In this Issue
Fresh on Facebook
When the novel coronavirus outbreak first took hold in California, this was the advice given from state and local public health officials.
But . . . what if there is no ‘place?’ Project RoomKey was a statewide effort – including site locations in Fairfield and Vallejo – to help contain coronavirus by creating a place for the unhoused populations in communities throughout the state.
Avoiding contact with potentially exposed individuals was the best option to keep large swaths of the community as protected as possible from coronavirus, but public health experts knew members of what are known as “curbside communities,” or the homeless in more marginalizing terms, were potential roving time bombs waiting to go off around the state.
The unhoused are transient by nature and that mobile element meant they presented a significant health challenge in the midst of the pandemic.
Dr. Michele Bunker-Alberts, an assistant professor at Touro University California, helped coordinate the effort locally in Vallejo, having worked extensively with the unhoused population throughout her career.
Getting people in curbside communities into contiguous housing was crucial in slowing the spread of the virus, she said.
“They need their own place with a door that closes and their own bathroom,” Bunker-Alberts said. Staying isolated and washing hands frequently isn’t practical for people who have no real way of isolating themselves, nor soap and water on demand as so many others do.
“There needed to be some option to keep them safe,” Bunker-Alberts said, commenting also on the difficulty in tracking and tracing cases with a transient population. “There’s no guarantee they aren’t going to transmit it in the community.”
Project RoomKey helped open up motel rooms for 115 residents at its peak, with about nine of those individuals since finding permanent housing in the process, Bunker-Alberts said.
Transiency also creates issues with trying to get those in curbside communities adequate healthcare access in general. Existing medical conditions are a complicating factor for coronavirus and the unhoused face sincere challenges maintaining prescribed medication protocols.
These individuals often do not have IDs to pick up prescriptions, money to pay for them, or addresses to mail the medications to.
“A lot of times they lack even a basic (medical) history,” Bunker-Alberts said. “Project RoomKey has bridged people’s access to medical, gotten them back on their hypertension medication, gotten them back on their diabetes meds and back to a place where they are less at risk.”
For her students, the pandemic provided a clinical opportunity in a time when practical learning avenues were blocked due to shutdowns throughout the state.
It normally starts with an awards banquet or an over-sized check, but gifts from corporate foundations to universities are nothing new.
At a larger university – perhaps with a football stadium and ample naming rights opportunities – these donations might get lost in the shuffle.
At Touro University California, the generosity shown by neighboring corporate sponsors have a more significant impact. Such is the case with Syar Industries.
More than 70 years ago, in a stroke of perfect timing, C.M. Syar began a construction company just as the nation was emerging from the Great Depression. That company served Fairfield, Vallejo and neighboring communities in Solano County, including construction materials for operations at Travis Air Force Base and the future home of TUC, Mare Island Naval Shipyard – just in time to support the war effort during World War II.
Syar’s influence on the surrounding community is hard to ignore, having helped with the construction of Interstate 80, the building of the Monticello Dam and other major construction projects.
The Syar Foundation is engaged in supporting vocational training in the trade industries, but also places a high value on programs targeting children, education, and healthy lifestyles. That news makes a great many of the student doctors at Touro … Happy.
“The Syars have deep roots in Vallejo. The city was the home of C.M. Syar and his businesses for many years and still has a special place in our hearts,” said Susan Syar. “Project HAPPY is exactly the type of win-win project with lasting impact – good for the doctors in training as they start their education, good for the child in the community as they build their foundation for life – that the Syar Foundation is excited to support.”
COM’s Project H.A.P.P.Y has served children in Vallejo, and their families, for two years, and the program has gotten generous support from Syar.
Project HAPPY is a community-based, family-centered educational series that teaches positive psychosocial development, good nutrition, and healthy exercise habits to children and their families, according to program director Dr. Tami Hendriksz. “This program is designed as a living classroom, in which first-year medical students from Touro University California College of Osteopathic Medicine participate as family navigators and health coaches for the participants (while remaining under direct supervision by a licensed pediatrician),” Hendriksz said.
Prior to 2018 there had not been an evidence-based obesity and diabetes prevention program focused on the pediatric population in Solano County. In this way, Project HAPPY has been the first of its kind, Hendriksz explained.
