"My unit has been the designated unit since the first patient in Kentucky was diagnosed with COVID. Yes, there has been chaos, panic, fear, and uncertainty throughout all of this but, first and foremost, there has been an incredible group of people (I call them coworkers) willing to dive head-first into that uncertainty. I am beyond proud of the nurses, respiratory therapists, EVS workers, doctors, clerks, and spotters that have all come together to provide the absolute best care possible for the people of Kentucky. I will say going to work every day has its new challenges. Donning and doffing the protective gear needed to care for the COVID patients takes a lot of time and energy and prevents staff from following their normal routines. Before ever entering the patient’s room you have to gather everything you may need to cluster your care as much as possible. Once you are in the patient’s room you think about every step you take, your protective eye wear is fogging up, you’re hot, your gown is sticky, and you have a mask covering your mouth preventing you from fully communicating with anyone outside of the room. It can be a very isolating and lonely feeling when you are alone in the room trying to communicate through a doorway. It is a very odd game of charades to say the least. Once you are ready to exit the room, you have to think about every movement you make to safely remove the protective gear. Although it can feel isolating, there is always more than one member of the healthcare team right there ready to jump in at any time to help. I am thoroughly honored to be a critical care nurse and I will never forget how we as a healthcare team, state, country, and world have come together to fight this fight! I have to say thank you from the bottom of my heart for all of the support and kind words. I know my coworkers and I greatly appreciate the recognition because nursing can sometimes be a thankless job."

Yes, we seem to have landed in historic times. The novel COVID-19 virus was first recognized by an ophthalmologist in China when he saw a cluster of patients with eye complaints associated with the fever and respiratory symptoms we hear so much about. Sadly, he succumbed to the disease despite being a healthy 34 year old. UK Healthcare preparations began in January and quickly evolved as we gained better understanding of the oncoming threat. Our strategies were changing daily as new data emerged. I am pleased to report UK is currently well prepared for a surge that, thankfully, has been smaller than predicted so far. UK Advanced Eye Care is one of the few offices remaining open for urgent and emergent patients. We have continued to triage patients and - carefully, with proper screening and protection for all - provide care and surgery as needed. We have ramped up telehealth initiatives, and have even set up a process to do drive-through exams with eye pressure checks for glaucoma patients. Our doctors also stand ready to be deployed to COVID units as needed. Since many of us haven't done intensive care for years, we are undergoing training to be prepared for a supporting role. Sometimes the changes and possibilities seem overwhelming. But every day is also filled with positive, reaffirming moments. Crisis is definitely the mother of creativity! Attached picture is me with daughter, Dr. Ellen Sanders (TLS 2005), UK's one and only Pediatric Optometrist, before masks were mandatory. (By the way, it's fun to look across the room at a faculty meeting and realize your kid has become your colleague.) Our other daughter, Riley Ferguson (TLS 2011), is trying to navigate her first year of medical school at University of Cincinnati by remote learning. Tricky to recreate anatomy lab...

In regards to the virus, it has certainly changed my practice in some significant ways. After completing my residency in family medicine at the University of Wisconsin in Madison in 2019, I took about six months off to spend time with my now twenty-month-old son, Evan. I started my career as an outpatient family physician on February 24, 2020 at a clinic in the greater Madison area. Within two weeks, clinical life had changed quite a bit due to the effects of the virus. Like many others across the country, our healthcare system is trying to practice social distancing to protect our vulnerable populations, so we have transitioned to a model of primarily video visits with established patients when needed. Given that I had not yet had time to establish a robust patient panel, I was redeployed by our healthcare system to work in the COVID clinic, where we diagnose and triage patients with suspected COVID-19. As our understanding of the virus is ever evolving, we are constantly changing how we approach testing and care, so every day is different. So far, Wisconsin had been pretty successful in flattening the curve with social distancing - however, we have seen a slight uptick in cases in the past week, so hard to know what the future will hold. I have been assigned to the second wave of backup hospitalists in case we have a surge of cases and need all hands on deck. It is certainly an interesting time to start my career!

In early March, I had a lot of trouble imagining the impact that COVID-19 would have on my day-to-day job and my life outside of work. Shortly after that, the numbers here in New York, along with feelings of fear and uncertainty, quickly started to ramp up. Initially, we cancelled all elective cases and all of our non-urgent office visits (except for our pregnant patients). All of our vacations were cancelled. Patients were prohibited from having visitors. We started wearing masks at all times, both at the hospital and then in public. Then, in early April, all of the OBGYN residents, along with most of the other residents in the hospital, were re-deployed to cover medicine floors and ICUs. At that time, two thirds of our 600-bed hospital was COVID positive. It seems we have reached plateaued in the last few days, so I hope to go back to Labor and Delivery soon. Although I never could have imagined anything like this happening to all of us, I am thankful for the support of my husband and my family, my co-workers, and our Stony Brook community. And I am learning not to take simple things for granted, like good health, drinks with friends, and finding peanut butter at the grocery store.

