reminders to everyone out there and that is that we need to reduce
avoidable visits to doctors offices clinics emergency rooms and hospitals
the biggest risk in other countries that are further along with this epidemic
than we are is overwhelming the health care system with a sudden rush of
patients so if we reduce our exposure to one another and slow the spread and
reduce the spread of the virus and if we reduce our visits that can be avoided to
healthcare facilities we will have played our part and we ask everybody
there to do that everybody out there in Birmingham Jefferson County and the
state of Alabama wherever you may be so if you have an appointment to your
physician or other health care provider you should call in or use your patient
portal if you have one and ask whether that visit is necessary it may be better
to reschedule that visit if you are ill you need to do the same thing please do
not come directly to the physician’s office do not go to an emergency room
unless you’ve been instructed to do so or it’s a dire emergency in order to
reduce exposure to one another if you do come and you appear to be ill or believe
you are ill you may wind up being exposed to other people that it would be
better not to be exposed to if you can avoid that if you have the opportunity
as we do with our patients to do electronic visits we are geared up now
for telemedicine either by telephone or or by virtual visits using Skype type
technology in order to handle many uncomplicated problems that can be
handled that way and so that is that is an important option but you’ll need to
check with your physician or other healthcare provider or their staff
either by phone or your patient portal one of the questions that comes up is
how do I know if I may if I may be at risk for kovat 19 the symptoms are
usually like those of the flu initially maybe with a runny nose the sore throat
a very sore throat sometimes COFF and fever that overlaps a lot with influenza
we still are seeing some cases of influenza and so it’s important for us
to try to distinguish that the difference will become evident over time
perhaps with kovat because of the severe shortness of breath so if you have those
kind of flu-like symptoms and you’re severely short of breath you need to
contact your physician or other health care provider immediately to get advice
about where to go the other overlapping set of symptoms is with allergies the
allergy season is arriving now in Alabama with the pollen and so scratchy
eyes runny nose or stuffy nose a little bit of a scratchy throat that comes and
goes maybe an occasional cough though could be symptoms of allergy again it’s
better to take that up over the phone or the portal or with a virtual visit
rather than going to the doctor’s office and please do not go to the emergency
room unless it is a dire emergency and better to have checked before you do
that the final point that I want to make before we open to questions is about the
blood supply UAB is a very large consumer of transfused blood for our
patients where the major trauma center the only one in central Alabama and
because of that and and necessary operations surgical operations we use
huge quantities of blood there is a blood shortage now because people are
not getting out and and donating please if you are able to do that and willing
to do that call or go to the blue cross to the red cross in order to determine
where the best place is to go for you to donate blood we need that today so those
are the those are the points that I wanted to make and I’m happy to take any
questions great great questions so the distance of six feet is a little further
than a call for sneeze can travel ordinarily so you’re trying to get
yourself if someone fails to cover their call for sneeze then you would be safer
if you’re that distance away so six feet is good a little further might be better
but but that seems to be the best some people say four to six but you want to
be out of coffin sneeze range as far as the flattening of the curve is concerned
there are two ways this can go Italy is one example in South Korea as the other
so in Italy there was a sudden onrush of a large spike of patients in a short
period of time needing healthcare it overwhelmed their healthcare facilities
equipment and staff and so they have people backed up in hallways and people
not able to get into health care facilities
literally or going and lacking treatment and quite possibly having deaths it
could have been avoided if that could have been spread out so if you think of
the curve as being like a big peak going straight up like this that is that is
one scenario the other scenario is more like what happened in South Korea so
that even if you have the same number of people instead of the big peak that goes
up like this you have a flattened peak that’s that’s going over a longer period
of time if you think back to the h1n1 outbreak of ten years ago we had
somewhere in the neighborhood of 40,000 people I believe in the US who died from
h1n1 we seem to have forgotten that and moved on one reason that was not so
although it was terribly tragic many of us lost friends and family to that
epidemic it was better handled by our health system because it’s rolled out
over a period of three or four months not three or four weeks so if we can
spread out the time over which the virus assaults the community and assaults the
healthcare system then we can manage that
with our capacity we can flex capacity some but only so much and so that’s
that’s the that’s the point about flattening of the curve does that answer
your question good thank you I think it all depends on how tall that
curve is that’s why it’s so important that people distance and isolate and if
necessary self quarantine if they’ve been exposed or maybe expose or if
they’re advised to quarantine there is some excess capacity in our hospitals I
know here at UAB we are always full our ICUs are always full we have 300 ICU
beds but they are always deployed and so we have to we have to make
prioritization and find some ways to increase some of that capacity other
hospitals may have a little more excess capacity we have hospitals that have
closed my home county of Pickens closed its hospital two weeks ago there may be
ways to use some of that space around the state and some of those hospitals if
that can be done in a safe and sound way people have talked about using national
guard and pop up mash type units and that sort of thing I’m not an expert on
that but it may come to being necessary to do that that can be done well and has
been done in other places so we have some excess capacity we also can
prioritize what we do in the hospital we can reduce elective operations elective
procedures of various kinds and we can try to find ways to expedite people’s
care so that they can be cared for safely at home to open up those hospital
beds so it’s going to take a lot a lot of disaster management sort of work in
what we call triage to decide what the best use of the resources will be but
again we hope to be managing moderate moderate and modest to moderate sorts of
capacity problems and not the sort of thing that we’ve seen for example in
Italy so idea we can flex some but we need people to do their part this is
something we’re all in we’ve never seen anything like this before
in our country so we’re asking people to engage in what really is a battle we
have to do this together if it’s going to work you have any further questions for dr.
