On the frontlines of a pandemic

Alumni describe their experiences confronting COVID-19

Dr. Mary McLean

Mary McLean, M.D. ’17, is an emergency medicine resident physician in the New York metro area. She's been working in the emergency department (ED) and ICU before, during and after the peak of COVID-19 in the Northeast.
 
When did COVID-19 first come across your radar screen? 
COVID-19 first came across my radar screen in the end of January. My mother-in-law was watching a news report about it while I was visiting Oregon, and she was becoming more and more concerned. I thought little of it initially – I thought we would be able to face it easily as a country, and that the media hype was a bigger problem than the virus itself. My mother-in-law won that argument! I started becoming very concerned at the beginning of March while traveling by Amtrak from Albany back to New York City. People were coughing and having gastrointestinal symptoms on the train. One rider even vomited on the floor and the train had to be stopped so the ambulance could bring him to the hospital. Suddenly I found myself feeling unsafe in this public place in the face of the growing concern for the pandemic. I started taking social distancing seriously at that point.

How did you respond?
Physicians carrying the virus home with them is a real concern. My husband and I needed to live apart for months – me in New York, and him in Oregon. I needed to get all my emotional support virtually, either by phone, FaceTime, email or social media. My life was work and home, and the only people I saw face-to-face were my coworkers in the ED and ICU. We went through serious things together, trying to help so many critically ill patients who had been hit hard by COVID-19, and we bonded more than ever. Our community came together and helped take care of health care workers with food, drink, PPE donations, homemade surgical caps and masks, clothing donations and even homemade mask headband “ear savers.” It was heartwarming and so important in these difficult times.

How did your education and training help you prepare?
My education and training at OHSU definitely helped me prepare for the COVID-19 pandemic. From the basic science courses in anatomy and cell structure and function, to the numerous clinical exposures that started early in the first year of medical school, it was all important to my understanding of this new and evolving disease. ED rotations and residency training brought it all together in time for me to be helpful during this epidemiological crisis.
 
What adaptation or change would you like to see continue after the pandemic passes?
It’s all about our leaders. When a crisis happens on a large scale like this, our leaders must step up, make informed and smart decisions in collaboration with seasoned top experts in the field, and be the role models we need.
 
What is the biggest challenge you face?
It is extremely frustrating going to work and risking my own health for my community when there are people being reckless, ignoring social distancing and choosing not to wear masks for unimportant reasons. Even more difficult to face is the knowledge that some people believe COVID-19 is a hoax altogether. I wish they could shadow an emergency physician in a hot zone for one hour, but that cannot happen. We will keep caring for patients, but it feels like a slap in the face.
 
What have you learned during the pandemic? 
During the pandemic, I have learned how big a difference it makes to have a cohesive team of coworkers whom you can trust, and with whom you enjoy spending time. My coworkers made all the difference on shift, and we got each other through this global crisis that otherwise would have felt even more traumatic. I feel so fortunate.

What are your thoughts about the future?
We need to think about how our system failed us and how we failed ourselves. We need to analyze every hole in this Swiss cheese model, take action and never make the same mistakes again. The COVID-19 pandemic was (and continues to be) a global crisis, but there will be more pandemics and more crises in our time. Our leadership, our policies,and our individual responses are supposed to help keep us safe. When we have put none of the puzzle pieces in the right place, we have made ourselves vulnerable.

Geoff Melly, Ph.D. ’19, is a microbiology fellow at Washington State Public Health Laboratories. The state experienced one of the earliest outbreaks of COVID-19 in the United States.

When did COVID-19 first come across your radar screen? 
I first became aware of COVID-19 in early January, when I started hearing about an outbreak of viral pneumonia in Wuhan, China. I’ve been interested in emerging infectious diseases for a long time, so I am hypersensitive to news reports of illnesses of unknown etiology. As more and more information about the new outbreak became available, the similarities with the 2002-3 SARS outbreak were readily apparent. From a technical standpoint, I remember being astounded at the speed with which the SARS-CoV-2 virus was identified and its genome sequenced. As I started to hear about human-to-human transmission, and suspected a-/pre-symptomatic transmission, I realized we were heading into something we hadn’t seen before. On a scientific/professional level, I felt a kind of focused exhilaration, since in a very basic sense, this was why I decided to work in microbiology. On a personal level, however, I was worried about my friends and family, many of whom have risk factors for severe COVID.

