COVID-19 hospital medicine update

Friday, January 22, 2021
Post submitted by Dr. David Gallagher, Chief of Hospital Medicine programs at Duke University Health System

The Duke hospital medicine team continues to play a key role in helping treat patients with COVID-19 infection and develop hospital-based processes and policies to keep staff safe. We last reported out on the status of Hospital Medicine in Spring 2020 and we are happy to provide an update.

By January 2021, the hospital medicine services (and emergency departments and intensive care units) are all experiencing greater numbers of patients with active COVID-19 infections since Fall 2020. The number of community infections and hospitalizations are rising in tandem with the holiday season (see graph from Performance services). We have been seeing approximately 9% weekly increase in COVID hospitalizations over the last few weeks and we have had to implement COVID surge planning. The Department of Medicine has done a great job in floating some available attending physicians to assume general medicine teaching responsibilities, thereby freeing up hospitalists to work in our COVID units. At Duke Hospital, we now have 6 adult COVID-19 isolation units: 2 ICUs and 4 intermediate step down units. DRH and DRAH each have large intermediate step down COVID isolation units as well. Residents on general medicine teaching services are also rotating in the COVID units. Dr. Cara O’Brien is leading efforts for hospital medicine and Department of Medicine to create an enhanced home care support for patients with COVID infection to avoid need for acute hospitalization.

Hospital workflows & processes

Hospital workflows and processes remain similar from Spring 2020. Visitation restrictions remain in effect with limited visitation for non-COVID patients and very restricted visitation for COVID patients. PPE is in good supply because of the fantastic efforts of our procurement and materials teams and donning & doffing of PPE is second nature to many of our providers now. Hospitalists have signed up enthusiastically for the COVID-19 vaccine and we are now finishing second dose for most of our providers.

Research

Our hospitalists continue to help support many of the ongoing research trials involving COVID treatments. Participating hospitalists include Dr. Thomas Holland, Dr. Noel Ivey, Dr. John Franzone, Dr. Lana Wahid, Dr. Emily Ko, and Dr. Tatyana Der.

Resilience

Resiliency work during this pandemic is crucial for everyone including hospitalists. We still try to connect socially via Zoom, Webex, etc., but we miss the in-person collegial interactions and hope and pray this changes by summer! Hospital medicine is also so grateful for the overwhelming support of all of our colleagues at Duke Health and our communities – this support is what keeps us focused during these challenging times.


 

Dr. David Gallagher
Chief, Hospital Medicine Programs