LEADERSHIP IN THE TIME OF COVID Charles V. Sanders, M.D. Edgar Hull Professor and Chair
Department of Medicine LSU School of Medicine New Orleans, Louisiana
ABSTRACT Like medical departments throughout the United States and the world, the Louisiana State University (LSU) Department of Medicine has experienced a year of profound challenges as it contended with the myriad ramifications of COVID-19. At the same time, these challenges have presented opportunities for growth, and there have been many lessons learned that have helped us to handle this crisis and would be useful in coping with any crisis.
“In the shock and devastation… residents began… to take stock, to evaluate shortcomings and areas in which lack of preparedness was evident in a city that had perhaps grown too complacent about the potential for disaster. It is only wise to make such assessments and then attempt to learn from them.”
insignificant to be worthy of a name—are less clear, though the World Health Organization researchers currently looking into that very issue in Wuhan have recently affirmed that it appears to have been zoonotic in nature. Like a storm in its infancy, the early stages of an unusual disease attract the attention of those highly specialized professionals trained to study such anomalies, but the threat only garners widespread notice once it is large enough to be of pervasive danger. Although the novel coronavirus began infecting humans in the waning days of 2019, it was not until January 2020 that reports thereof started to trickle out to the world, and very few people really seemed to pay it much attention at first. No one was stockpiling PPE or formulating disaster plans. Here in New Orleans, we were our characteristically exuberant selves, holding our decadent Mardi Gras festivities without a second thought of the invisible pathogen spreading its deadly way through the crowds of revelers. Exactly onemonth later, NewOrleans (Orleans Parish) had “the highest per-capita death rate for the coronavirus among all American counties to date.” 2 In March 2020, like every March, I was scheduled to attend on our hospitalist service at University Medical Center of New Orleans (UMCNO) with the two incoming Medicine chief residents. I was happy: treating patients and teaching students and residents are two of my favorite activities. Little did I know that COVID-19, which had seemed so far away and disconnected from our reality here in New Orleans, was about to slam into our city the way that Katrina had 15 years prior. UMCNO admitted its first recognized case of COVID on March 9, and when I learned about that upon reporting for service the following day, I made arrangements for another physician to cover for me and left. That day, March 10, 2020, was my last day on the 44
The above sentences are not about the COVID-19 crisis but are, rather, excerpted from an article I coauthored several years ago about the challenges faced and the lessons learned from shepherding the Department of Medicine in the LSU School of Medicine through the cataclysmic damage and suffering wrought on the city of New Orleans by Hurricane Katrina in August 2005. 1 Given that the focus of the present article is also on the challenges and lessons that resulted from a disaster—the pandemic, of course—I felt compelled to look back at what I had previously written and noted that many of the same points could still be accurately made. Not merely in NewOrleans this time, but in the whole country and nearly the whole of the world, there had been insufficient preparation for disaster, resulting in shock and devastation. The only thing to do in such situations is to look squarely at such mistakes and learn from them. Katrina and COVID-19 have been the two great tragedies that have indelibly marked my 32 years of service as chair of the LSU Department of Medicine. While the difficulties they caused were different, they were definitely both responsible for the two most trying times in my professional career. At the same time, both illustrate the truism that strength arises from struggle, crisis from opportunity; and ultimately there was considerable overlap in many of the lessons learned. Pandemics, like hurricanes, start small. The storm that would become Katrina—initially too insignificant to be worthy of a name—was born on August 19, 2005, ten days before it would slam with all its fury into the city of New Orleans. In the warm, late-summer waters north of Puerto Rico, it quietly took shape, formed out of the rather unholy, though seemingly innocuous, union of the remains of Tropical Depression Ten and a tropical wave. The origins of what would come to be known as COVID-19—initially too
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