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| Medical Students, Sidelined for Now, Find New Ways to Fight Coronavirus | Medical Students, Sidelined for Now, Find New Ways to Fight Coronavirus |
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| As hospitals around the United States brace for an ongoing surge in coronavirus cases, one question they are grappling with is whether medical students should be deployed to help care for patients infected with the virus. | As hospitals around the United States brace for an ongoing surge in coronavirus cases, one question they are grappling with is whether medical students should be deployed to help care for patients infected with the virus. |
| For now, the nation’s 90,000 medical students have been largely sidelined from patient care during the crisis. Last week, the Association of American Medical Colleges recommended that medical students end all patient contact for at least two weeks. The reasoning is that sending medical students home helps conserve scarce personal protective equipment — including masks, gloves and gowns. It also gives schools time to educate students on Covid-19 should the students eventually be needed for patient care. | For now, the nation’s 90,000 medical students have been largely sidelined from patient care during the crisis. Last week, the Association of American Medical Colleges recommended that medical students end all patient contact for at least two weeks. The reasoning is that sending medical students home helps conserve scarce personal protective equipment — including masks, gloves and gowns. It also gives schools time to educate students on Covid-19 should the students eventually be needed for patient care. |
| Disappointed by the abrupt halt to their training, medical students around the country have responded with grass roots efforts to secure masks, staff patient call centers and even provide child care for beleaguered doctors. | Disappointed by the abrupt halt to their training, medical students around the country have responded with grass roots efforts to secure masks, staff patient call centers and even provide child care for beleaguered doctors. |
| Students at the N.Y.U. Grossman School of Medicine began using a Slack channel to mobilize volunteers. One of the largest efforts involves creatively sourcing personal protective equipment from a range of businesses, including veterinarians, tattoo parlors, dry cleaners, hardware stores and hair and nail salons. So far, students from N.Y.U. have collected about 8,200 surgical masks and 700 of the more protective N95 respirator masks. | Students at the N.Y.U. Grossman School of Medicine began using a Slack channel to mobilize volunteers. One of the largest efforts involves creatively sourcing personal protective equipment from a range of businesses, including veterinarians, tattoo parlors, dry cleaners, hardware stores and hair and nail salons. So far, students from N.Y.U. have collected about 8,200 surgical masks and 700 of the more protective N95 respirator masks. |
| “I thought I’d be learning to listen to the heart and lungs or conduct an outpatient interview, but that’s not what is needed right now,” said Elyse Berlinberg, a second-year medical student at N.Y.U. “Part of the role of being a physician is being part of the community and knowing their needs and responding to them. I think the service we are doing now is part of forming our professional identity.” | “I thought I’d be learning to listen to the heart and lungs or conduct an outpatient interview, but that’s not what is needed right now,” said Elyse Berlinberg, a second-year medical student at N.Y.U. “Part of the role of being a physician is being part of the community and knowing their needs and responding to them. I think the service we are doing now is part of forming our professional identity.” |
| Another “mask drive,” held by medical students at the University of California, San Francisco, over the weekend, collected almost 15,000 masks for local hospitals. | Another “mask drive,” held by medical students at the University of California, San Francisco, over the weekend, collected almost 15,000 masks for local hospitals. |
| At the University of Colorado School of Medicine, student organizers used a GroupMe texting app, Facebook and email to mobilize not only classmates but also area nursing, physical therapy and pharmacy students. Now more than 300 student volunteers are working at nine locations in the area, including hospitals, elder outreach programs and the local Salvation Army. | At the University of Colorado School of Medicine, student organizers used a GroupMe texting app, Facebook and email to mobilize not only classmates but also area nursing, physical therapy and pharmacy students. Now more than 300 student volunteers are working at nine locations in the area, including hospitals, elder outreach programs and the local Salvation Army. |
