Volume 31 | Issue 2 | July 2020

A few months ago – what seems like a century – I daydreamed about all the good news that would come from our Annual Meeting in San Francisco. I was confident I’d be writing about how the meeting was a phenomenal success and how well SOCCA was positioned for the future.

Perhaps unsurprisingly, this issue of Interchange is devoted to COVID-19. As a professional society comprised of critical care anesthesiologists, SOCCA members have responded in numerous ways to the unfolding pandemic: clinical care at the bedside, reconfiguring perioperative spaces, leading surge responses at all levels, developing clinical and operational guidance at the national level, and remaining at the forefront of investigative efforts. In the meantime, the critical care fellowship match cycle has drawn to a close, and those of us in academic settings are both celebrating our departing trainees while preparing for the influx of new faces.

The SOCCA Research Committee met in-person during the February 2020 SCCM Congress in Orlando. We arrived upon several goals further outlined below. While progress has been slower than planned for obvious reasons, we remain committed to gradually ramping up over the coming weeks.

Given the extraordinary disruption to training and medical practice caused by COVID-19, the American Board of Anesthesiology (ABA) has taken swift action to relax policies, offering increased flexibility for anesthesiologists. The Board has also worked to provide seamless access to educational and mental health resources for impacted physicians.

Natalia Ivascu, MD (Weill Cornell Medicine) and Jonathan Hastie, MD (Columbia University Vagelos College of Physicians and Surgeons) are critical care and adult cardiothoracic anesthesiologists in New York City. Their leadership of a coordinated COVID-19 pandemic response across the New York-Presbyterian health care system was recently featured in NEJM Catalyst.

Among its many impacts, COVID-19 has spawned a plethora of early data and literature. That which is not high-quality may hinder progress toward our understanding of the disease. Critical care and, more broadly, perioperative medicine are clinical arenas that generate massive volumes of data. As we routinely care for patients with COVID-19 in those settings, these data hold promise to further our understanding of the disease.

Nicole King is an anesthesiologist and critical care physician at the University of Cincinnati. She is currently obtaining her Executive Masters in Clinical Quality, Patient Safety and Leadership at Georgetown University. She answered a call for volunteers in New York and staffed a repurposed operating room intensive care unit for a month. While there, she chronicled her experience via e-mail. Excerpts from those e-mails are reproduced below. Only minor edits have been made where necessary for readability and to guard privacy.

The COVID-19 pandemic has raised many ethical and moral dilemmas in the realm of public health, social order, duty of care, and fair distribution of resources. Difficult decisions must be made about how, where, when, and to whom resources should be allocated. Physicians and health care workers are bound by a duty of care, therefore, obligations to the patient’s well-being are generally considered to be primary. This is grounded in the principle of beneficence, among others. There is also a reciprocal obligation placed on health systems to provide the best possible infection control modalities at the disposal of healthcare workers, to provide them preferential access to care should they become ill, and to consider the well-being of the families as critical to supporting healthcare workers.

Telework, or telecommuting, is an alternative work arrangement where “employees perform tasks elsewhere that are normally done in a primary or central workplace”. According to the US Bureau of Labor Statistics, more than 25 million people were telecommuting in 2018, and the number of telecommuters increased 115% between 2005 and 2015. Workplace social distancing, including telework, has been considered a possible mitigation strategy during influenza pandemics, and a number of companies and governments have encouraged workers to telecommute because of the current COVID-19 pandemic.

Of all the disruption created by Coronavirus Disease 2019 (COVID-19), nothing remains more constant than its enormous uncertainty. How the immediate and long-term future of the pandemic will play out remains unclear. Yet, it is certain that the world is now fundamentally different. COVID-19 has and will continue to adversely impact individual and population health, both directly and indirectly.

Read members-only job posts—including learning about a role with the International Anesthesia Research Society (IARS), which is seeking candidates for the position of Medical Officer for the IARS-FDA SmartTots Public-Private Partnership—at SOCCA’s Job Board.