Patricia George, MD - COVID19 - phaware® interview 323
Apr 24, 2020
BREAKING: COVID-19 SPECIAL EDITION: Patricia George, MD is a PH pulmonologist and co-director of the pulmonary hypertension program at National Jewish Health. She is also one of the original 4 racers on Team PHenomenal Hope. In this special LIVE edition of the phaware podcast, we connect with Dr. George as she and her colleagues board a plane to NYC to spend a week treating coronavirus patients in the ICU. #phaware #phawareMD
Steve Van Wormer:
Hello, good morning and welcome to I'm Aware That I'm Rare, the
phaware podcast. I'm Steve Van Wormer. It is bright and early here
in Los Angeles, California. I am on the phone with Dr. Patricia
George, pulmonologist from National Jewish Health in Colorado,
director of the pulmonary hypertension program there. We're doing
an on the fly episode here for you, because there's a great timely
event happening with Dr. George, and I want her to tell you all
about it. Patty are you there?
Dr. Patricia George:
Good morning, Steve.
Steve Van Wormer:
Hello. You are actually on the road, on your way to a tarmac right
now. Why don't you tell everybody what is happening with
you?
Dr. Patricia George:
I am driving hands-free of course, headed to a local airport, where
in just under an hour we're going to be wheels up and four of my
colleagues and I will be flying to New York City. We're on our way
to work as pulmonary and critical care docs for a week. I'm not
going as a pulmonary hypertension doc, but as we all know, there's
been that Coronavirus pandemic, and we have a relationship at
National Jewish Health with Mount Sinai in New York City, so
through that we were very fortunate to get the opportunity to serve
alongside our colleagues there. Hopefully, bring a little bit of
relief, do whatever we can to help in the next stint.
Steve Van Wormer:
What have you heard from your colleagues that have already taken
part of this? How long has this been going on?
Dr. Patricia George:
We've been sending doctors every week for the last three weeks.
This will be the fourth trip going out I believe, and the two
doctors who went initially are actually returning on this trip.
I've heard a lot from them, it's been really motivating and
inspiring to see my colleagues out there devoting themselves to
helping out. In fact, all of the doctors in our PH programs have
taken a stint and taken their turns out there. I'm just very proud
of them for stepping up as internists in pulmonary and critical
care docs in this challenging time. It's busy, they go out there
and work hard and you expect to work hard. Everybody who has gone
has said it's been a real privilege essentially, and an incredible
experience to be able to go out and help. It's pretty amazing to
hear what they have to say.
Steve Van Wormer:
Have you been involved in this kind of Doctors Without Border
relief work before?
Dr. Patricia George:
No, I have not. It was something that I thought about doing early
in my days but just never had the opportunity to do it. It'll be
exciting for me to be able to go this time.
Steve Van Wormer:
Can you tell me a little bit about Colorado over the past six weeks
or so. What impact have you seen in your day to day practice?
Specifically, in the PH community there, the patients you're
serving. What kind of impact is [covid19] having in Colorado?
Dr. Patricia George:
Great question and big question. Colorado started sheltering in
place early with social distancing, relatively, I mean in
mid-March, and as soon as that happened and even before then, of
course we saw these things pick up and I'll answer this question on
multiple levels. First, for the PH clinic, we responded right away
by doing as much as we can over the phone, and it shifted to
telehealth. One of our doctors who is really into IT, worked his
tail off to get National Jewish up and running with telehealth,
which has really helped us be able to keep people safe. At the same
time, the institution really went to take measures to keep patients
safe and people safe who actually came to the clinic. We have an
acute respiratory clinic for people who think they may have the
Coronavirus, and the entrance to that is separate from the main
entrance, negative pressure rooms, and they really have taken a lot
of care to keep people safe.
Dr. Patricia George:
People can go for Coronavirus screening and just stop at a tent in
the parking lot. They've really done their best to do social
distancing for people who have to go to the clinic. Of course, our
clinic volumes in person are way down because everybody, I think
patients and doctors, are trying to do what's safer for patients,
but it's important to realize that even though we have a pandemic,
people still have pulmonary hypertension and they still have
chronic heart and lung disease and those issues don't just go away
because of the pandemic. It's been important for us to stay open,
to be able to take care of our patients, and even see them in
person when we can.