| Some students have been deployed to Covid-19 call centers, fielding questions about people’s symptoms and when to get tested or go to the hospital. Others students stand outside hospital doors, screening visitors. | Some students have been deployed to Covid-19 call centers, fielding questions about people’s symptoms and when to get tested or go to the hospital. Others students stand outside hospital doors, screening visitors. |
| “I was supposed to start a palliative care rotation on Monday, and I can’t, and I won’t get those skills,” said Jake Fox, a fourth-year medical student who helped coordinate the effort, and who will start his residency at Massachusetts General Hospital in Boston in June. “That said, what we are doing is very purposeful. Doing something meaningful now supersedes that disappointment.” | “I was supposed to start a palliative care rotation on Monday, and I can’t, and I won’t get those skills,” said Jake Fox, a fourth-year medical student who helped coordinate the effort, and who will start his residency at Massachusetts General Hospital in Boston in June. “That said, what we are doing is very purposeful. Doing something meaningful now supersedes that disappointment.” |
| Students at the University of Minnesota School of Medicine organized Minnesota CovidSitters, a student-run group that created a website to match medical students with health care workers who need child care, pet sitting or errands during the crisis. | Students at the University of Minnesota School of Medicine organized Minnesota CovidSitters, a student-run group that created a website to match medical students with health care workers who need child care, pet sitting or errands during the crisis. |
| Laura Bowman, a second-year medical student there, volunteered and was matched with a medical resident who needed child care for two young children. Ms. Bowman spent a rainy day last week baking chocolate chip cookies, doing a dinosaur puzzle, and coloring a Paw Patrol Rescue Pups coloring book with two young children of a medical resident. “It isn’t exactly what I pictured myself doing, but it’s in line with my idea of health care providers,” Ms. Bowman said. “It’s been a great opportunity to help in a different but meaningful way.” | Laura Bowman, a second-year medical student there, volunteered and was matched with a medical resident who needed child care for two young children. Ms. Bowman spent a rainy day last week baking chocolate chip cookies, doing a dinosaur puzzle, and coloring a Paw Patrol Rescue Pups coloring book with two young children of a medical resident. “It isn’t exactly what I pictured myself doing, but it’s in line with my idea of health care providers,” Ms. Bowman said. “It’s been a great opportunity to help in a different but meaningful way.” |
| Opinions are divided and changing as the outbreak progresses. Some argue that students’ lack of experience limits their value in treating patients and puts the students needlessly at risk. Others say they will be needed, can be trained to help safely and will learn valuable lessons from being involved. | Opinions are divided and changing as the outbreak progresses. Some argue that students’ lack of experience limits their value in treating patients and puts the students needlessly at risk. Others say they will be needed, can be trained to help safely and will learn valuable lessons from being involved. |
| Dr. John Prescott, chief academic officer for the Association of American Medical Colleges, said the group will continue to update its guidelines for medical students, but the decision on whether to deploy medical students to the front lines is up to each school, depending on the local situation. | Dr. John Prescott, chief academic officer for the Association of American Medical Colleges, said the group will continue to update its guidelines for medical students, but the decision on whether to deploy medical students to the front lines is up to each school, depending on the local situation. |
| “What was normal a week ago, even two days ago, is not where we are now,” said Dr. Prescott. “The situation continues to evolve and change.” | “What was normal a week ago, even two days ago, is not where we are now,” said Dr. Prescott. “The situation continues to evolve and change.” |
| Boston Medical Center has decided to keep medical students away from patients with suspected or confirmed coronavirus infection, Dr. Ravin Davidoff, the center’s chief medical officer, said. | Boston Medical Center has decided to keep medical students away from patients with suspected or confirmed coronavirus infection, Dr. Ravin Davidoff, the center’s chief medical officer, said. |
| “Our primary emphasis is to protect them from unnecessary exposure,” he said, but added that the shortage of personal protective equipment was also a major reason for limiting the students’ roles. | “Our primary emphasis is to protect them from unnecessary exposure,” he said, but added that the shortage of personal protective equipment was also a major reason for limiting the students’ roles. |
