Currently, the U.S. and the world at large is in the midst of a pandemic caused by a novel coronavirus (SARS-CoV-2).  The virus is believed to have originated in China in late 2019 and over the past few months has spread to all continents except Antarctica.  The main clinical manifestation of Coronavirus Disease 2019 (COVID-19) is a respiratory infection with typical symptoms of cough, shortness of breath and pneumonia.  Some emerging data shows that atypical symptoms can include trouble smelling or tasting, as well as gastrointestinal symptoms like diarrhea.  The elderly (>65 years) seem to be the age group most at risk for severe disease and complications including respiratory failure and death. However, we are beginning to see severe infections across all age groups including infants and young adults.

As the numbers of COVID-19 infections and deaths grow, cities and nations across the world are responding by limiting exposure and instituting stay-at-home orders while trying to meet the rapidly rising healthcare needs of their citizens.  On the education front, to prevent transmission and ensure social distancing,  health professions education schools across the country have transitioned from physical classes to online instruction, with classes holding via video conferencing platforms such as Zoom and WebEx.  Students in the clinical setting have also been sent home and some institutions are using telemedicine platforms to continue instruction.

This pandemic has exacerbated the existing gaps in infrastructure particularly for our most vulnerable populations:  the elderly, people with disabilities, people experiencing homelessness, those who are incarcerated and people with social needs. The impact of COVID-19 on our vulnerable populations will be significant.  As health professions educators, our clinical care and education are intertwined.  Whether we are on the frontlines of providing care to patients with suspected/confirmed COVID-19 or teaching students and residents through e-learning, we need to ask questions about what is being done for these vulnerable populations and how can we make a difference through clinical care, advocacy and/or education.   What areas can you lend your voice and shine a light?  How can we:

  • Ensure that COVID-19 testing and clinical care is equitable and resource allocation is fair?
  • Provide for the communities who lack basic supplies?
  • Provide clear communication for everyone, especially people with low health literacy and those with low English proficiency?
  • Highlight the financial impact that quarantine and shelter-in-place orders have on patients and communities and explore ways to support them?
  • Meet the needs of the housing-insecure and people experiencing homelessness who are at great risk for COVID-19?

What are some of the ways you are teaching and/or addressing SDOH during this pandemic?  Share below in the comment section.

These are uncharted waters, and as we flatten the curve and make headway in gaining control of this pandemic, my hope is that our vulnerable and marginalized populations are cared for and not left behind.

Stay safe and healthy.

-Mobola Campbell, MD, Co-Director of the Community of Practice

Dr. Mobola Campbell (@mobolacampbell) is an Assistant Professor of Medicine at Northwestern University Feinberg School of Medicine.  She serves as the Associate Program Director of the NU Internal Medicine residency program and leads the McGaw Health Equity and Advocacy Clinical Scholars Program.  She also serves as the co-Director of the NCEAS Community of Practice.

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