A Department Built for COVID

My first patient with suspected COVID-19 had returned from Italy in early March. Upon hearing his symptoms—fever and diarrhea—I wasn’t sure whether he was likely to have the infection. Our drive-through testing site was still days from opening, and it was at that moment I realized that all my training and experience would fail me in this crisis. My first reflex when presented with somebody who is sick has always been to say, “Come to my office and I will meet you there in 30 minutes.” With COVID, this was precisely the wrong advice.

However, thanks to Dr. Stephen Klasko and Dr. Judd Hollander, Jefferson had developed an infrastructure of telehealth resources enabling our doctors to see patients remotely while keeping them isolated and protected from spreading this virus to their family members, our staff, and our physicians. Telehealth introduced me to my first COVID patient, and it became Jefferson’s secret weapon in winning the war against the virus. As I was treating this patient, Jefferson was gearing up for battle, funneling the first influx of patients through our JeffConnect portal, opening up drive-through testing sites throughout the region, and preparing for the next wave of patients that numerous models were predicting for later in March, April, and May. Indeed, our primary care team rapidly pivoted to the telehealth platform, helping scores of patients who were able to remain at home.

When this current outbreak subsides, telehealth will be validated as one of our great shields in fighting this contagion; it has provided access, advice, and connectivity while maintaining distance. I am convinced that telehealth dramatically helped flatten the curve here in Philadelphia and far beyond. We also have leveraged telehealth to keep up with the ongoing care needs of our substantial population of patients requiring primary care or management of their chronic health conditions through our expert faculty and residents. This important technology has been transformative in medicine, and will remain a significant tool in caring for our patients as we go forward.

But technology alone doesn’t save lives. It is the people utilizing that technology who deserve the credit for answering the call to action during the COVID crisis.

If the Department of Medicine is the front line, then our nurses, nurse practitioners, PAs, respiratory therapists, technicians, and medical assistants are our backbone. The spirit of teamwork at Jefferson has never been stronger, and is part of our formula for success. This team also includes the EPIC electronic health record builders, nurses who collect nasal swabs, pathologists who get patients fast results, hospital-based nurses and doctors, telehealth teams, pharmacists, nutritionists, social workers, administrators, food service employees, and security personnel.

Our balance of specialties were perfectly aligned to match up as the virus tried to surmount our defenses. Aiding in the fight were our colleagues from the departments of Anesthesia, Medical Oncology, Neurosurgery, Trauma Surgery, Cardiovascular Surgery, the Farber Neurohospitalist Group, and others. In addition, our amazing administrative team, working behind the scenes, has helped enable all of this important work.

Our faculty and house staff working on our Hospitalist service under Dr. Jonathan Woo have demonstrated great resiliency, earning the moniker #COVIDWARRIOR. Our Infectious Disease staff, led by Dr. John Zurlo, have guided our scores of policies designed to protect our patients and staff.  On March 23, they made the difficult decision to require all staff interacting with patients in both hospitals and the clinics to wear a mask regardless of whether the patient is infected with COVID or not. This important step has helped protect our patients, healthcare workers, and staff. Of course, this would not be possible were it not for our administrative staff, who worked tirelessly to ensure a continuous supply of critical PPE.

On the research front, with the leadership of many in the Department of Medicine, we are engaged in more than a dozen clinical trials, which promise to offer new hope and new options to sick and exposed patients as well as discovery to help in the weeks, months and years ahead.

I must say, this experience has been one of the most gratifying of my life in academic medicine. As the scope of the pandemic in Philadelphia became clear by the end of March, we engaged our residents in a crucial conversation; we knew that we needed the partnership of our residents, just 9 to 32 months out of medical school, to help on the front lines. As we prepared for the more than 150 patients that would ultimately challenge our resources, we learned that the courage of our residents would lead the way. Residents and faculty alike moved forward to confront the outbreak head-on, many volunteering for duty even before we asked.  

I believe that the ingenuity and power of American medicine will help us recover and return to a more normal life for our patients, our families, our neighbors, and our nation. And you can rest assured that Jefferson will be leading the way as we continue to serve those infected with COVID, and work to ensure a safe recovery for our community. 

Gregory C. Kane, MD ’87, MACP
The Jane and Leonard Korman Professor of Pulmonary Medicine
Chair, Department of Medicine
Sidney Kimmel Medical College at Thomas Jefferson University