Fortunately, Utah has been able to stall the predicted surge of COVID-19 critically ill patients with great county leadership and compliant social distancing. Thus far, it has been manageable, but the predicted rise in the number of cases has been projected to occur over the next 4-6 weeks with a peak in late May/early June. In general surgery, we receive training in critical care, thus our 4th and 5th year residents are among the first back-ups called to help with if we see a surge in our ICUs similar to NYC or Seattle. Thankfully, as I noted above, that surge has not yet become a reality, and I sincerely hope that we can avoid the difficult situations confronted by our colleagues around the country. My role during the pandemic has been both administrative and clinical. Administratively, I have helped with the hazard call schedule for the general surgery residency. This has been challenging given that two of our residents have tested positive for COVID-19. Also, as one of the rising chief residents tasked with the educational curriculum, I have worked with our program director to create educational content for our residents despite the current situation. The shake-up of normal clinical operations has led to interesting dilemmas regarding case numbers and educational requirements for graduation. Clinically, I am one of two residents tasked with running the surgical oncology, breast, and colorectal services at the Huntsman Cancer Hospital. As you can imagine, there are several cancer cases which cannot be delayed despite the imminent danger of the COVID-19 pandemic. This has resulted in difficult situations, as our hospital has a “no visitation” policy which does not allow close friends and family to be in the hospital with their loved ones. I cannot imagine being hospitalized for a week after major cancer surgery without this integral support network. I have found that the human element of my job (while already the most important aspect) has become even more important as I am obligated to directly support my patients at bedside and communicate with their families promptly to alleviate the fears and anxiety in these circumstances.

"Fortunately, thanks to great steps in social distancing taken by the people around Kentucky, my time has been spent working with the UK Healthcare team in strategic planning for a potential surge in Covid-19 cases and not an actual patient surge. As the Chief Resident for the internal medicine program, I am coordinating the deployment of our team to help staff needed services throughout the hospital. The IM residency program is the largest program and also one of the best equipped to care for the complex medical care of those hospitalized with Covid-19. Working with the pulmonary/critical care staff and fellows of UK and hospitalists, we provide the backbone of physician care for patients in this region that present with Covid 19 complications. Along with the administrative side of my job, I am also a board-certified internal medicine physician and stay busy working as a hospitalist at UK Chandler Medical Center and the Lexington VA Medical Center."

As a dermatology resident in New York City, my co-residents and I have been deployed to the frontlines to work on the COVID hospital floors and intensive care units at Jacobi Medical Center. I am currently working along side military physicians and FEMA nurses from all over the nation. My medicine team consists of an Air Force family practice physician and residents from several specialties including radiology, dermatology, general surgery, gynecology, neurology, and anesthesia. We are all practicing outside of our respective specialties. Initially, PPE was very limited, but adequate PPE is now available for all health care workers. I spend my day directly caring for patients, managing ventilators, and communicating with families. While I look forward to getting back to practicing dermatology, this experience has been unique and rewarding!

Although I have not been on the front lines throughout this pandemic, my practice has changed significantly. Most of my patient visits are now virtual (phone or video) with only occasional office visits for essential and immediate needs that cannot be met virtually. I do much of my work remotely, coming into the office about once a week. As a rheumatologist, most of my patients are on immunosuppressive medications which put them in a higher risk category with COVID-19, so I have had a lot of discussions with patients about how to best manage their individual risk. We’ve also faced critical medication shortages, most notably with hydroxychloroquine which is an essential medication for lupus and other autoimmune diseases and received some press as a potential therapy for COVID-19. I have been trained in inpatient palliative care as part of our hospital’s surge plan. Thankfully, so far California has not experienced a surge that would overwhelm our usual hospital capacity. I am grateful that sheltering in place has helped to flatten the curve and I wish everyone health and safety going forward.

As a resident, I have been relatively protected from the majority of Covid-19 cases, both on the general medicine wards and the MICU, but I have been involved in the care of many unfortunate patients who are infected, nonetheless. We have discontinued all but the rarest of visitation in the inpatient setting, and as an organization, we are now requiring masks and strict social distancing in all public areas of the hospital and clinics. There are site managers on all Covid floors, roles filled primarily by nurses from other areas of the hospital or around the country. These people help ensure that all team members don and doff PPE appropriately. Many rotations have been canceled. For instance, I am supposed to be on Geriatrics at the moment, but instead have been working outside the hospital on curriculum development and waiting on call to fill in for other senior residents as they are quarantined awaiting test results or refused entry from the hospital due to fever measured at check points. With Emergency Room Covid tests now resulting in a matter of hours, there is some level of absurdity (and subsequent gallows humor) that team members must wait multiple days based on the decision to limit the types of testing provided. This is worsened by the strain already placed on the personal and material resources of our healthcare system. Here in South Caroline we have been lucky in our relatively low number of cases, but we are subject to the whims of government officials with far different priorities than our own - formal political affiliation aside - so we await the dropping of the proverbial other shoe as we rush to roll back social protections. In the outpatient setting, we are seeing few patients in person and now are conducting primarily phone or video visits. There are advantages and disadvantages, but I suppose at least it provides the illusion of safety. Also, the connection has a tendency to "fail" when patients become belligerent, a feature sorely lacking in a face-to-face visit.