“I Couldn’t be Prouder:” The COVID-19 Response

As the state of Vermont began to shut down in mid-March in response to the COVID-19 pandemic, members of the Department of Medicine mobilized for a potential influx of patients throughout the UVM Health Network.

Mark Pasanen, M.D. (at left), former chief of the Division of Hospital Medicine, says the effort to set up a system of care has relied on solid teamwork, trust, communication, and a good deal of flexibility. Although the pandemic is far from over, as many states see a resurgence of cases and community spread, Vermont has managed to keep case numbers low thanks in large part to the leadership and expertise of department members.

“Almost everyone has had to do something new on the fly,” he says. Pasanen served as chief of the Division of Hospital Medicine until July of 2020, when Caroline Lyon, M.D., associate professor, took over the position.

Gilman Allen, M.D., professor in the Division of Pulmonary Disease and Critical Care Medicine, has been heading up the biological branch of the incident command structure the state set up in the early days of Governor Phil Scott’s Stay Home, Stay Safe Order. Cindy Noyes, M.D., associate professor in the Division of Infectious Disease and Amy Teleron, M.D., former assistant professor in the Division of Hospital Medicine, also both played key roles in this organization.

Physicians and staff in the Divisions of General Internal Medicine and Geriatric Medicine had to rapidly shift gears to triage patients presenting with COVID-19 symptoms and provide a “higher level of care closer to hospital-level.” Serious outbreaks at nursing homes and skilled nursing facilities in the Burlington area also required a quick, coordinated response, led by Jennifer Gilwee, M.D., associate professor and chief of the Division of General Internal Medicine and Michael LaMantia, M.D., M.P.H., associate professor and chief of the Division of Geriatric Medicine.

At UVM Medical Center, the Division of Hospital Medicine took the lead on reconfiguring floors to isolate and care for COVID-19 patients. MaryEllen Antkowiak, M.D., assistant professor in the Division of Pulmonary Disease and Critical Care Medicine, continues to play a key role in managing the ICU, which was modified to accommodate critical COVID-19 cases. Teleron and Michael Latreille, M.D., assistant professor in the Division of Hospital Medicine, set up a system using iPads to communicate with hospitalized COVID-19 patients when possible, reducing risk to families and hospital staff.

Clear and consistent communication from Department of Medicine Chair Polly Parsons, M.D., and other medical center leaders has helped to ease concerns and make sure staff have the resources and information they need to do their best for patients.

“It’s been a really proud moment for the department,” Pasanen says.

As Vermont looks ahead to the fall, the Department of Medicine continues to plan and prepare for any potential resurgence of the disease. Sourcing PPE remains a focus, as does ensuring an adequate supply of testing materials. The experience of quickly standing up temporary medical sites in March at the Champlain Valley Exposition and the Patrick Gymnasium has prepared the state should it need these facilities again.

Members of the Department of Medicine are also hard at work on potential treatments and vaccines. New research collaborations as a result of the pandemic are promising: Pasanen says COVID-19 has helped to break down silos between researchers who may not regularly work together. Rheumatologists, pulmonologists, critical care physicians, infectious disease specialists and many others have come together to better understand the disease, explore potential treatments and vaccines, and improve care for COVID-19 patients.

Now, the goal is to continue to provide good “modeling and messaging” to the public around mask-wearing, physical distancing, and hand hygiene. Vermont, with leadership from the Department of Medicine, seems ready for the challenges to come.

“We’ll continue to be focused on how to do a better job of taking care of people who are sick and at risk of getting sick,” Pasanen says. “We’ll need to maintain energy and focus in the months to come.”