Dear Colleagues,

We’re now more than two months into the COVID-19 pandemic and we’re all getting a bit tired. The runners among us have likened this to a long-distance race, with the added difficulty of not knowing how long it will last. But I take comfort from the words of Lisa Richardson: “It is the point in the race when all I want to do is quit. But I know that if I trust my training and push through, I’ll hit that zone where I feel like I could run forever”.  

I know we will develop strategies to provide safe and effective patient care and educate trainees under these new circumstances. But the pace of change means that we’ll need to develop and adopt these rapidly and with incomplete and evolving information. As our clinical and education leaders create new systems and schedules, please be patient and flexible, collaborate and contribute ideas, and be prepared for future changes when things go less smoothly than desired. We are all working hard and learning as we go.

Despite the many challenges at work, home and in the community, we can be grateful that we have not yet experienced overwhelming surges of patients or needed to invoke critical care triage tools. We have seen the government, university, hospitals, staff, trainees and the public working together to achieve a common goal. We have already become comfortable with clinical care in the COVID-19 era, and we are very good at it (see these profiles of Ariel Lefkowitz and Susan Tory providing front-line care, and our faculty and trainees featured in Faces of Covid created by Seema Marwaha, Arnav Agarwal and Rishi Bansal). In a matter of weeks, we have developed new COVID clinical care resources and podcasts, augmented virtual care to provide support to long-term-care homes and primary care providers, supported care for underhoused populations, created virtual curricula, and launched clinical trials, all while providing front-line care and maintaining our other academic responsibilities. I look forward to seeing what we will achieve together in the coming weeks and months as we develop sustainable models of patient care and medical education remaining committed to the well-being of our faculty and trainees.

With thanks and admiration for everything you do,
Moira

Dr. Moira Kapral
Director, Division of General Internal Medicine, University of Toronto

Meetings/Events

U of T GIM in the News

1. Lack of leadership to limit “futile” end-of-life care leaves Canada hamstrung in COVID-19 pandemic. Lucas Vivas and Travis Carpenter. Journal of Medical Ethics Blog

2. The term asymptomatic is more complicated than it seems when it comes to coronavirus infections. Isaac Bogoch and Allan Detsky. Forbes. 

3. It's not hopeless: These doctors explain what Covid-19 has in common with diseases we know how to manage. Allan Detsky and Isaac Bogoch. Forbes. 

4. Why coronavirus antibody test will not be a panacea. Allan Detsky and Isaac Bogoch. USA Today. 

5. Two doctors explore the physical - and psychological - science behind masks. Allan Detsky and Isaac Bogoch. Forbes. 

6. Beware these behavioral changes that could make the coronavirus pandemic worse. Allan Detsky and Isaac Bogoch. Forbes. 

7. Why comparing the fight against Covid-19 to war is ethically dangerous. Elliot Ackerman and Allan Detsky. Time Magazine.

8. 'Crazy thing to do": Health experts alarmed by Trump's use of unproven drug. David Juurlink quoted in Politico.

9. Elimination, not adaptation, is the courageous COVID-19 choice for Canada. Irfan Dhalla. The Globe and Mail.

10. The long road to recovery after COVID-19. David Frost and Angela Cheung interviewed on CBC News.

11. Fourteen days on the COVID ward. Ariel Lefkowitz. Toronto Life

12. Inside the ICU: What staff at a Toronto hospital have learned about COVID-19. Featuring Susan Tory.  Global News.

13. Coverage of Faces of Covid:
CBC Frontline Heroes
Zoomer Radio
CBC News
National Newswatch
Hamilton Spectator: 
Toronto Sun
Here and Now with Gill Deacon

Contributions by Trainees

Arnav Agarwal quoted in Canadian Press: https://cfjctoday.com/2020/03/19/provinces-urged-to-end-newcomer-waits-for-public-health-insurance-amid-pandemic/

Arnav Agarwal quoted in Huffington Post: 
https://www.thestar.com/news/canada/2020/03/19/provinces-urged-to-end-newcomer-waits-for-public-health-insurance-amid-coronavirus-pandemic.html

Interview with Arnav Agarwal about a UofT DoM initiative called Dear MD To Be: 
https://www.dearmdtobe.com/podcasts/2020/5/18/episode-9-a-pandemic-with-dr-arnav-agarwal

Copyright © 2019, Department of Medicine, University of Toronto, All rights reserved.

To submit items for inclusion in this bulletin, or to subscribe, please email Dr. Moira Kapral at Moira.Kapral@uhn.ca