curry okay if there’s no questions from the call I’m gonna take a few from
social media the first dr. curry is on a healthcare worker of what extra
precaution should I be taking well it partly depends on where you work in a
healthcare system I obviously be working in ICU it’s very different and I suppose
you’d be getting in buys there it is of course the basic protection that we have
is hand washing and when we’re in an area of exposure using some sort of mask
barrier the CDC just in the last day or so has modified their recommendation
that it is okay to use a standard surgical mask as opposed to the n95
respirator mask if they’re not an abundance of n95 mask if you have access
and then 95 get it fitted properly and use it but it is okay to use a surgical
mask and then if we’re going in with a patient we know has koban 19 or as
suspected and may be awaiting confirmation we use full isolation of a
room with isolation room make sure the patients in that right kind of room
we also wear full protective gear gown and gloves and the right kind of mask
and a face shield if there’s going to be the chance of anything spraying and so
I’d say consult consult your facility or supervisor and other people in in your
institution for the full information about how to do that but that is well
worked out and it also is addressed on the CDC website if you want to go there
triage initially finding the the ill or potentially ill patients and getting
them into an isolated area first is one of the things that’s happening
increasingly and that’s terribly important to be effective for your
institution to have that but for your personal safety I think I mentioned
essential points compromised right so so
immunocompromised is a broad area and its relative not everybody is the same
as everybody else but then perhaps the most severe would
be a patient with cancer who’s on chemotherapy and has their white cells
suppressed what we call being neutropenic that is a very at-risk
patient anyone in that situation should be staying at home and making sure their
family are taking precautions about where they go and how they wash wash
their hands and wipe surfaces and how they handle things together as a family
so that that’s the first thing that needs to be done obviously talk with
your your a physician about what they advise you to do in in any further
detail but that is a very high-risk person other people who are on various
kinds of immunosuppressive medicines for say rheumatoid arthritis or lupus both
of which reduce your immunity anyway or at a reduced at increased risk as are a
lot of other people that that we we call em you know suppressed and some people
just have a natural immunosuppression lack of immunoglobulin so I would say
consult your physician about specifics but you need to be even more careful you
are in the high-risk group along with the people with heart failure COPD
diabetes and so you would need testing quicker if you seen if you start to get
ill and you certainly need you need to contact your physician or other health
care provider immediately if you if you do that is what’s being quoted so that
would mean on a on a tabletop or on clothes and we have to be very careful
with these white coats about what we do after we wear them where we’ve been it’s
recommended to change clothes when we get home if we’ve been in an area where
we may have been exposed to the virus all of those kind of things but that is
that is at least the best information that seems to be out there right now you
touched on this but just to reiterate to folks who are watching
people are asking about blood donations where can they donate blood so he
recommended calling the red the Red Cross is best but partly so they can
they can manage the the flow of people so just call the American Red Cross here
in Birmingham or in in your area and ask them where the best place is to go to
make a blood donation thank you for thinking about that so I am NOT an
expert on this but it makes sense to reduce elective procedures because
aerosolizing the virus getting it sprayed out into the air is one of the
most dangerous points and that’s true for medical procedures such as
intubation or bronchoscopy or things of that sort and it would be true for
dental procedures so certainly mask and face shield
protection if you’re having to do an emergency procedure is something that
can’t wait like an abscess or other sorts of things like that but elective
procedures really ought to be thought through very carefully right well there
are two sides to that one is medications that would be needed for patients who
have kovat 19:00 there’s a lot of talk about a variety of medicines like
hydroxychloroquine and some other antivirals plus the antivirals that are
being developed I’m not personally aware of how big the stockpile is of those
medications they some are generic and but I do not know what the capacity is
for those another larger question is about the general medicine medication
supply a lot of our medications come from China is as everybody is now
talking about a lot that is a long range issue that needs to be addressed but in
the short range it does appear that China is continuing is getting back into
their into their usual manufacturing and and exporting and so I’ve not heard of
any major shortages at this point but that could be a problem for a lot of
medicines that are not that are not having to do with infectious disease but
we have to wait and see how that goes but so far we seem to be doing okay
and the official last question I thought this was important there’s a woman who’s
concerned about her pregnancy and what can you say about pregnant women and how
they should be responding to this outbreak I just spoke with an
obstetrician on the way over here that was helpful there appears to be no
evidence so far that there’s any increased risk to the the fetus or to
the or to the baby in the womb the the risk to the mother obviously is that an
infection of any kind may create complications of pregnancy so it’s
important to go through all the same distancing social isolation and trying
to avoid avoid contact and all the hand-washing even more intently if
you’re pregnant but it’s just more to protect to protect the pregnancy and
baby there’s not does not seem to be as far as anybody knows yet as far as I
know not an obstetrician but having talked with them there does not seem to
be a unique risk there and continuing these news briefings

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