The coronavirus pandemic has brought life to a standstill, but for UVA alumni in the health care industry, it’s been all hands on deck. Here’s a look at how some of these nurses, doctors and scientists are responding to the historic fight.
Seth Wood (Nurs ’16)
Critical Care Registered Nurse
UVA Pegasus Medical Transport Team
Seth Wood remembers the moment he knew his world had changed. As a volunteer with a rescue squad in Charlottesville, he realized in early March how aggressive the coronavirus was, and he told his crew: “Be hyperaware of your personal hygiene. Wash your hands. Now is the time to be a germophobe.”
Because first responders must act fast and go wherever they are called, he reminded his team that they could be asymptomatic carriers and introduce the virus into a nursing home or their grandparents’ house. “That doesn’t mean panic or go into complete shutdown,” he told them. “It just means please, please, please be aware.”
Wood feels a loss of innocence that he fears may never return. He had hoped the odds would be favorable, “but it’s actually been the reverse,” he says. “The relentless mathematics of epidemiology says it was too late two weeks ago to get control of this. Now we just have to hunker down and hope we can ride this out.”
Dr. Ernie Esquivel (Med ’94)
Associate Vice Chair of Education, Department of Medicine
Weill Cornell Medical College, New York City
“I’ve never been more afraid as a physician to be in a hospital,” says Dr. Ernie Esquivel, an attending at New York-Presbyterian, one of the hospitals hit hardest by the coronavirus in Manhattan. “When I look at the profile of those patients, nearly half are younger than me. It’s scary to be confronted with the reality I could easily be as sick as they are.”
After working through the “very difficult calculus of how much I want to put myself at risk,” Esquivel—who also teaches internal medicine to second- and third-year medical students—decided to become a virtual-attending physician. He now helps from home in conversations with patients and their families, assists with clinical decisions and has created virtual learning opportunities for his students.
“People [in medicine] younger than me are facing these same situations,” he says. “They’re seeing people their age dying. Their colleagues are getting sick, too, and they’re trying to figure out, ‘What do I do now?’ ”
Jane Muir (Nurs ’16, ’22)
Emergency Department Nurse
UVA Health System
The coronavirus has highlighted the ability of emergency room staffs to adapt on the fly. “Change is the only constant you have in the emergency department,” says Jane Muir, who splits her time between work and studying nurse burnout for her dissertation. The staff members who keep the department running are “the most primed and ready to go. Our brains are shaped in that way. We always adapt.”
Although it is “a sad, scary, uncertain time,” Muir says she is proud of how her department is always creating innovative solutions. “We’re very collaborative and team-based,” she says. “That’s essential to resiliency.” Muir knows that when she puts on a gown to go into the room of a coronavirus patient, a team of nurses outside the door will line up and offer her support and encouragement.
Muir also praises how swiftly her hospital rose to the challenge. “One tremendous thing that struck me is how diversely talented the health system is,” she says, recalling how scientists, doctors, website designers, IT experts and executives rushed to give doctors and nurses fact sheets, posters and new web pages with the latest information on how to best fight the virus. “Knowledge,” Muir says, “is power during a time of fear.”
Dr. Janine Jagger (Grad ’87)
Epidemiologist and Professor Emeritus
UVA School of Medicine
More than a decade ago, Janine Jagger sounded the alarm that N95 masks don’t work. “Zero effective” is how Jagger describes 90 percent of them, because, she says, most hospitals fail to “fit test” the masks to workers’ faces. “Watch TV, and the health care workers are answering questions, and their masks are flopping up and down,” Jagger says.
She helped write Preparing for an Influenza Pandemic—Personal Protective Equipment for Healthcare Workers, a 2008 study by the Institute of Medicine—the health arm of the National Academy of Sciences—which called for the creation of better masks. The Centers for Disease Control and Prevention later funded the development and testing of one improved design, but it never came to market, Jagger says.
“This was such a massive disappointment that so much could be known in advance and not be done,” says Jagger, a MacArthur Fellowship recipient. “It has been extremely disappointing.”
Despite the limitations of such masks, Jagger believes their widespread use in all settings will speed a return to normalcy. She urges the use of masks with eye shields because viruses can enter through eyes’ mucous membranes. “Your eyes are very vulnerable,” she says. “Even wearing a pair of utility goggles would be perfect.”
