Every Infectious Disease That Came Before COVID-19 Prepared Us

Q&A

• Question

  When did you first become aware of COVID-19 outside of the United States?

  Answer:I happened to be in Switzerland at the time and was with friends with whom I had graduated from medical school. We were reading in the news what was happening in China and discussing whether the illness was a global threat, whether this could be the next SARS or the next epidemic.

• Question

  Were you afraid in the early days?

  Answer:No. As a health care epidemiologist, you’re always thinking about what could be. Always in the back of your mind, you think, “What should I be worrying or thinking proactively about? Could this virus come to the U.S.? How should we prepare?” As epidemiologists, we are engineered to think ahead. It’s really a question of how do you detect or how do you prevent infection. For example, what PPE (personal protective equipment) should you use? What are the needed diagnostic tests? Ventilation systems? Etcetera.

• Question

  When did you start to realize that a global threat was emerging?

  Answer:Toward mid-January 2020, we started hearing about something unusual going on in Italy. Within weeks, it was clear that the situation was remarkable and dangerous. Illnesses started appearing in the region of Bergamo in northern Italy. That was when my attention became very narrowly focused and I started thinking about San Diego and a need for a headquarters of local operations. Then, in late-January, we got the phone call that planes would be arriving from Wuhan. That was our unified call to action at UC San Diego.

• Question

  What prepared you for the patients’ arrival from China?

  Answer:Every infectious disease that came before COVID-19 prepared us. In 2014, we prepared for Ebola and even designed and built an infectious disease unit to care for potential patients. Before that, there was SARS, H1N1, and avian flus. All of the lessons learned came into play. While there was no test for COVID-19 early on, we already had intense safety protocols to prevent disease transmission, plus the CDC team was onsite for consultation. We knew that this was a respiratory virus, so if we had good protection, and we knew how to doff (or remove) our PPE without contaminating ourselves. We would have appropriate layers of defense.

• Question

  What did you see in the patients’ faces when you entered their rooms?

  Answer:For me, one thing that struck me about the patients from China was the fear. The fear of being targeted because of the perception of bringing a disease into a new country? The racism, the inherent fear of being targeted, the abrupt separation from family all became factors. All of the patients had a connection to the U.S and so were allowed to get on that plane, but their fear was real. When I saw them, I observed how isolated they were. I felt the pure humanity of it all. Very few of the patients actually tested positive. One happened to be a grandmother and nurse bringing her grandson to the U.S. She had to be separated from him to be hospitalized and how heart-wrenching that was to see. In the grandmother, in all the patients, was this fear of rejection, and this feeling of guilt. Survivor’s guilt. But at the same time, a lot of gratitude towards us, who were willing to take care of them, and welcome them.

• Question

  What was the game-changer in altering the course of the pandemic?

  Answer:One of the things I greatly appreciated was a leadership team deeply grounded in reality. They were very keen on learning from a wide variety of experts and polling them on a regular basis to guide the health system forward. They made hard decisions to protect the integrity and the survival of the health care ecosystem, especially our CEO. It was gutsy to stop all surgeries because we wanted a safe environment for all employees and patients, knowing that there would be economic consequences. Our C-suite was among the heroes in this community. We took in the first patients, launched the first clinical trials and vaccinated the first community members. None of this would have been possible with leaders who were not nimble and present every single day.

• Question

  What traits about UC San Diego Health helped us survive the pandemic?

  Answer:One of the things I greatly appreciated was a leadership team deeply grounded in reality. They were very keen on learning from a wide variety of experts and polling them on a regular basis to guide the health system forward. They made hard decisions to protect the integrity and the survival of the health care ecosystem, especially our CEO. It was gutsy to stop all surgeries because we wanted a safe environment for all employees and patients, knowing that there would be economic consequences. Our C-suite was among the heroes in this community. We took in the first patients, launched the first clinical trials and vaccinated the first community members. None of this would have been possible with leaders who were not nimble and present every single day.