Ranked among the nation’s top hospitals by U.S. News and World Report, Michigan Medicine has emerged as a leader in the state’s response to COVID-19. From treating one of the first patients in Michigan to be diagnosed with the illness, to launching same day in-house testing, the University’s hospital systems have gone above and beyond to protect and inform not just the U-M community, but the public at large.
As hospitals across the globe prepare to treat an increasing number of COVID-19 patients, hospitalists—specialists in inpatient care—take unique positions on the frontlines of the pandemic. Michigan Medicine’s chief of hospital medicine, Dr. Vineet Chopra, shared his team’s preparations, challenges, and advice during this unprecedented time.
As chief of hospital medicine, what are some of the key roles you’ve played in Michigan Medicine’s response to the COVID-19 pandemic?
Chopra: Hospitalists are on the front lines of taking care of acutely and critically ill patients with COVID-19. My role was to stand up a team to be able to care for these patients and activate a unit where patients could receive world-class care in an environment that was safe for them and for providers. I was supported by my co-leads—Dr. Chris Smith and Dr. Valerie Vaughn—in this work and a slew of individuals across the healthcare system. This unit, called the Regional Infection Control Unit or RICU, has been up and running caring for COVID patients over the past 10 days. We have designed innovative rounding models on this unit where all consultants round with our teams at the same time. We also have integrated social workers, palliative care teams, nutritionists and respiratory therapists into our rounding structure. The staff that provides care for these patients includes four hospitalists during the day and four at night.
What are the obstacles faced by hospitals when confronting this new disease? What has Michigan Medicine done to prepare?
Chopra: The biggest challenge has been uncertainty. This disease presents in many ways and often surprises us when we least expect it. The lack of availability of reliable testing has made things more challenging. And the resource needs to care for these patients—ICU beds, ventilators, nursing and physician manpower, personal protective equipment—are substantial. Many hospitals run at full capacity and simply do not have the space to be able to care for these patients. Michigan Medicine made some difficult but important choices early in the course of this disease to free up space and resources.
U-M recently established a one-time paid time off bank for employees during the COVID-19 pandemic. How else has Michigan Medicine assisted medical students, faculty, and staff through the current situation?
Chopra: Our response has really focused on preparing to care for the many patients who may end up with this disease. In addition, we have ramped our communications platform to keep everyone informed of what we are doing to prepare and all of our efforts to safeguard our staff and personnel. On an operational front, we have strengthened our ability to provide care by closing down elective procedures and non-urgent activities to focus on this pandemic. We have stood up our regional infection control unit (RICU) which is now staffed by hospitalists and intensivists to provide care to the sickest COVID patients. U-M has done more than just give time off—we have been busy preparing and informing the public.
Are there any myths about the virus that you want to debunk as a hospitalist and COVID-19 front-liner?
Chopra: There are so many, but perhaps the most prevalent are that this virus will kill all that it infects. That is not true. Most people who will contract this disease will have a mild illness. While some will be more ill and there have been deaths, these pale in comparison to, for example, influenza. So, it is important to not lose sight of the big picture.
What can the general public do to support medical and healthcare professionals at this time?
Chopra: Stay at home; wash your hands and help flatten the curve. Trust the professionals, we are as well prepared as we can be. Look for updates from reputable sources including CDC, WHO, and Michigan.