Dr. Patricia George:
On a bigger level, the institution, it's been pretty incredible to
witness just everybody pitching in as a team. On every level. From
the people on the ground at the front lines, our nurses, our MAs...
By the way, the nurses in the PH clinic have taken on a lot more
because there's a lot more phone calls and a lot more phone care
and they're just amazing. They always have been and they've risen
to the challenge for sure. The nurses, housekeeping, the doctors in
the clinic, everybody's pitching in, but I've been super impressed
with our leadership, the infectious disease group, and occupational
medicine developing PPE protocols and there are policies that seem
to evolve and change day-by-day as guidelines change and as
resources change. Everybody's really all hands on deck to keep us
safe, keep our patients safe and do the best we can in this time of
crisis.
Steve Van Wormer:
I know this might not be your particular area of expertise, but I'm
curious, with you and your colleagues, what discussions or impact
are you seeing, not necessarily just for PH patients but for entire
communities or people that are impacted with being holed up, [are
they struggling with] depression or anxiety that young and old
people are going through?
Dr. Patricia George:
Good question. I think some of us, admittedly myself, feel it as
well, at least this anxiety of this time of pandemic, for sure. Our
patients, part of these telehealth visits, especially for routine
follow-up for patients who've been doing well, it's really
important for me to check in. I feel it's important anyway, because
I want to know that they're sheltering in place and they're doing
all the things, but I also want to know that they're okay. Not just
physically, but mentally with what's been happening. We're several
weeks into this now and some people had more concerns up front, and
I think some people have gotten used to this, hopefully temporary,
we don't know how long, but new normal. It's interesting to see the
morale shift over the weeks as we all mature in this crisis, or as
the crisis matures I should say.
Dr. Patricia George:
In terms of colleagues and people that I see, whether it's in the
Twittersphere or in person, online, in multiple Zoom meetings with
multiple grand rounds and webinars about COVID19 in various
settings and various organ systems. I think we've tried to squash
our anxieties with reading as much as we can. Trying to get as much
information, knowledge, sharing experiences, really seeking to
learn as much as we can about this new disease that we really don't
understand yet. It's a challenge. It's the challenge of our
generation of doctors, and I hope and pray that we're rising to
that challenge. I certainly see it around the country and around
the world every day, what I read from people, both in the journals
and online.
Steve Van Wormer:
How are patients, and you, adjusting or coping with, you mentioned
all the work you and your colleagues are doing with telemedicine?
How are you adjusting, or what misnomers do you think that you
could tell patients about what it's like to do a telemedicine
visit?
Dr. Patricia George:
I can tell you, because the first couple of weeks before we had our
telehealth connection up, I was calling patients on the phone
rather than seeing them in person, for the most part, I love my
patients. I love talking to my patients, laughing with patients,
helping people however I can, it's why I got into this, and that
relationship. But once we had the telehealth connection up, it's
not the same as in person, definitely not, but I'll tell you what,
it's really nice to actually see a face rather than just be talking
on the phone. To have that eye contact and to have that shared
experience in the clinic. I'll be honest, for some of our patients,
especially ones who live in the mountains or who live an hour and a
half, two hours away or even farther, I think they dig, even the
ones who live close, to be honest, many of them dig just being able
to telehealth in and not leave their homes. I've met some people's
cats and dogs. It's been awesome. I've enjoyed that. Certainly
better than the telephone. Just nice to connect.
Steve Van Wormer:
You're making your way to the airport here. Will you and your
colleagues touch down and you just snap into action or what are you
expecting?
Dr. Patricia George:
We'll get in today, we'll pass our colleagues at the airport in New
York. We've had five people out there who are coming back and I
feel like it's such an honor to get the handoff from them. We've
each been assigned to different hospitals in New York City that are
affiliated with Mount Sinai. I'll be headed to Queens. Today will
all be about getting checked into our hotel, they're kind enough to
find us places to stay and all of that sort of thing, and then we
go over and get our orientation, get our badges, figure out how to
log on to the computer. All that usual first day of work, first day
of school stuff. Then tomorrow we get ready to roll. I don't yet
know what my role will be. I've heard what the current two doctors
have done when they're at Queens, and I don't know if I'll be
literally taking on their service or how I'll be serving, and just
looking to help out however I can as a pulmonary and critical care
doc.
