Sars-CoV-2 and COVID-19

Los Angeles County was among the first regions to have patients with COVID-19 and has been leading the nation in the number of COVID-19 cases. Within Los Angeles County, Glendale had some of the earliest cases, but the volume currently is low-average for the county. Timely actions both at Adventist Health Glendale (our home hospital) and at Family Medicine Center (our outpatient continuity office) helped our program stay ahead of the COVID curve.

Outpatient:

In the outpatient setting, a large majority of patient encounters were converted to telemedicine visits, thereby minimizing person-to-person contact. Recognizing that all concerns could not be addressed over video or phone, our office incorporated new screening protocols and recommendations for personal protective equipment (PPE) both for staff and patients in concordance with guidelines released by the Los Angeles Public Health Department and the CDC. We are happy to report that the number of COVID-19 cases in our community has decreased, thus we have increased the number of in-person visits, though still using previously mentioned screening protocols in order to provide quality care to our patients while maximizing the safety of our clinicians and staff.

Inpatient:

At our home hospital AHGL, in an attempt to preserve the health of our inpatient team members and patients, we reduced the number of people involved in direct examinations to one attending and one resident per day when caring for patients either confirmed to have COVID or a person under investigation. In terms of PPE, masks, gowns, gloves, and eye protection has always been and still is available when needed.

Additionally, before the first reported case in Glendale, a COVID Task Force committee was formed. This committee included of specialists in Pulmonary & Critical Care, Infectious Disease, Pharmacy and hospital leadership; it has been the driving force behind evidence-based policies, guidelines, and management recommendations for our hospital. The hospital has flexible capacity for additional ICU beds and patients that require respiratory isolation. Patients with or suspected to have COVID are placed on the same unit(s) within the hospital.

Select rotations and didactics

Given that some of the outpatient rotation offices were closed during the peak of the pandemic, our administrative staff in conjunction with our faculty worked very hard to re-allocate affected residents to alternate rotations. Our didactics were transitioned to online Zoom conferences and our faculty members offered once a week zoom meetings to touch base with residents and ensure the mental health and wellbeing of residents during an unprecedented time. Moving forward, we are continuing to offer didactics remotely for those that are interested.