Physician-in-Chief's Message
March 30, 2020
Dear Colleagues,

Please see updates below. I have asked Stuart Gold, Martha Perry and Kenya McNeal-Trice to lead Coping and Wellness in the time of COVID. Please reach out to them with ideas!
UNC COVID Updates
General Updates
  • Effective tomorrow all faculty and staff will receive “Wellness Checks” prior to assuming duties at all inpatient and outpatient sites. This will include temperature checks and symptom review.
  • Masks are recommended in every clinical setting for all individuals having face-to-face contact with patients regardless of whether the patients have symptoms. Detailed protocols and information will be available on the UNC Health Intranet in the near future.
Inpatient Care
  • We still have an ongoing number of Patients Under Investigation but no pediatric patients that are positive for COVID-19.  
  • Rooms 7C15 through 7C24 have been converted to NCCC beds and the move went well this morning.
Virtual Care
  • The goal is for all providers, including residents, to have access to video visits by Friday. There were glitches with video visits through Epic today. Until we get new direction, continue trying to expand video visits in whatever way available, and sounds like UNC is working on an expanded solution soon.
  • Click HERE for a simple description of how to open, document and bill for Phone Visit (phone or video), Patient Outreach Encounter (phone or video), and Video Visit in Epic.
  • Click HERE for a single page billing sheet for virtual visits.
Ambulatory Care
  • UNC Health is working to get all ambulatory clinics on the Chapel Hill campus, with the exception of the Hem-Onc, to off-campus locations. This will decrease patient flow through the hospital and open up extra work spaces or patient care spaces. We are looking for the best location on campus but outside of the hospital for the few patients that need outpatient care here.
  • The Franklin Street Primary Care Clinic is continuing to provide most of the care virtually with a small number of patients being seen in clinic when medically indicated.
  • Click HERE to review the new specialty clinic scheduling workflow.
Your COVID-19 Questions & Answers
Response from Tom Belhorn

Q : I know it's been said that the highest risk group is the elderly and those with some of the comorbidities discussed, but is there any data on how adults 30s-50s are faring? I have been hearing anecdotal reports of otherwise healthy people in this age group having a hard time and having respiratory failure, but was curious if any data had actually come out of this?

A: We do hear news reports of younger previously-healthy individuals becoming quite ill with COVID-19, but it is important to look at the overall data from the CDC or local health departments to see the big picture. Sometimes patients who are “outside” of the usual risk groups may be highlighted by media. Like with any disease process occasionally we can see individuals in low risk groups become ill. But the initial epidemiology from China seems to be consistent with US data to date regarding the main risk groups: older individuals (stated as >65, but in truth with advancing age) and those who have a serious underlying medical condition (e.g. chronic lung disease or heart disease, diabetes, certain forms of immune compromise, etc.). The current CDC data reports that 80% of the deaths (8 of 10) due to COVID in the US have been in people older than 65 years old. We are still intrigued, and have many hypotheses, about why children for the most part seem to be spared from serious illness. But we still need to take all efforts to avoid infection –no matter your age or other coexisting illnesses.
Coping and Wellness in the time of COVID
  • We are searching for ideas and inspiration to support wellness for Children's staff, learners & trainees, faculty.
  • We need your help! Here are a few preliminary ideas we are considering:
  • Grand Rounds: Have a grand rounds or conference specifically focused on providers coping during COVID. Presented by Pediatrics faculty with some input from Psychiatry.
  • Social Media: Shared private Instagram page for people to upload happy or encouraging pictures and photos with captions
  • Virtual gatherings: Zoom cocktail parties, yoga, meditation, grief support group
  • Peer Support: Develop a 1:1 buddy system for internal support
  • Collection of Wellness Tools: Develop a list of tools to help with eye strain, increased screen time, cognitive overload and general stress of the current situation (e.g., Headspace, Calm, Stop Breathe & Think apps; scalp massagers, eye pillows, aromatherapy, progressive muscle relaxation)
  • Be Vocal and Transparent: Continue to emphasize we are all going through this, it is natural to have a variety of emotional responses. We recommend everyone consider connecting with a mental health professional for a baseline check and to establish a relationship that can be accessed when/if future worsening stress-related symptoms occur.
  • Please reach out to Stuart Gold, Martha Perry or Kenya McNeal-Trice with any thoughts on these ideas or any new concepts that may help keep us all well and whole.
Please reach out to me with any concerns or questions. Also, don’t forget to attend our webinar on Thursday at 11:30 am entitled The Impact of COVID-19 in Children (Session 2).

Gratefully,
919-417-3130 (cell)