Hendriksz is keenly aware of how important financial support is in helping entrench and expand the program within the community.
“The grant from Syar allowed Project HAPPY to order to expand the reach of the program to the broader community, & to take place at a more centralized location for the 2020 cohort and beyond,” she said.
The young students and their families benefit from education and other resources not always made immediately available to lower income households, but Touro’s student doctors also benefit greatly.
"What I get from HAPPY is the sense of community it encourages and fosters to make the simple changes for a healthy life that can be difficult to implement for many of us alone,” said Cameron Perez, a co-Student Coordinator of HAPPY. “Much of establishing healthy habits is consistency and encouragement, and I feel extremely grateful to help create that for our HAPPY families every week.”
Fellow student doctor Kathleen Winger agreed.
“I pursued medicine because I wanted to empower my community to be their healthiest and Project HAPPY offered me that exact opportunity,” Winger said. “Counseling and education are some of the most essential components of care and HAPPY offered early and frequent exposure to both that allowed me to craft a confident and calming demeanor during patient interactions.”
For so many student doctors, HAPPY offers a very real understanding of the need to strengthen healthcare in communities like Vallejo.
“I recognized a profound need for health education, particularly in at-risk communities that lacked access to quality care and consistent medical attention,” said Helen Meng, another co-student coordinator of HAPPY. “I went into medicine hoping to make an impact in the lives of other people and Project HAPPY was the perfect opportunity for me to get into the community.”
“I really got to learn how to effectively implement these skills and I know I will be utilizing them throughout my medical career,” Meng added.
This outreach effort was a perfect pairing for Syar’s community giving goals, according to Roni Krueger of the Syar Foundation.
“The Syar Foundation is the legacy of C.M. Syar,” Krueger said. “(It) is his gift to the communities where he started, operated, and built Syar Industries into the company it is today.”
“C.M. Syar’s desire was that the Syar Foundation support the communities which supported him and his company for so many years,” Krueger added.
That support has paid off dramatically for HAPPY, Hendriksz explained.
The initial project in 2018 ran for six weeks, expanding to 12 weeks in 2019, bolstered largely from the grant from Syar.
Doctors and other healthcare professionals are probably most at risk from COVID-19 of anyone. Nobody knows that as acutely as Dr. Jan Pring, a TUCCOM graduate from the Class of 2007.
Dr. Pring contracted COVID-19 and was eventually admitted to the ICU, sick, afraid, and unsure of what the future would hold.
That future, it turns out, included a trip down a lengthy hallway, greeted by proud, supportive nurses and doctors as Dr. Pring was wheeled to the excited and waiting arms of his loving, grateful family. That happy future, however, might not have happened without a fortunate past.
Suffering with respiratory failure, pneumomediastinum and pulmonary embolism, Dr. Pring’s condition had deteriorated greatly from eight days prior during an ER visit with complaints of shortness of breath and high fever.
Unlike average patients, Dr. Pring is keenly aware of what is happening to him. Not only had he followed the news about New York hospitals running out of room to store the bodies of people who had succumbed to COVID-19, he’d followed the CDC guidelines and understood the physiology of what was happening within his respiratory system.
“The ICU is a daunting place,” Dr. Pring said. “At any given time, multiple alarms are beeping, and multiple patients are calling. But the frightening thing is, at all times, there are lives who are critically sick and on the edge of death.”
Each new action his care team takes - oxygen for lungs, antibiotics for possible bacterial co-infection, steroids for inflammation, Lasix for excess bodily fluid, frequent blood draws, early morning chest x-rays, follow-up CT of the chest, and investigational therapies with Actemra, Remdesivir, and plasma – Dr. Pring knows why they are doing it.
Rather than having a calming effect, Dr. Pring’s time is dominated by anxiety.
“The anxiety is unbearable,” Dr. Pring said. “What will happen to me? Did I get my family sick? Who is watching over my family? Why me? Am I going to die?”
Luckily, there is also someone else who knows what steps to take, which tests to order, and what therapies to recommend. And this is where the past and future collide.
A doctor visits Dr. Pring and helps ease his mind.
