{"id":2847,"date":"2020-05-12T17:06:45","date_gmt":"2020-05-12T21:06:45","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2847"},"modified":"2020-05-12T17:09:29","modified_gmt":"2020-05-12T21:09:29","slug":"our-public-hospital-leads-massachusetts-in-caring-for-coronavirus-patients","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/05\/our-public-hospital-leads-massachusetts-in-caring-for-coronavirus-patients\/","title":{"rendered":"Our Public Hospital Leads Massachusetts in Caring for Coronavirus Patients"},"content":{"rendered":"
\"Frances<\/a>

Dr. Ue is a Chief Resident in Internal Medicine at Cambridge Health Alliance in MA.<\/p><\/div>\n

Cambridge Health Alliance (CHA)<\/a>, where I work, is a small hospital system serving the north Boston-metro area across two campuses in Cambridge and Everett but, despite its modest scale, it has arguably become the center of Massachusetts\u2019 fight against COVID-19. <\/span>This is no small feat, given that Massachusetts has the third largest number of coronavirus patients in the U.S.<\/span><\/p>\n

\"Frances<\/a>

Coordinating the delivery of 10,000 N95 masks from @MADmasks2020 and Harvard Business school alumni in China & Singapore! Myself with Eugene (transitional year intern).<\/p><\/div>\n

As of April 28, 2020, according to the statewide COVID-19 inpatient update, CHA has the greatest proportion of hospital beds and resources devoted to suspected and confirmed COVID-19 patients \u2014 85% of our general medicine beds and 88% of our critical care beds. As a result, we greatly outrank similar-sized counterparts and even many hospitals with greater capacity. While we have been able to transfer very sick patients to tertiary care hospitals, it is alarming how disproportionately this virus is affecting the poorest and most vulnerable patients \u2014 patients for whom CHA is a lifeline.<\/span><\/p>\n

Our capacity has more than doubled since the start of this pandemic more than 8 weeks ago, with additional medicine and critical care spaces. These spaces hardly resemble life in the hospital before <\/span>COVID-19, with dedicated areas on each floor for donning and doffing personal protective equipment (PPE). Each provider is covered from head-to-toe with a face shield, scrub cap, goggles, N95 mask, Tyvek suit, nitrile gloves, and shoe covers. With only eyes visible, it is a miracle that I can recognize all our new colleagues that we welcome to the inpatient medicine teams \u2014 from primary care, family medicine, psychiatry, podiatry, and surgery. In this fight against coronavirus, we have collaborated to maximize our resources to meet the needs of all patients.<\/span><\/p>\n

My role as Chief resident has greatly evolved during this pandemic, that role is addressed in this Academic Medicine article by our colleagues at the Beth Israel Deaconess Medical Center: <\/span>Five Questions for Residency Leadership in the Time of COVID-19<\/span><\/a>. There are, however, additional challenges faced by residency leadership in small community hospital settings. CHA is unique, as it is one of the few major publicly funded, safety-net healthcare systems in Massachusetts and serves as the main care provider for some of the most diverse patient groups.<\/span><\/p>\n

Challenges have included:<\/b><\/p>\n

\u00a0<\/span>1. Delivering just and culturally appropriate care to patients<\/b><\/h2>\n

More than half of our patients identify as racial or ethnic minorities and receive their care in another language, and during this COVID-19 pandemic, that percentage has continued to rise. Similar to other contagious diseases, like HIV\/AIDS, coronavirus highlights health disparities of race, class, and socioeconomic status.<\/span><\/p>\n