If your medical center hasn’t been hit by the pandemic yet, get ready. Much will happen very fast. PPE will run out. Labs will shutter. ERs will overflow. How can you prepare? No matter how busy you are, you have WAY more time now than you will. Move to a war footing TODAY. 1/

Clinical needs will dominate. PPE. Diagnostic tests. Ventilators. Staff getting cik. Redeployment. OB/GYNs will staff the ER. Traditional seniority will break down. New leaders will step up. Are you one of them? 2/

PPE stands above all else. Face masks, gloves, shields, gowns. You think you have enough? You don’t. Get your engineering dept on manufacturing NOW. Have a dozen 3D printers sitting idle in a lab? Start printing face shields. Specs available online. 3/

Your hospital won’t want the gadget you made. It’s not approved. Get them to plan for when they run out. Is it better to use non-commercial gear or a bandanna? I know which your doctors/nurses will prefer. Make your hospital set a policy on this NOW. Force the issue. 4/

Hospitals want one unit collecting/distributing PPE. It makes sense. It’s logical. It’s not enough. A whole dept. may have sufficient PPE on average, but that nurse’s station in the corner has run out. Official lines of communication become clogged. How do you fix this? 5/

Columbia’s med student volunteer org– CSSC –numbers hundreds of volunteers who know the frontline nurses, residents, and fellows. They get reports. Consider using med students as a second line of communication to overcome the fog of war. 6/ https://www.ps.columbia.edu/education/covid-19-student-service-corps-cssc

After point of care will be testing. Diagnostics. Serology. Viral load. These need to be developed, submitted, and approved for in-house clinical use NOW. All of this is doable until you consider the scale which will be 3-4 logs higher than usual. 7/

No you can’t just run RTPCR in your lab. Clinical tests are held to high standards because they inform life and death decisions. Don’t try to do this yourself. Figure out how to help your clinical diagnostics lab. If they got it in hand, stay out of their way. 8/

Next is research. No one will know who is doing what. Set up a REGISTRY of COVID19 research at your institution NOW. Make it accessible by everyone so folks can connect organically. Find a way to connect multidisciplinary teams who can work together on specific problems. 9/

Get a biorepository for COVID19 samples IRB approved NOW. Set up workflows. Determine if it’s BSL2+ or BSL3. Find expanded staff and more space. Figure out who’s labeling the tubes. This is a truly critical resource that is needed right now. It will enable critical research! 10/

Admin will stretch thin. Emergencies shuffle needs. Functions that normally take 2 people now require 8. Others will have little to do. Some will feel powerless to help. Others will be overwhelmed with not enough help. How can we connect these two groups in a facile way? 11/

In the past 10 days, I helped launch CRAC Teams – an organization at Columbia that connects volunteer researchers with critical needs at Columbia. @Columbia_CRAC We’re marshaling the extraordinary personnel and resources of our institution to meet the challenge of COVID19. 12/

With ~400 volunteers, we launch teams of skilled experts to tackle projects, e.g. sterilizing used PPE, staffing a biorepository, helping our IRB with data management, tech support for an online mini-symposium of COVID19 research, etc. More info here.13/ https://columbiacovid.weebly.com/ 

I’ll post soon how CRAC Teams works. Key bit: we don’t try to supplant official efforts, but rather support them. Trust your experts. Find out what they need. Get it for them. Build contacts with administration. If you show you can fix problems, they may come to you for help.14/

A volunteer org can bridge across domains in unique. By including reps from engineering, basic, translational, epidemiological, and computational science as well as clinical efforts, we can rapidly deploy multidisciplinary teams to address complex problems.15/

Crises put us to the test, but they also bring out the best. I cannot fully express my pride in @Columbia. Scientists teaming to respond. Administrators working overtime to help. Heroic caregivers risking their lives for their patients. We will make a difference. You will too.16/