March 25 Dean’s Daily COVID-19 Update

Message from the Dean

To: WCM Community

Subject: March 25 Dean’s Daily COVID-19 Update

Yesterday Governor Andrew Cuomo was reported as saying that the peak of COVID-19 infection would likely occur in two to three weeks in New York.  This is in line with a model developed by Weill Cornell Medicine faculty, NewYork-Presbyterian leadership, and New York City officials. 

At this point, it’s too early to say how many people will be infected.  There’s still time to flatten the curve by practicing strict social distancing measures.

Strategies like closing down borders and quarantining sick individuals are effective, primarily before the point that an infectious disease has spread throughout the community.  New York City already has community transmission, which means that the sources of new cases cannot be identified.  The most effective thing we can do now is to practice social distancing by minimizing in-person contact with others and staying home, especially when experiencing mild flu-like symptoms.

At Weill Cornell Medicine, we are doing everything we can to stem this crisis.  We are preparing for more patients, increasing our testing capacity, collaborating with global contacts to acquire medical supplies and equipment, and working closely with government and public health officials to mount a coordinated response.

All of you have been stretched already in your work and personal lives.  You’ve adapted to unprecedented circumstances with resilience and strength.

As the surge in COVID-19 cases continues over the coming weeks, we will be asking many of you to be stretched even further, sometimes in new and unanticipated ways.  We thank you in advance for your responsiveness and your willingness to step up and do what is necessary.  As healthcare workers, as employees who support a robust and vibrant clinical workforce, and as individuals united in our commitment to improve human health, our time is now.

New York City is an epicenter of the COVID-19 pandemic.  That means we are on the front lines, dealing with the first wave of patients in the US.  The knowledge that we gain and the steps that we take now will be invaluable to the rest of the country and the rest of the world in controlling this virus.  The situation will get worse before it will improve, but we will get through it.  Thank you so much for everything you are doing.

Please continue to check WCM Central regularly for ongoing updates and to direct questions for me to answer during my Friday video message here.

Sincerely,

Augustine M.K. Choi, M.D.

Stephen and Suzanne Weiss Dean
Weill Cornell Medicine
Provost for Medical Affairs
Cornell University

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Global Situation

• Worldwide. As of March 24, more than 409,000 cases were reported globally in 169 countries and regions. The Prime Minister of India announced a lockdown on the entire country for three weeks.  The Chinese province of Hubei permitted most of its residents to resume movement on March 24, and the quarantine on the city of Wuhan will be ended on April 8. 

• United States. The federal government will formally trigger the Defense Production Act to secure additional coronavirus testing kits. President Trump also signed an executive order to fight price gouging and hoarding of medical supplies. The number of cases in the U.S. surpassed 50,200 on March 24.

• Tri-State area. Governor Lamont of Connecticut extended public school closures to at least April 20 as COVID-19 cases in the state continue to rise.

• New York. On March 23, New York State received FDA approval to test the use of plasma from recovered patients as a treatment for COVID-19. The state has more than 25,600 confirmed cases of COVID-19, as of March 24. New York City has reported more than 14,700 cases. 

WCM Updates

• Care for COVID Patients. There are now many dedicated teams of hospitalists, physician assistants, and residents treating hospitalized COVID-19 patients.  The outpatient fever clinic is continuing to see patients triaged from the emergency department, and increasingly, symptomatic individuals who are referred from other departments. 

• Redeployment of Clinical Staff.  As the surge in COVID-19 cases increases, we anticipate a growing need for physicians, nurses, and staff who will be asked to work in new capacities, especially intensive care.  Already faculty have been given new work assignments in Workforce Health & Safety, the emergency department, and telemedicine, and residents have been sent to fill critical needs at NewYork-Presbyterian Lower Manhattan Hospital.  Training and supervision will be provided as clinical staff are asked to take on new roles and responsibilities.  Thank you in advance for responding to these requests promptly.

• Hospital for Special Surgery.  HSS is being incredibly supportive in this time of crisis.  More non-COVID patients were transferred to HSS from NewYork-Presbyterian/Weill Cornell to free up beds at our medical center.  Physicians and nurses from Hospital for Special Surgery are now working at NewYork-Presbyterian/Weill Cornell to provide anesthesiology, intensive care, and other services.

• Personal Protective Equipment (PPE). The biggest challenge currently is the nationwide shortage of personal protective equipment, especially protective masks.  WCM continues to work closely with NewYork-Presbyterian and Columbia to acquire more PPE.  We are pursuing many potential sources around the world, including China, and have received donations from many individuals and groups.  Many thanks to all of you who have contributed this essential equipment, which is so critical to ensuring the safety of our healthcare workers.

• Testing. Our testing capacity is increasing rapidly, and we expect to be able to perform 1,000 tests per day by the end of the week.  Along with NewYork-Presbyterian and Columbia, we’ve acquired new equipment that will speed the processing of tests to 4-8 hours.

o   WCM labs are investigating the new rapid test from Cepheid recently approved by the FDA (RT-PCR), which is capable of processing samples in a couple of hours. 

o   WCM labs are also working on a new kind of blood test that would detect antibodies to COVID-19 quickly, cheaply, and with high-throughput.  The antibody test would be used to study the epidemiological course of the disease and could identify where in the immunity curve a person was after becoming infected.  This kind of information would be useful in determining a person’s readiness for work or for reentry into the community.

o   The NYC Department of Health and Mental Hygiene has issued a health advisory discouraging COVID-19 testing, unless patients are sick enough to be hospitalized.  Patients with COVID-like illness not requiring hospitalization should be instructed to stay at home.  This includes healthcare personnel who are mildly to moderately ill.

Tips for Healthy Eating While Social Distancing

The below nutrition tips were developed by Janet Lau, RDN, CDN, CLT, Holistic Coach and Dietitian at the Integrative Health and Wellbeing Program at Weill Cornell Medicine, in partnership with NewYork-Presbyterian.  There are many other sources of information available online, and I hope that you may find some of the websites listed below helpful.

• Stick to your routine mealtimes.  Aim to have 3-4 complete meals per day that are about 4 hours apart, leaving 3 hours between dinner and bedtime.  Avoid snacking if not hungry.
  • Aim to choose foods from the Mediterranean Diet.  Be mindful of what is on your plate.
  • Protein: lean is preferable
  • Starch: eat whole grain and/or replace with a root vegetable
  • Vegetable: dark green is preferable, especially when embellished with colorful veggies
  • Fruit: consume 1-3 servings per day

• Mindful Eating Tips
  • Eat when hungry and at set mealtimes.  Start with small portions and eat slowly.
  • Chew your food well at least 20 times.
  • Enjoy the taste, texture, aroma, and colors of the food you are eating
  • Avoid watching TV or being distracted while eating.
  • Additional information regarding healthy snacks can be found here.

• For delicious healthy recipes, consider these websites and apps: Food & Nutrition, Physicians Committee for Responsible Medicine, Two Blue Lemons, Allrecipes, and Yummly.

• For “healthy” food delivery systems, consider Green Chef, Whealth, Daily Harvest, and Hello Fresh.

For tips on making healthy grocery lists, look here.