There used to be a sense of luxury associated with working from home – to avoid distraction and interruption, I'd enjoy the occasional escape from the busy surroundings of the PATH building to stay home in my sweatpants, focus on important time-sensitive tasks, and pound out the work that needed to get done. But thanks to COVID-19 sheltering at home, the luster of being at home is gone – I've been waking up tense just thinking about the 7 am COVID-19 Zoom call update with 100 health system leaders where we might hear about a worsening pandemic and where there were frequent questions and expectations re: COVID-19 testing. Because of the many Zoom calls that follow, it has been hard to find the time to drive into the office – in fact, I've often wondered if there would enough of a break so that I can shower, comb my hair, or put on something resembling normal clothing. As you might guess, I don't use Zoom's video feature, so I've been looking a bit like a homeless person – but of course, I have a home – in fact, too much of a home since I'm rarely leaving it.
Thanks to all of us who have minimized excursions outside our homes and accepted social distancing, the Sacramento area and UC Davis Medical Center have not experienced a substantial COVID-19 patient surge. In fact, the Sacramento region has the lowest reported SARS-CoV-2 infection rate among the nation's 50 largest metropolitan areas, according to a Sacramento Bee analysis using data from John Hopkins' School of Public Health. The numbers of our COVID-19 in-patients are now dropping which brings some optimism for the summer. We are all grateful to have been spared the tragic consequences of overwhelmed ICUs, inadequate ventilators, and excessive death from COVID-19. But the pandemic has nonetheless taken its toll – stress, fear, depression, grief, limited health care for our community, and financial adversity for many.
For all of these reasons, I'm so pleased about – and so ready for — UC Davis Health's new Restore Renew Reimagine (R3) initiative to scale up our activities in all missions and create a new normal while remaining prepared for a potential COVID-19 resurgence.
R3 is about living in the accompanying graphic's growth zone where we learn to focus on the future while living in the present, find creative ways to adapt to change, and spread hope.
I especially like the initiative's name which does not stop with just Restore. Bringing back activities in our new COVID-19 world means doing things in new ways – being creative and imaginative, as well as renewing our energies and spirit to make this happen.
Along with the rest of UCD Health, our department will be defining how we restore, renew and reimagine – and we'll be working collaboratively with other units and workgroups. Members of department are already involved in key committees – for example, faculty Sarah Barnhard and Dorina Gui are members of the Operating Room Committee, representing transfusion services and surgical pathology respectively. Lab Director Iyda Antony and I co-chair the Testing Workgroup, a group that will interact with many committees and projects since testing is a key piece to restoring, renewing, and reimagining all that we do. Many of our lab staff and faculty are part of this workgroup. We will be looking to integrate many department members into the other committees – as well as pulling other departments and units into our Testing Committee. After all, pathology and laboratory services is foundational to every service and mission at UCD Health.
Defining the activities within this initiative has just beginning, but I see a few key areas within our department where we need to restore, renew, and reimagine:
- Clinical service:
- It is time to restore non-emergency elective health services since further delays in care can create serious health problems. Surgical pathology is just one section where we expect a surge since postponed surgeries and biopsy-generating procedures such as screening colonoscopies will ramp up once again. To accommodate these waiting patients, extended hours and weekend surgeries are under serious consideration. Other pathology chairs have shared that similar plans are in the pipeline at their institutions, and no one expects this to be a short-term change.
- Distance work for safety and efficiency will also be our new normal for clinical service. We therefore need to reimagine how we deliver clinical service through technology. We should continue to expand our use of digital pathology/telepathology and further explore untapped features of the electronic medical record to extend and empower our pathologists, laboratorians and other healthcare professionals.
- COVID-19 testing to identify infection as well as the presence of antibodies will grow in volume. The virus has not gone away, and there is concern for resurgence in the fall or winter. Our laboratory is preparing by growing our bench strength in the molecular pathology section. In addition, new testing platforms and methods will emerge. As a recognized leader in clinical trials, our laboratory needs to be prepared and ready to continue our role as innovators and early adopters so that we can shape the future and offer the best and more effective tests to our community.
- I'm proud that our residency and fellowship programs quickly moved to teaching via Zoom and other platforms, and that this has been so well-accepted by our faculty and trainees. As we restore, we need to thoughtfully integrated these practices into our routine teaching, including our clinical teaching. Telepathology and remote signout has to also become standard in clinical teaching since these will likely be the practice standard for our graduates throughout their professional lifetimes. Likewise, our clinical lab science program and medical student electives could benefit from a fresh approach using new technologies. But we need to also ensure that the personal touch to education isn't lost, and that our trainees still have opportunities for in-person hands-on learning experiences so that they can see role models in action, and fully develop mentorship relationships with faculty, and professional relationships with staff.
- Research activities:
- Research is what makes our University great. We benefit the people of California and the world through the discovery of new knowledge, new approaches and tools. We therefore need to restore research activities by reimagining how laboratory work conducted. Just like in the hospital, research laboratories need to ensure safety with personal protective equipment and appropriate physical distancing. And we need to continue to support research and creative work focused on COVID-19. Our department is at the nexus of many COVID-19 related projects, thanks to our biorepository, the need for expertise in transfusion medicine, vaccine development, mouse biology, testing expertise, and informatics that uniquely reside in our department.
- The human connection:
- Lastly, I've really missed seeing our colleagues and teammates during the sheltering – I feel isolated and lonely when I work from home. The office feels lonely too because it is so empty at our medical center. Conference calls and Zoom meetings just aren't the same as the spontaneous and friendly interactions in the hallways or on the sidewalk, or when dropping-in a colleague's office. A recent article in Harvard Business Review shared the importance of these “weak tie” interactions – interactions that aren't with your best friend or family, but that are informal and short, and provide spontaneity, happiness and a sense of connection. Since distance work won't be going away, the authors suggest reaching out to casual friends and teammates on e-mail or social media to check in, offer help, express gratitude, and share personal experiences to strengthen the relationship. The authors point out “the best social interactions are those that tell others you are thinking of them, without an expectation of a return of time, energy, or attention.”
Keep an eye out for more on the R3 initiative — leave those sweatpants behind and get ready to restore, renew, and reimagine. Wishing everyone good health as spring unfolds!