Kellen Squire (Nurs ’11)
Emergency Department Nurse
Sentara Martha Jefferson Hospital, Charlottesville
Kellen Squire, who has worked in the ER for nearly a decade, recalls countless times when people have cried on his shoulder or held his hand in moments of fear and despair. “But we can’t do that now,” he says. “Now we’re behind a big ol’ visor and a mask all the time, so that puts you at a distance.” Because of strict visiting rules enacted to slow the spread of the coronavirus, one family of a new patient had to sit in their car in the parking lot. “We called them back and forth, and they were crying on the phone because they couldn’t come in,” Squire says. “It was tough. It made me tear up, too.”
As with the August 2017 protests in Charlottesville, Kellen hopes something good can arise from this crisis, too. “We had positive progress opening eyes after those events, but the cost we had to pay … ” Squire says, his voice trailing off. “We have to seize on every good thing we can take from this. If we don’t, all it will have been is heartbreak. We have to make sure something like this doesn’t happen again. We have to learn every single lesson we can and take them forward, but I know the cost to get there is going to be tough to bear.”
Dr. Christopher Crum (Col ’70 Med ’74)
Senior Pathologist and Professor of Pathology
Brigham and Women’s Hospital/Harvard Medical School, Boston
On March 3, Dr. Christopher Crum lectured at an Academy of Pathology conference in Los Angeles and watched the Lakers play that evening. After flying back the next day, life turned on a dime. When he went to work the next week, everyone at his hospital knew the virus was highly transmissible, and everyone would be socially distancing.
“When I’d go down to the frozen section room in the hospital, I’d take the back stairs,” says Crum, 71. “I did everything I could not to get close to anybody.” Early on, while at his microscope, he remembers someone leaning over to say something. “I began to worry because they’d violated the 6-foot [rule],” he says.
Crum can’t work from home because he must use his lab microscope to view samples from tumor cases. But he weighs his risks. “It’s very difficult because I love my job and my profession,” he says. “Patients need their diagnoses. As a physician, you feel obligated to get them done.”
His microbiologist wife worries that this coronavirus is just the beginning. “She tells me this is the warmup for something really horrible that’s going to kill a much higher percentage of the population someday,” Crum says.
Dr. Jon McCullers (Col ’89)
Pediatrician-in-Chief and Dean of Clinical Affairs
Le Bonheur Children’s Hospital/University of Tennessee Health Science Center, Memphis
“We were absolutely unprepared,” says Dr. Jon McCullers, who researched flu viruses for 15 years and has been a consultant to the World Health Organization, the CDC and Congress. “Even though we scenario-planned [a possible pandemic] and knew how to meet the thing, we couldn’t do it, because we didn’t have the people and resources in place we should have.”
After the 2009 H1N1 pandemic “nearly depleted” the U.S. strategic stockpile of protective gear, McCullers says Congress never appropriated funds to refill it. On top of that, he says, state and local health departments have also been underfunded.
McCullers, who is leading the local coronavirus response at a major regional medical center and a children’s hospital, believes it will be three years before a “good portion” of the U.S. population is vaccinated—if a vaccine can be developed. “We’ve been working on a SARS vaccine for 17 years,” he says. “And we haven’t been able to do it.”
Dr. Francis Collins (Col ’70)
National Institutes of Health
As head of the world’s largest biomedical research center, Dr. Francis Collins is working to fast-track a coronavirus vaccine, identify other therapies and enact policies to keep his staff of 30,000 at the NIH safe—not to mention supervise medical expert Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
Collins praises how Americans have stepped up to do their part in stopping the spread of the virus. It’s amazing “when you consider what people have been asked to do with little warning, to step away from their jobs, and [they’re] willing to do so because they recognize this is a way to save not just themselves, but many people they haven’t met, particularly those who are most vulnerable.”
Though he hopes the United States and China can sustain information-sharing about fighting the virus, he has a dim view of China’s “very authoritarian, top-down approach” to social distancing. “That’s not our country,” Collins says. “We achieved the same thing with a bottom-up approach. Americans recognized it was the right thing to do.”
