CUIMC Post-COVID Recovery Task Force Update

To: CUIMC Executive Leadership
Subject: Post-COVID Recovery Task Force update

Dear Colleagues,

The COVID-19 pandemic has changed our personal and professional lives in ways that we could not have anticipated. Together we have learned, adapted, and supported one another while our clinical faculty and staff provided lifesaving care to thousands of patients, our researchers led the way with new discoveries, and our educators continued vital programs, much of it done remotely. We should all be enormously proud of how we have collectively faced these unprecedented challenges.

As we look at the most recent data, albeit with caution, many of the public health strategies and physical distancing put in place 60 days ago seem to have worked. The number of COVID patients hospitalized at the CUIMC/NYP campus is down by about 60 percent from its peak on April 13, the number of patients on ventilators is down by more than one-third, and hospitals throughout the tri-state area are seeing similar declines.

We are now entering a new phase. With the number of cases slowly declining, New York and other states are discussing plans to allow certain businesses to open on a limited basis. Although the Governor has not yet allowed the New York City area to come off its “pause,” it is important for us to prepare for a ramp-up of our activities.

With this reality in mind, last month we announced the appointment of a CUIMC Post-COVID Recovery Task Force, with 62 members representing all four CUIMC schools and with liaisons to both NYP and the Columbia Morningside campus. Each of these task force committees has deliberated extensively and now has shared preliminary recommendations, which are summarized below. In addition, a “back to work” employee guide is available on the HR website.

Please join us in thanking the committee members for all their work. Please also note that these recommendations are not “optional” and cannot vary by building or department. To avoid a recrudescence that would require us to contract our operations, we must continue our vigilance for the sake of our students, employees, patients, and community.

Thank you again for all you have done in these extraordinary times, and thank you in advance for your help with this next phase of our clinical, research, education, and community service missions.

 Sincerely,

 Lee Goldman, MD
Dean of the Faculties of Health Sciences and Medicine
Chief Executive, Columbia University Irving Medical Center

Anil Rustgi, MD
Director, Herbert Irving Comprehensive Cancer Center
Irving Professor of Medicine
Associate Dean of Oncology

CUIMC Post-COVID Recovery Task Force

Principal Recommendations

Health and Working Environment Committee

• Working from home will continue to be preferred. Where possible, working from home is preferable in order to reduce the number of individuals in the workplace and to minimize travel and possible exposure.
• Staggered work days and/or arrival times. Staggering workdays and spreading out arrival times in the mornings will help us reduce crowding in lobbies and elevators and improve safety. Departments, labs, and practice sites should coordinate work schedules.
• Face covering. Consistent with CDC, NYS, and NYC guidelines, face covering that covers the mouth and nose will be required in all public areas and shared workspaces. Face covering will not be required in private offices when the door is shut and there is no other occupant. Face covering is required in all other parts of the workplace. Staff at entrances will be checking to see that all who enter have a face covering, and if not, will provide such.
• Physical distancing. Six feet of space is needed to be safe and should be observed in the workplace to the extent possible.
• Limit meetings and meeting size. Technology should be used to replace in-person meetings even if people are on site.
• Break rooms. Stagger usage for taking breaks and meals. If there is no break room, conference rooms may need to be repurposed.
• Surface cleaning and hand washing. Disinfectant wipes should be used on shared surfaces in your workspace including keyboards, the mouse, doorknobs, copier/scanner machines, and other similar areas that you touch. Of course, you should wash your hands frequently.
• Spaces. Additional cleaning of shared spaces, including lobbies and bathrooms will be provided.
• Childcare. Childcare will continue to be an issue for many people and ongoing childcare options will continue to be made available.
• Testing for COVID. PCR testing for employees who either have symptoms of COVID or suspect they have been exposed to someone with COVID will continue to be available by calling WHS at 646-697-9470. Serologic (antibody) testing is also available. For both the PCR and serologic tests, the test results will not change the recommended precautionary behaviors and PPE.
• Visitor Policy. Access for non-employees to any Columbia space will be strictly limited. Security personnel will screen all visitors. We will continue to enforce the existing policy of Faculty and staff making arrangements to pick up any small items that are delivered to lobbies by sending someone to designated check-in points. Large deliveries will continue to be received via loading docks.
• Business travel. Business travel will continue to be restricted, as nearly all business meetings can be conducted via technology.

Clinical Committee*

• Maintenance of gains in telehealth. Patients (and clinicians) will be encouraged to continue to use telehealth.
• In person visits. Beginning May 11, we started an intentional ramp up. We will need to be sensitive where lobbies are shared with NYP or are in leased spaces. Elective procedures (other than urgent) still cannot be performed pending state regulation.
• Scheduling. Scheduling is being done only for semi-urgent patients, and capacity is being planned to maintain social distancing. Pre-screening for symptoms is being performed. Patients are also being advised of visitor limitations and mask requirements. Staff are encouraged to collect administrative and clinical information at the time of scheduling and to do as much as possible paperless.
• Arrival. Protocols are being changed so that patients are no longer instructed to arrive 15 minutes early. Patient and accompanying person need to be masked, and there can be no more than one accompanying person per patient. Patient time in the waiting room is being minimized.
• Practice layout. Lobbies, elevators, waiting rooms, and reception areas must accommodate physical distancing of six feet and markings will be placed on floors to facilitate spacing.
• PPE. The FPO will procure and coordinate distribution of PPE (surgical and N95 masks, eye protection, gowns) and other disinfectants. All practices will use enhanced cleaning and disinfection protocols.

*Protocols for ED/ICU/medsurg/surgical areas are being coordinated with NYP and, with respect to PPE, will involve additional precautions.

Education Committee

• Timeframe. CUIMC health professions learners will resume their clinical education as soon as training and clinical sites can assure adequate provisions for teaching, including the capacity for didactic teaching, appropriate case mix, adequate personal protective equipment, and supervision.
• COVID infections among students. CUIMC will develop the capacity to identify, treat, and quarantine learners who develop symptoms of COVID-19.
• Working with COVID patients. Learners should expect to work with patients suspected or known to have COVID-19. Each program will develop an opt-out mechanism for students with risk factors for poor outcomes of COVID-19.
• Central resources. Resources for resuming clinical education will include appropriate personal protective equipment (surgical mask and/or N95 mask with additional equipment as indicated for specific settings), capacity for testing and contact tracing for students, quarantine-compatible housing, and funds to support transportation to training and clinical sites.
• New curricula. New curricula will be developed for students across all schools/programs in COVID-19 care, telehealth, mental health, and health care justice.

Research Committee

• Identify and prioritize on-campus research needs. Programs will determine which research needs can be performed on campus and which research can be done remotely. Two tiers of research priorities will be determined in each laboratory-- A and B (e.g., based on critical research, papers, grant/fellowship commitments, animal care, etc.) for gradual ramp up/down.
• All work that can be done remotely should be done remotely. Activities including writing and analysis, laboratory meetings, talks, journal clubs, programs, and all meetings will continue remotely/virtually.
• Anticipate that research programs will need to operate at one-third of normal occupancy. Occupancy guidelines will be established for labs, conference rooms, and communal spaces by the Research Committee. Shifts will be determined per laboratory or shared space will be developed to ensure occupancy. Guidelines will be established for shared resources, staggered use of benches, and research spaces.
• Training. All faculty and staff will receive an orientation regarding the newly established guidelines including required PPE and cleaning protocols (e.g. wiping down work surfaces with a disinfectant, alcohol/bleach before and after use, UV lights for equipment). 
• PPE. Departments should continue to submit orders to Purchasing; they, in turn, will aggregate and centralize the ordering to ensure the best pricing.