How did you respond?
I started a fellowship at the Washington State Public Health Laboratories in mid-February. A state Incident Management Team was already in place, given that the first case of COVID-19 in the US had been identified in WA, in mid-January. I was going through the on-boarding process and getting started on my project when two things happened almost simultaneously: the first known COVID-related deaths in the nation, and the realization that SARS-CoV-2 had already been circulating undetected in Washington. The Washington Dept. of Health reacted immediately by expanding the scope of the IMT and pivoting agency-wide to address the emerging COVID pandemic.  My group turned into a PCR testing team, so I’ve been performing and analyzing tests that detect the presence of viral genetic material in patient samples since the start of the pandemic.

What has been the outcome so far?
We have tested thousands upon thousands of patient samples, and we are constantly improving our testing efficiency to better support the state public health response.  We have also been collaborating with local research groups to perform genomic analyses of SARS-CoV-2 strains circulating in Washington State.

How did your education and training help you prepare?
My training in molecular microbiology (Dr. Georgiana Purdy Lab shout-out!) has prepared me well for my current role. The technical and analytical skillset I gained at OHSU is the foundation of my current role as a public health microbiologist and has enabled me to make an immediate contribution to the COVID-19 response in Washington State.

What adaptation or change would you like to see continue after the pandemic passes?
We need to substantively address systemic inequity in American society. Dramatically expanding access to health care, especially longitudinal care and especially to traditionally underserved populations, would be a start in this direction. We should also start to valorize proactive public health measures and basic biomedical research.

What is the biggest challenge you face?
Early on, we were dealing with rolling reagent/material shortages as seemingly every lab in the nation was standing up a COVID testing program. Luckily, we adapted and were able to maintain our testing capacity through this tumultuous period. In a larger sense, it is very discouraging to realize the extent to which science denialism has become entrenched in mainstream discourse. It is challenging to find a way to meaningfully counter the blatant misinformation that I see on a daily basis.

What have you learned during the pandemic? 
Speaking as a microbiologist, it is absolutely fascinating to be on the ground as this is unfolding in real time. Each day brings a new revelation about this virus and the disease it causes. However, this is tempered by recognizing the morbidity and mortality that is being caused by this pandemic. Lives and livelihoods are being upended, and these effects are unevenly distributed. This pandemic is making everything that was already true about life in the United States even more so.

What are your thoughts about the future?
I want to believe that we will learn from this. I don’t see any problems that can’t be solved with some hard work and empathy. We’d better start getting to it.

Lee Shapley, M.D. '12, is vice president of medical affairs at Asante Ashland Community Hospital in Ashland, Oregon.

When did COVID-19 first come across your radar screen? 

COVID first really appeared on my radar on January 20th. That is the date that I created my outlook folder called “Novel Coronavirus” with an alert from the Oregon Public Health Division. I know that I had heard some rumblings in the news about it a month earlier and throughout January. While it certainly was concerning, it was hard to imagine the effect it would have ultimately.

How did you respond?

I was pulled off of clinical duties and placed into a more administrative role to help coordinate our response. We are the ICAR (Infection Control and Response) hospital for the region and we do have some extra infrastructure that came in very handy and made us more prepared for this. We essentially shut down almost all operations and then rebuilt.

What has been the outcome so far?

We did have a small surge, but it was very reasonable. We are, so far, very fortunate to be in one of the regions in the country that has a low incidence. However, we are a tourist destination and, having a low incidence cuts both ways.

How did your education and training help you prepare?

I was fortunate to work with a number of other OHSU-trained physicians and nurses here in southern Oregon to mount a solid response. These OHSU grads were some of my strongest allies and most reliable partners through the entire process.

What adaptation or change would you like to see continue after the pandemic passes?

I feel that a greater emphasis on public health infrastructure is overdue in this society and needs to continue.

What is the biggest challenge you face?

My role has changed forever as a result of this, and I am now the administrator of my small hospital, so my challenge will be to continue to have the hospital function on a high level and to remain flexible enough to both respond to future outbreaks as well as continue to provide services to our community.

What have you learned during the pandemic? 

I have learned to value the little things. That is what I really learned from this, is that the little things matter in life and that these are the things that make us happy.

What are your thoughts about the future?

Fingers crossed…