“He possesses a comforting voice that asks me to rest and relax,” Dr. Pring said. “I found comfort in his confidence. He reassured me that all is being done to help me get through this COVID-19 infection. He outlined the plans of the day. He reassured my anxieties and my fears.”
Dr. Pring draws comfort not just in knowing his care provider, Dr. Kevin Tsui knows what to do by virtue of his medical training, but it’s comforting to Dr. Pring to know Dr. Tsui knows exactly the same things and was taught in exactly the same way.
That’s because Dr. Tsui is himself a TUCCOM graduate.
Stranger still, not only did Dr. Tsui graduate from the same program as Dr. Pring, they were at the Vallejo campus for nearly their entire stay at Touro, with Dr. Tsui graduating in 2008, just one year after Dr. Pring.
“He brought confidence to a scary situation,” Dr. Pring said. “And when all was said and done, he kept me alive. He gave me a chance to be with my family again, to hold my wife and children.”
Dr. Pring’s gratitude is hard to express fully.
“How can I pay back this person for the kindness that he showed and the love that he demonstrated?” Dr. Pring said. He credited Dr. Tsui for, “Tireless duty to humanity, dedication to (his) profession, (and) unwavering love for life. (Dr. Tsui) represents the best of we can be and serve as a role model for those following in your footsteps.
Like so many members of the Touro University California faculty, Interim Assistant Dean of the College of Education and Health Sciences and Interim Director of the School of Nursing, Dr. Terrye Moore-Harper didn’t end up at Touro, she came here purposefully.
Moore-Harper makes her 70-mile one-way commute to the Vallejo campus, passing two major universities and several community colleges along the way, including her previous place of instruction, San Joaquin Delta College, which is about a five-minute drive from her house.
In her nearly six years at Touro, Moore-Harper has been engaged in teaching and leadership roles, taking over as the interim Assistant Dean for CEHS in May, which has been a challenge in the midst of a pandemic.
“The experience has been fast-paced but very supportive,” Moore-Harper said. In fact, the qualities of Touro she was attracted to in the first place were on full display “as the school pivoted from a traditional campus-based model to an online format” as the coronavirus pandemic took hold.
How Touro managed that situation she credited to the foresight of nursing program founder, Dr. Ann Stoltz, as well as Provost and Chief Academic Officer Dr. Sarah Sweitzer, and CEHS Dean Dr. Lisa Norton.
“Over the past year, our leadership encouraged the faculty to explore opportunities to move our programs online to stay more competitive in the nursing education market,” Moore-Harper said. “It’s been quite an experience to see how fluid the school was able to pivot to this.”
The whole effort fits nicely into what Moore-Harper deems as, “the three Rs.”
As the Marine Corps has their familiar mantra, “Improvise, Adapt, Overcome,” Moore-Harper says nurses are defined by the three Rs, “Resilient, Responsive and Relevant.”
How the nursing students adjusted to both their education and their workload fighting coronavirus showed their resilience, she said “We have to stay the course and be flexible,” Moore-Harper said. “We have to find that strength somehow, in ourselves and from one another.”
That resilience plays into the second R (the duty to be responsive), in many ways.
“We don’t always get to go home after that 12-hour shift,” Moore-Harper said. “We respond because it’s the right thing to do.”
Grit in the face of difficulty is really a defining characteristic for nurses, she said.
“We make ourselves relevant to what’s going on,” Moore-Harper said. Whether it’s a pandemic, a natural disaster, an attack or a warzone, nurses find a way to become part of the solution. “We always show up. We have a social contract with society,” she said, “and the responsibility to be compassionately and competently present and accountable to the people we serve.”
Our nursing students share these fundamental qualities at Touro, she said. The supportive environment helps students thrive at Touro and it is what lured Moore-Harper here, as well.
“I chose Touro. I love my job,” Moore-Harper said. “This is what I’m called to do, to serve, to lead, to teach the next generation of nurse clinicians and leaders.”
Every 10 years, the @uscensusbureau undertakes a mammoth task: counting all the people residing in the United States. This count affects the allocation of funding for our community’s public resources (e.g., roads, hospitals, schools), how we plan for the future, and our voice in government. Learn more about the importance of the #2020Census and how to participate: 2020census.gov.
Copyright 2005 - 2020, Touro University, All Rights Reserved.