Professors and staff at the University of Medicine of South Carolina are sharing their hard-earned knowledge about COVID-19 with colleagues around the world who are battling new waves of infections.
From Charleston, Lacey Menkin Smith, MD, director of the Global scholarship in emergency medicine at MUSC, is leading an effort to get practical information to physicians at OneWorld Health Masindi Kitara Medical Center in Uganda, one of many locations around the world that the MUSC Center for Global Health works with.
And specialist in infectious diseases Krutika Kuppalli, MD., co-founded a non-profit group, India COVID SOS, which has strived to gain information for both the public and medical professionals as India was hit hard and is now expanding its focus to Africa and other parts of Asia as COVID goes around the world.
June saw a record number of cases and deaths in Uganda. And with less than 1% of the population vaccinated, on June 18, Ugandan President Yoweri Museveni imposed a strict 42-day lockdown.
Only a week before, MenkinSmith had returned to Charleston from Masindi Kitara Medical Center. She was there to work on a grant from the Centers for Disease Control and Prevention evaluating the effectiveness of an online training program for healthcare workers on high-risk infectious diseases.
But as COVID cases are already on the rise, she and her team have used their free time to help their Ugandan colleagues set up an isolation service and update protocols to deal with suspected or probable COVID-19 cases. .
As she was preparing to leave Uganda, she learned that the MUSC Center for Global Health had awarded her team a virtual exchange grant to facilitate the creation of continuing medical education for Masindi Kitara Medical Center. and its three peripheral clinics. When his team initially applied for the grant, the idea was to create educational modules on a variety of topics related to emergency medicine. But with the COVID spike, the medical director of the Ugandan health system has asked him instead to focus on COVID – and complete the modules as soon as possible.
Back in the United States, MenkinSmith sent a call to her colleagues at MUSC – who, she asked, would be willing to tape a useful lecture on a COVID topic? Already, MenkinSmith and hospital epidemiologist Cassandra Salgado, MD, have recorded and lectured on hospital protocols and clinical presentation of COVID. Infection preventionist Kristen Stoltz and Ryan Taylor, RN, host a conference on infection prevention and transmission while infectious disease specialist Scott Curry, MD, works on a conference on diagnostics.
Conferences are simple PowerPoint-type presentations. MenkinSmith said they were focusing more on getting news out to Uganda quickly than making Hollywood-worthy videos.
âPerfect presentations that arrive in three months won’t make a difference,â she said.
She is also keenly aware of the resource differences between the United States and Uganda, and she and Taylor, who also worked at Masindi Kitara Medical Center, coordinate with other MUSC presenters to ensure information can actually be used by the Ugandan team. .
For example, COVID testing remains a scarce resource in Uganda. At MUSC Health last winter, the emergency department could test a patient and get the results in an hour or two, MenkinSmith said. At Masindi Kitara Medical Center, doctors are to send PCR tests to the capital and will not get results for a week. A nearby hospital sometimes has “rapid” tests, which return results in about three days.
As a result, Ugandan doctors have to rely on clinical diagnosis. These are the protocols that the MenkinSmith team worked with their Ugandan colleagues to develop, which classify patients as âprobableâ or âsuspectâ cases based on a combination of symptoms.
âBy the time the diagnosis comes back, they could have been in the hospital for a week. If we hadn’t used the right infection prevention strategies with them, then we would have risked transmission, âshe said. “At the same time, if we make the criteria too loose and everyone becomes a probable case, there isn’t enough PPE to last.”
She also helped develop protocols for who should wear what personal protective equipment in which areas of the hospital and how to safely reuse N95 masks for one week at a time.
Since internet connections can be spotty in Uganda, MenkinSmith sends the lectures to the country director, who then downloads them and takes them to the hospital for viewing at morning staff meetings.
Meanwhile, infectious disease expert Kuppalli focused on the pandemic in India. India’s push, which peaked in May, has overwhelmed its healthcare system. India now has the second highest number of cases and third highest number of deaths in the world, according to the Johns Hopkins Coronavirus Resource Center.
In April, Kuppalli and a few other doctors developed a infographic with simple and straightforward instructions on how to treat COVID-19 at home when hospital care is unavailable. Importantly, the infographic also included a list of treatments that were no longer considered effective.
The infographic filled a void as it quickly went viral and was picked up by the Indian government, the World Health Organization and others. Kuppalli and the others then created India COVID SOS, a coalition of physicians, researchers, engineers and community partners working to share evidence-based solutions. The group has created additional educational resources for the public, which have been translated into dozens of languages, as well as launching fundraisers and donations of equipment and educational resources for health professionals, assistance in mental health for medical professionals and creative engineering to conserve oxygen.
Now the group is expanding its efforts, as much of the work is applicable to Southeast Asia, where cases are on the increase.