A guitarist who famously spoofed Frank Sinatra’s song “My Way” when he was the 2001 UVA commencement speaker, Collins has always looked to music to get through stressful times. Ever since singer Bill Withers died in early April, his 1972 hit “Lean on Me” has been running through Collins’ head. “We’re all leaning on each other right now,” he says.
Amber Kuo (Col ’15)
General Medicine Nurse
NYU Langone, New York City
April 1 marked the first anniversary of Amber Kuo’s career caring for seriously ill patients. “I was getting into a groove,” she recalls. “I knew the types of patients I’d be getting and how to manage them, but, of course, we celebrated in the midst of a huge pandemic.”
Normally, the floor of her Manhattan hospital serves a range of patients. But as the days in March passed, “It was like every floor turned into a COVID floor,” she says. “So it’s like everyone is COVID. All the floors are COVID. It’s been interesting.”
While at work March 18, Kuo started to get chills. At home, her temperature reached 101.6. “As soon as I wasn’t go, go, go, the virus hit,” she says. “I felt like I was going to die.” After four days, her fever broke, and after being fever-free for three days, she was allowed to return to work.
Kuo is haunted by the memory of one patient who likely had the virus and died five hours after being admitted. She had been walking and talking, and 30 minutes later, she was dead. It was “really, really just jarring,” Kuo says. “We had other people who had multiple [chronic diseases or conditions] who were intubated and then somehow went home. It feels very much feels like a Russian roulette of who is going to make it and who isn’t, and you really never know.”
Dr. Ed Ellison (Med ’81)
Executive Medical Director and Chairman of the Board
Southern California Permanente Medical Group
Dr. Ed Ellison took up meditation 18 months ago. After all, it can be stressful even in the best of times to oversee 9,000 Southern California physicians who take care of 4.5 million patients. He finds that his daily evening practice quiets his spirit—which is especially needed these days.
“I am a senior leader who is helping ensure we are executing on a grand scale,” says Ellison, who began his career as a family doctor. But he demurs when asked if he thinks he’s like a general fighting a battle. “I’m not a militaristic person in the way I think,” he says. But he admits that “it does feel like executing a war against this virus. It is about strategy, execution, planning and people. I’m a big people person. I’m not losing sight of the people. I greatly believe in the value of the team.” Ellison leads multiple daily conference calls on infection rates and hospital and personnel use and gets reports from regional and national command centers in Kaiser Permanente’s health network.
“My days are a blur,” he says. “Weekdays, weekends are all the same. There is no normal.” He finds time to pay in-person visits to his medical centers and run virtual town halls to field questions from far-flung doctors and staff. “You can never communicate enough,” he says. “You can never say ‘thank you’ enough.”
Ellison says the crisis has sped up the adoption of virtual care via telemedicine, and he thinks this may become the new normal. “I’ve always been a proponent of making use of the opportunity that’s ahead of you,” he says. “In this tragedy, there is opportunity to reinvent ourselves.”
Dr. Lilian Peake (Med ’99)
Virginia Department of Health
Dr. Lilian Peake saw the pandemic coming—21 years ago. “I have known my entire career this could happen,” she says, but she feared that a flu virus, not a coronavirus, would cause a global crisis. In mid-January, she told colleagues, “If the trajectory doesn’t change, we are headed into a serious pandemic.”
Her office focuses on providing medical guidance for Virginia’s clinicians. What Peake calls her “decision point” came Saturday, Jan. 18, the holiday weekend before Martin Luther King Jr. Day and five days before Wuhan, China—where the virus originated—was quarantined. “We wanted to make sure we didn’t take a chance by waiting,” she says. “Our staff pushed information out to local health departments and physicians to let them know what was going on in China.”
In a job that demands a mastery of medical knowledge and stellar communication skills, it’s fitting that Peake joined the health care field after a decade in public relations. She tries to live by the best advice she’s ever received: “Be honest and sincere.”
Peake is awed by the resiliency of her team, which she says is overwhelmed by a flood of information that changes “incredibly rapidly” and the need to analyze and transmit it swiftly.
“We all have to keep working,” Peake says. “I would say every day I get to a point where I feel like, ‘My gosh, I don’t know if I can do this,’ but I push through it and keep going.”
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