AN INTERNAL MEDICINE RESIDENCY RESPONSE TO THE COVID-19 PANDEMIC IN LOUISIANA Seth M. Vignes, MD; Brittany L. Boudreaux, DO; Shane E. Sanne, DO; Catherine M. Hebert, MD; and Lee S. Engel, MD, PhD Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans
Seth M. Vignes, MD , is a Medicine Chief Resident for the Internal Medicine Residency Program and an Assistant Professor of Clinical Medicine in the Section of Hospitalist Medicine in the Department of Medicine at Louisiana State University Health Sciences Center, New Orleans Brittany L. Boudreaux, DO , is a Medicine Chief Resident for the Internal Medicine Residency Program and an Assistant Professor of Clinical Medicine in the Section of Hospitalist Medicine in the Department of Medicine at Louisiana State University Health Sciences Center, New Orleans Shane E. Sanne, DO , is an Associate Program Director for the Internal Medicine Residency Program and an Associate Professor of Clinical Medicine in the Section of Hospitalist Medicine in the Department of Medicine at Louisiana State University Health Sciences Center, New Orleans Catherine M. Hebert, MD , is an Associate Program Director for the Internal Medicine Residency Program and an Associate Professor of Clinical Medicine in the Section of General Internal Medicine in the Department of Medicine, and Co-director of Clinical Science Curriculum in the Office of Undergraduate Medical Education at Louisiana State University Health Sciences Center, New Orleans Lee S. Engel, MD, PhD , is the Program Director for the Internal Medicine Residency Program and a Professor of Medicine in the Section of Hospitalist Medicine in the Department of Medicine at Louisiana State University Health Sciences Center, New Orleans ABSTRACT The novel human coronavirus disease, COVID-19, was first identified in Wuhan China in December 2019 and quickly spread to the entire planet. While New Orleans enjoyed Mardi Gras in February of 2020, we were unaware that the ongoing mix of tourism and gathering of large crowds would fuel the spread of the COVID-19 pandemic to our city and state. New Orleans saw its initial and largest COVID peak to date in early April 2020. At the peak, all the hospitals in the greater New Orleans area quickly became inundated with patients affected by COVID-19. The goal of this article is to share our experience, our designed responses to the multitude of issues facing our internal medicine residency program, and the lessons we learned during the COVID-19 pandemic.
INTRODUCTION The novel human coronavirus disease, COVID-19, that was first identified in Wuhan China in December 2019, represents the fifth documented pandemic since the 1918 flu pandemic. 1 The initial rapid ascent of COVID-19 in New Orleans and Louisiana was likely the result of a combination of increased global tourism in our city and the gathering of large crowds for the Mardi Gras celebration that occurred in February 2020. With the subsequent availability of testing, the first reported case of COVID-19 in Louisiana occurred on March 9, 2020 at the Veterans Administration Medical Center in New Orleans. By the following day, there were two more cases at separate New Orleans area hospitals. The World Health Organization declared coronavirus a pandemic on March 11, 2020. Reported coronavirus cases rapidly increased and the first Louisiana death was reported on March 14, 2020. During the following ten days, schools closed, hospitals limited visitors, bars and restaurants shut down, and drive through testing sites opened. Confirmed cases increased to over one thousand, and a “stay at home” order was issued for Louisiana. By the end of March, there
were over four thousand COVID-19 cases in Louisiana and a few states set up interstate checkpoints to prevent travelers from New Orleans from entering. On April 1, 2020, Louisiana had the highest per capita deaths from COVID-19 in the U.S. A pre-publication report by researchers at Scripps Research Institute, Tulane University, and LSU Health Shreveport proposes that the coronavirus most likely arrived in New Orleans about two weeks before Mardi Gras 2 . These researchers suspects that one case source exploded into 50,000 confirmed cases over those first few months after evaluating genome sequencing and cell phone tracking data. 2,3 As of this writing, there have been over four hundred thousand cases of COVID-19 with over nine thousand deaths in Louisiana. The largest peak in the New Orleans area occurred in April 2020 with other smaller peaks in July 2020 and January 2021 (Figure 1). Here we share the responses that the internal medicine residency program at Louisiana State University Health Sciences Center (LSUHSC) in New Orleans made to the pandemic with regards to resident/ intern-delivered patient care, communication, resident/ intern education, resident/intern wellness, residency 36
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