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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

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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