ROCHESTER, N.Y. (WROC) — As Chief Medical Officer at Rochester Regional Health, Dr. Robert Mayo is a guiding hand in our local response to COVID-19.
He’s responsible for both the care of the community and the RRH staff — a big job with big responsibilities.
He took time out of this busy schedule to sit down with News 8 this week about this effort and where we go from here.
Adam Chodak: What has the adjustment been like within the entire health system?
Dr. Robert Mayo: Adam, there have been many adjustments. Rules and boundaries that we’ve held for many, many years have been adapted out of necessity and they are appropriate adaptations, but that’s part of what makes this difficult. We want to adapt and we want to be proactive, we don’t want to go too far and make mistakes, we don’t want to wind back decisions that we make, there are many many changes and there’s a long list of state and federal regulations that have also been adapted to assist us in our adaptations, but steps that they’ve taken that we would not have anticipated.
AC: Speaking of anticipation I have to imagine that in your role there’s been many talks, a lot of literature about what a situation like this would look like. What have been some of the key surprises for you that perhaps people didn’t think would happen?
RM: There are approaches and patterns that have been known for many many years on how to approach pandemics but the last major global pandemic of this kind is nearly 100 years old and personal experience is such a powerful teacher but writing about smaller pandemics and extrapolating them to one of this size don’t always capture all the things that otherwise you would have liked to have known.
But I would say one of the challenges is the cultural mind shift that we’re making and we try to make those thoughtfully and with an evidence and scientific base but we are emotional beings and it’s stressful for people and so there grows out of that stress rationales for lots of things that don’t always get balanced in the work that we do so we’re just trying to receive input many sources, identify the most important face-based information and then make meaningful decisions out of that.
AC: What’s one or two of these misguided rationales that you’ve been trying to address over the last 2 or 3 weeks?
RM: Misguided, I’d rather not use that word because most the rationales I hear come from a very earnest place and we’re all searching for the best answer and none of us are sure exactly what it is. Early on – gosh, it feels like a long time ago, but if you look at a calendar you realize it wasn’t that long ago – three weeks ago, a lot of our team member were asking us about mask management and what type of masks to use and how to properly use them and this is not unfamiliar to health care workers and they were asking good questions.
Some of those folks were asking questions then that we weren’t prepared to answer, but today many things have changed about how we’re using masks. For example, at that point in time, the incidents in the community were low so we were applying masks in focused ways. That at times was challenged. People would say how you do you know this disease isn’t spreading faster than it it is? Or how do you know it’s not being transmitted on surfaces? So we would regularly touch base with the CDC and so forth and a lot of those things have changed, right?
So now we’re in a universal masking scenario and there are probably some folks who are saying, I told you so, we were going to get here, and it wasn’t that I didn’t imagine we couldn’t have gotten here, we were just trying to take it at a pace consistent with what we’re learning about this disease.
AC: What has the morale been like among the staff. Those who are in the rooms, in the hallways, entering the buildings every day?
RM: I think they’re stressed. Health care workers I think are a very resilient group of people, they prepare themselves in their career choice to confront difficult situations. They know they will have emotional reactions to when their patients pass away, they will hold the hands of family through very trying times, so these individuals prepare for that and they take pride in their ability to manage that and they do a wonderful job.
But I feel overall people are feeling uncommonly stressed because this is a very new scenario and we don’t have all the answers and we want to protect them and we want to protect our patients and so I think the uncertainty have it has been unnerving.
AC: When we talk about the surge, at this point, given the number of ICU beds that Rochester Regional has, the ventilators, the PPE, do you feel like you’re prepared for a surge in our community?
RM: Preparation is a continuous process, it’s not a moment of arrival, at least in my mind it’s not. There’s been incredible efforts, incredible good preparatory actions that have been put into place. There’s still a lot of work for us to accomplish between now and the day we may see a large surge and we’re working hard to read the predictive models so that we can be as accurate as possible, but if there’s a massive surge in the community it will be very difficult for all of us to get through that and triage resources and to prioritize resources in a way that is for the greatest good.
AC: Do you think you’re encouraged or discouraged by the numbers you’re seeing right now in our community?
RM: Well, I would just say it is what it is and I prefer to try to channel my emotional energy to the positive and moving forward. I’m discouraged by it. I rather quite heartened by the teamwork I see within RRH as well as in our partnership with University of Rochester and the county. This is unprecedented collaboration and I’m very encouraged by all of that and we will weather the storm together.
AC: When we talk about flattening the curve and allowing people to get back out in some fashion obviously a vaccine is the chalice that everybody is seeking. At the same time, we’re talking about treatments, testing, testing to see if you had it. What are you looking at when it comes to safety in the community? What do you want to see progress the fastest here.
RM: There are a lot of “what ifs” enfolded in that question, but I think it’s a good question to stay prioritized and focused on what we’re doing and what really matters. And I think what really matters is continued social distancing and our commitment to that and it’s very awkward for all of us and it’s heartening to see people remind each other, “Oh, no hug,” or, “No handshake” and deliver it at the door and that sort of thing, but that is very very important, that is fundamental for our safety and this community’s success through this pandemic.
I think it would be a wonderful thing to have greater clarity around medication availability and though there are no clearly established treatment protocols there are numerous efforts to identify potentially successful drugs and the sooner we can have that the better we’ll all feel about this and the better it will be for our community. It will be some time before the vaccine is ready, but when it is ready, it’ll be a great blessing for all of us and not only us, but the world and I will remind the viewers that vaccination efforts have encompassed global efforts for years from smallpox to polio and all of the vaccines so we will catch up with this and we will one day look back and say wow, we accomplished something really great.
AC: We keep hearing about pneumonia in the patients that see the most severe symptoms. Is there a specific type of pneumonia that you’re seeing because they seem to be on ventilators a lot longer than other illnesses?
RM: Yeah, so pneumonias do have different categorizations that are used, but this is a diffuse bilateral pneumonia, it’s not localized to a single lobe of the lung and it does have a characteristic on CT scan although it’s not a specific appearance, this is a non-specific but characteristic description. So patients will severe symptoms do develop a condition known as ARDS, it stands for acute respiratory distress syndrome and this is basically a failure of lung function might require significant ventilator support.
AC: Is there anything else you’d like to add that I might have missed?
RM: I would just remind folks to remember all the good things in their lives. We’re all adjusting to things that feel like takeaways, things that feel like unhappy adjustments, but good can be found in those things and the human spirit is an indomitable force for all of us and we need to help each other stay focused on those positive things.