| Vanderbilt University Medical Center has also decided that medical students should not treat coronavirus patients. But Dr. William Schaffner, an infectious disease expert there, said it could be valuable training. | Vanderbilt University Medical Center has also decided that medical students should not treat coronavirus patients. But Dr. William Schaffner, an infectious disease expert there, said it could be valuable training. |
| Updated June 5, 2020 | Updated June 5, 2020 |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| “They’re going to have to deal with this as medical professionals, as practicing physicians, whatever their specialty turns out to be,” he said. | “They’re going to have to deal with this as medical professionals, as practicing physicians, whatever their specialty turns out to be,” he said. |
| At the same time, Dr. Schaffner said, concerns about the supply chain for personal protective gear were also leading Vanderbilt to limit the number of people entering isolation rooms to the minimum number truly needed to take care of the patient. | At the same time, Dr. Schaffner said, concerns about the supply chain for personal protective gear were also leading Vanderbilt to limit the number of people entering isolation rooms to the minimum number truly needed to take care of the patient. |
| Dr. Shanta Zimmer, senior associate dean for education at the University of Colorado School of Medicine, said the school decided that 184 third-year medical students would not return to their clinical rotations starting last Monday, for at least four weeks. | Dr. Shanta Zimmer, senior associate dean for education at the University of Colorado School of Medicine, said the school decided that 184 third-year medical students would not return to their clinical rotations starting last Monday, for at least four weeks. |
| “The most important reason is actually to help preserve PPE,” she said, referring to masks and other protective equipment, “and to let the important front-line providers have access to that.” | “The most important reason is actually to help preserve PPE,” she said, referring to masks and other protective equipment, “and to let the important front-line providers have access to that.” |
| Other factors, Dr. Zimmer said, included the fact that elective procedures have been scaled way back at the hospitals where University of Colorado students do their rotations, and that the students are needed at call centers and to check in with primary care patients. All students are also taking an online elective that the medical school just created about Covid-19. | Other factors, Dr. Zimmer said, included the fact that elective procedures have been scaled way back at the hospitals where University of Colorado students do their rotations, and that the students are needed at call centers and to check in with primary care patients. All students are also taking an online elective that the medical school just created about Covid-19. |
| “Not everyone is destined to be a front-line provider in situations like this,” Dr. Zimmer said. “But it doesn’t mean they can’t be super helpful right now.” | “Not everyone is destined to be a front-line provider in situations like this,” Dr. Zimmer said. “But it doesn’t mean they can’t be super helpful right now.” |
| As for whether the medical school would agree to deploy its students to the front lines in the event of a surge of patients, Dr. Zimmer said, “We are having this debate back and forth on my team right now. The fourth-year students, they’re almost doctors — graduation is in May. For the third-years, we are trying to prioritize their safety and keep them busy with virtual training.” | As for whether the medical school would agree to deploy its students to the front lines in the event of a surge of patients, Dr. Zimmer said, “We are having this debate back and forth on my team right now. The fourth-year students, they’re almost doctors — graduation is in May. For the third-years, we are trying to prioritize their safety and keep them busy with virtual training.” |
| Cyrus Ghaznavi, a second-year medical student at Washington University School of Medicine in St. Louis, said a child-care service organized by students to support hospital workers received more than 100 requests in the first 24 hours. | Cyrus Ghaznavi, a second-year medical student at Washington University School of Medicine in St. Louis, said a child-care service organized by students to support hospital workers received more than 100 requests in the first 24 hours. |
| “Anything we can do to relieve burden on the real heroes,” he said. “We can enable them to work at peak performance and that is more helpful than having us there when everyone is overworked.” | “Anything we can do to relieve burden on the real heroes,” he said. “We can enable them to work at peak performance and that is more helpful than having us there when everyone is overworked.” |
| Denise Grady contributed reporting from New York. | Denise Grady contributed reporting from New York. |