Steve Van Wormer:
You'll take all the steps and precautions and protective gear and
all that, as our first line responders are doing. What are some of
your best tips, suggestions that people, patients, general public
are listening, just best steps, best practices in these COVID19
times?
Dr. Patricia George:
We'll definitely be taking all of those precautions. First off, I
want to say, in general what I've found with our patients here in
Colorado and patients who I'm friends with around the country with
pulmonary hypertension, I've been super impressed. Sheltering in
place, in many respects, with people who live with chronic lung
disease, PH, it can be, for many people, a super power. They're
good at it. I think that's why we haven't heard of too many cases,
fortunately, of PH patients getting sick with Coronavirus. Now,
there's a lot of talk in the news now about loosening restrictions,
turning the economy back on and all of that sort of stuff. What I
would definitely encourage people to do is keep doing what's
working.
Dr. Patricia George:
This isn't gone yet and I think all of us feel a little bit of
anxiety with the thought of the economy turning on like the garden
hose, which I don't think will happen. I think most governors are
taking measures to talk about reopening things when we're ready and
stage wise and step wise. But no matter how that looks, keep
washing your hands, maintain some social distancing. Don't be first
out the door necessarily. I think our lives will change a little
while to come, because none of us are really thinking this is just
going to go away and this may be with us for a while. Stay at home
when you can because it'll keep you safe and it'll help prevent a
recurrence of the surge and help keep health care workers safe.
Steve Van Wormer:
Tell the listeners a little bit about one of the programs that you
and team are doing at Team PHenomenal Hope with the face masks?
Dr. Patricia George:
One of the things I really got interested in when this all started
was this concept of face masks and looking to find personal
protective equipment. I participated in some of that here at
National Jewish Health, and I was curious as to whether there were
good designs and would sewn face masks work? We've seen the
recommendations change a bit over time. With that week, even before
then, we launched a face mask campaign here at National Jewish
Health, and then on Team PHenomenal Hope, I saw patients around the
country, friends of ours who were trying to sew masks, et
cetera.
Dr. Patricia George:
We put some of that information online and wrote a blog post and
just called the campaign Sew For Hope, where people, wherever they
are in the country, we gave tips and guidelines how they might sew
masks for themselves, for their families, and/or local clinics and
hospitals. It wasn't for one hospital in particular, but just maybe
some guidelines and resources so that people could help out in
their own communities if they are gifted with the sewing machine.
Or even not gifted like me and just want to try.
Steve Van Wormer:
That's great. I will let you get back to it, I know you're in route
literally to the plane to send you to New York. I hope you will
come back and tell us what you found out or tell us what you
experienced and what kind of stories was with patients when you're
there.
Dr. Patricia George:
There's one other resource I wanted to put out there for PH
patients through Team PHenomenal Hope. We have a Patient Unmet
Needs Fund that we've had for a while, for over a year, where we
help patients with unmet non-medical needs. We opened it up for
people who are facing this crisis that may have extra expenses
right now due to COVID19. Whether it's trying to make a rent
payment or trying to cover COBRA coverage, that sort of stuff. It's
super easy to apply online, they can go to our website at
teamphenomenalhope.org and literally fill out an application on the
phone. It's there for people. I appreciate you letting me just
share that, in case people need this during this pandemic.
Steve Van Wormer:
Fantastic. Also, for the latest, obviously stay in touch with the
CDC. You can also go to our website, phaware.global/covid19. Patty,
thank you so much for being here. We will talk to you when you get
back, all right?
Dr. Patricia George:
Thanks, Steve, and stay safe.
Stay up to date with the latest on Coronavirus Disease 2019 at the CDC website
Click here for Important
COVID-19 Information & Resources
for PAH Patients & Caregivers from the phaware
website.
Team PH has launched an Unmet Needs Patient Impact Fund program to assist those with pulmonary hypertension in the communities affected by COVID19. Click here to Help Now