Flexing to meet the challenge of COVID-19, while keeping our faculty, learners, staff, and patients safe and engaged
Photo Credit: Kanwal Farooqi, MD
As the influenza pandemic of 1918 shaped a long-ago era, so too the coronavirus pandemic of 2020 has defined lives at Columbia and NewYork-Presbyterian Morgan Stanley Children’s Hospital (MSCH). The impact was sudden, tragic, and acute, not unlike the terrorist attack on the World Trade Center on September 11, 2001, as our city quickly became the U.S. epicenter and our medical center ground zero.
The number of patients with COVID-19 escalated rapidly from the first hospitalization in early March to thousands of patients in a matter of weeks. Hospital and university leadership switched to response mode. Everyone was needed and everyone was mission-critical.
The hospital’s medical and surgical intensive care units flexed to accommodate the surge in COVID-19 cases. To care for adult patients at NewYork-Presbyterian’s Weill Cornell campuses, the inpatient unit at the Weill Cornell’s Komansky Children’s Hospital closed and all pediatric patients who required hospital admission were transferred to the MSCH campus. Our intensive care units ramped up and expanded for additional critically ill patients, including some who were older, in addition to the large number of children needing care. Many pediatric faculty, fellows, and nurses volunteered to provide direct patient care on adult units or in the adult emergency department.
To meet this new challenge, our department of over 300 faculty and 150 learners, residents, and fellows and an administrative staff in the hundreds banded together. Over the days and weeks following the start of the pandemic our department members and teams:
- POWER (Promoting Overall Well-being, Engagement, and Resilience) initiative, a comprehensive wellness resource for staff members that offers meditation, yoga, individual and group therapy, assistance with child care, and more. Expanded our recently developed
- Established a Newborn COVID Nursery Clinic with a gift from Hyundai Hope on Wheels, offering high-quality, safe newborn care for infants whose mothers tested positive for the virus.
- Formed a dedicated COVID-19 fund with an initial gift from a Hope & Heroes Children’s Cancer Fund board member, which provided ride-share services for department members, enabling them to avoid public transportation as the city improved its public safety processes. The fund also offered meals and on-campus housing if needed.
- Developed a webinar series to educate pediatricians and educational videos for parents about symptoms, risks, how to have a safe visit to the pediatrician, and the importance of continuing vaccinations.
- Converted routine visits to telemedicine. We ramped up our telehealth capability from 50 visits pre-pandemic to more than many thousands during the pandemic, as families recognized virtual visits as safe, useful, and effective.
- Were among the first in the country to recognize multisystem inflammatory syndrome in children (MIS-C), a COVID-19 post-infectious process. Columbia specialists treated more than 50 cases and developed a successful therapeutic regimen to treat the illness with steroids and immune globulin infusions, now referred to as the Columbia protocol.
- Created a research collaborative joining laboratory and clinical investigators together to understand and share information about COVID-19, resulting in dozens of publications and expanding our knowledge of the virus’s effect on children.
- Created virtual livestream conferences, including grand rounds, morning reports, and noon teaching sessions, and hosted outside speakers addressing issues such as mental health for health care workers, remdesivir clinical trials, and COVID-19 and racial disparity.
- Helped establish the Columbia COVID-19 Student Service Corps (CSSC), an interprofessional service learning model to support patients, the workforce, and the local community. Working closely with pediatric primary care and subspecialty practices, CSSC student volunteers contacted and onboarded patient families to the telehealth platform and assembled a redeployment guide for pediatrics faculty and trainees reassigned to adult inpatient medicine or the care of adult patients with COVID-19 at MSCH.