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UPMC officials testify to Senate in regard to safe reopening

Steven D. Shapiro, M.D., executive vice president, chief medical and scientific officer, and Donald M. Yealy, M.D., chairman of emergency medicine, both of UPMC, detailed a “safe and smart” approach to reopening society and bringing back lesser essential procedures with a “targeted approach” to protect the most vulnerable in a recent Senate hearing.

“When the regions throughout Pennsylvania saw their first COVID-19 cases a few months ago, much was unknown about the virus,” Yealy said. “Since then, we have learned a lot — a lot about how to care for people with the COVID-19 illness and a lot about how the interventions to manage the virus not only affect our care but people. We are now in a very different place.”

He added that mitigation measures such as social distancing and isolation that were used to flatten the curve was used to make sure that hospitals, emergency rooms and intensive care units wouldn’t be overwhelmed by the enormous amount of patients.

“The curve flattened because of all the activity and cooperation,” Yealy said. “But flattening the curve cannot get rid of the infections. It simply spreads the cases out over a longer time. That allows us to learn.”

Recent observations and research has shown one of the most important notes in dealing with the virus.

“Worldwide, we know that the elderly are the most vulnerable people, especially those who reside in assisted living communities or nursing homes,” Yealy said. “Knowing that helps us take a targeted approach to keep as many people as safe as possible.

UPMC has been implementing and adjusting assisted living and nursing home safety plans during the outbreak to ensure the utmost safety. A testament to their hard work is that there has been zero cases of the virus at any UPMC senior facility.

The system is also working on numerous treatments in clinical trials, including a vaccine.

“The scientific community has been moving quickly,” Shapiro said. “(It) developed this adaptive clinical trial where instead of just testing one treatment, you can test multiple at a time.”

Shapiro added that antibody testing so far has been optimistic and successful alongside convalescent plasma transplants which have already been used on patients to help during the early stages of the viruses.

Though there is no specific timeline on the vaccine, it will unlikely be completed by the fall according to Shapiro.

In terms of schooling and childcare, Yealy and Shapiro agree that there is a safe way to bring students back into school if new protocols such as screenings for all children, staff and teachers, children staying home if they are sick and additional cleansing and sanitization within the schools.

Both Shapiro and Yealy also addressed the reopening of more elective-like surgeries where patients pick the date and find an opportunity to schedule care.

This is done on a case-by-case basis to bring in patients where the care is necessary because of health complications.

“What we have to learn to do is to provide the scheduled care and accommodate that in a system that also takes care of COVID-19 patients,” Yealy said.

Some protocols that have been added include testing all patients even those who are asymptomatic to ensure the utmost safety for those who are coming into or living in any facility, emergency room or hospital according to Shapiro.

Weekly testing and contact tracing of those residing in assisted care or nursing home facilities will begin and will happen over time as well.

In addition to those protocols, telemedicine and teleICU measures have also been created and utilized within the UPMC system, teleICU being innovative and also helping other hospitals in need.

“It is something we are constantly learning about,” Shapiro said. “This is a multisystemic disease.”

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