UMass FMCH Tuesday Talk Volume 48 2020| December 22, 2020
Tuesday Talk - New Format!
The Department of Family Medicine and Community Health Monday Morning Memo has undergone a facelift - Welcome to the FMCH Tuesday Talk. Please let us know what you think of the new format.

We will have a focus of the memo each week, along with timely upcoming events and other announcements.

Week 1 – Clinical Updates
Week 2 – Education Updates
Week 3 – Community Health Updates
Week 4 – Research Updates
Week 5 - (when available) – Other

Please continue to send us your announcements, celebrations, and accomplishments to [email protected]. Feel free to title according to the focus area. We look forward to hearing your news!
Upcoming Events
FMCH Grand Rounds
Yael Dvir, MD presents "Addressing Mental Health Crises in Youth During the Pandemic" on December 22nd, Tuesday - 12pm - 1pm

Department Town Hall
January 5th, Tuesday at 7:30 am

FMCH 2020-2021 Annual Faculty Awards Ceremony
January 12th, Tuesday - 12pm - 1pm: Please join us (virtually) to acknowledge great teaching, great care and community engagement in our department.

FMCH Virtual Town Hall Meeting
January 19th, Tuesday - 12pm - 1pm: Zoom information to follow

Department Member Recognition

New Director of Integrated Behavioral Health
I am pleased to announce that Shahida Fareed, PsyD, MBBS, MPH will begin work in the department on December 28th. Dr. Fareed will serve as Director of Integrated Behavioral Health, and she will see patients at Fitchburg Family Practice. Thank you to Daniel Mullin, PsyD, MPH who has very capably filled this role on an interim basis. He will step down from this role to focus more fully on the Fellowship program and leadership of the Center for Integrated Primary Care. Dr. Fareed earned her Doctorate in Psychology from Adler University, Chicago and completed her internship at the University of Rochester Medical. She completed a postdoctoral fellowship at Geisinger Medical Center, working in primary care Internal Medicine. Along with treating individuals with depression, anxiety and other mental health disorders, her clinical interests include working with individuals living with chronic illnesses, sleep disorders, psychosomatic illnesses, health behavior change and provider wellness. In addition to her Doctorate in Psychology, Dr. Fareed earned a Master’s in Public Health from Oklahoma University. She also received her Bachelors of Medicine and Surgery (MBBS) with an emphasis in Family Medicine from Karachi University, Pakistan. Please join me in welcoming Dr. Fareed to the Department.

Carole Upshur, EdD,
  • Reviewer - National Institutes of Health, NIMH, Research Review Panel, RFA MH-20-400 R01/R34 Effectiveness of Implementing Sustainable Evidence-Based Mental Health Practices in Low Resource Settings to Achieve Mental Health Equity for Underserved Populations, Oct-Nov. 2020
  • Islandic Research Fund-Reviewer for Social and Educational Research, Icelandic Science and Technology Policy Council Oct 2020 

James Ledwith, MD has been asked to serve as Faculty Supervisor for the UMMS Student COVID Response Task Force, coordinating volunteer service activities of our students in numerous areas, including a new initiative to assist in administration of COVID immunizations. Established free care programs across the city were converted into a coordinated telehealth program when most sites could no longer serve patients in person.


Carole Upshur, EdD, presented a Faculty Development Workshop on 'Improving Minority Representation in Medicine' on December 14th for Departments of Family Medicine, Internal Medicine and Pediatrics and University of Riverside Health System, Moreno Valley CA.
Job Opportunity

The New England AIDS Education and Training Center (NEAETC) is recruiting a Healthcare Data Analyst I to be responsible for data management, secondary data collection, and to provide training and TA to project partners. The ideal candidate will have an innovative approach to data management, analytics and visual presentation and also be committed to improving care for people living with HIV and those at risk. 
(Healthcare Data Analyst I - Job Number: 2020-36069)
Research News Spotlight
Sonal Singh, MD, MPH is a co-investigator for the D-PRESCRIBE-AD study (Developing a Program to Educate and Sensitize Caregivers to Reduce Inappropriate Prescription Burden in Elderly with Alzheimer’s disease), led by Dr. Jerry Gurwitiz and recently featured in UMassMed News.

Paula Gardiner, MD is seeking providers to participate in a study: Perspectives on Motivating Lifestyle Change in Women with Hypertensive Disorders of Pregnancy. The purpose of this study is to identify providers’ perspectives on dietary counseling and barriers faced in counseling pregnant women with obesity, chronic hypertension, gestational hypertension, or a history of hypertensive disorders of pregnancy. Additionally, we hope to elucidate referral patterns and barrier faced in providing referrals to dieticians and nutritionists in these populations. 
Clinical Services Spotlight: COVID 19 Updates
As this year draws to a close, I want to thank everyone for all that you do to care for our patients and communities throughout this tumultuous year. As we look ahead to 2021, with light at the end of the proverbial tunnel, I am grateful to the army of scientists and their colleagues who have managed the extraordinary feat of creating vaccines for COVID-19 in less than a year. I know we will do our part to help in the enormous task of getting the vaccine to essential workers and to patients. And for the foreseeable future, I know we will continue to come together to serve our patients, and support our colleagues, through the second surge.

However we may have celebrated the holidays in the past, this year will most certainly be different, but I hope for each of you and your families that they are the best they can be under the circumstances. Wishing all a restful, joyous, and safe holiday season. 

All caregivers are reminded to maintain social distancing, wear goggles in the patient care area, and wear a mask at all times. Please discuss with your clinical area leaders about when to wear N95 masks and additional protective gear. If you need a mask replacement, please contact the clinical area leader where you are working or your department liaison.

COVID-19 Vaccine Update
Current Status
  • Statewide metrics show overall test positivity stable at 7.5%. The positivity rate for UMass internal lab testing of symptomatic patients is now 18.5% (and 4.2% for asymptomatic patients).
  • Statewide COVID-19 hospitalizations continue to trend upward, currently about 2000.
  • Worcester’s test positivity rate is currently 12.7%.
  • Inpatient census at UMass Memorial of COVID-19 patients is 133 (35 in ICU) as of Monday am.
Second wave management
  • The Command Center reopened and can be reached at [email protected], or by phone (774-441-8886).
  • The DCU field hospital census is 22. Staffing is in place for expansion to additional units if needed.
  • There are currently no concerns about PPE availability.
  • The third FMCH inpatient team began December 13, with effort from both Barre and Hahnemann physicians.
  • Our health centers are continuing to increase the proportion of telehealth.
  • Visitors to non-COVID hospitalized patients are limited to 1 per day during visiting hours.
  • Visitors are still prohibited for COVID patients (with end of life exceptions).
  • A total of 102 employees have tested positive in the last week. At present 236 individuals are unable to work due to COVID, with obvious impact on a number of services. Please remain vigilant at home and at work with regard to social distancing and mask use.
Vaccine Rollout
  • Highest priority (tier 1a1 clinicians) have begun getting the vaccine. About 500 employees have appointments for today and tomorrow. Individuals should wait for the invite and then schedule their appointment. See details in separate communication sent on Friday evening.
  • At present there is not additional information about when we will receive a second shipment of Pfizer vaccine, or the first shipment of Moderna vaccine.
1. Who is in the Phase 1a1 group?
• Phase 1a1 includes those providers who spend a great deal of time with COVID-19 positive patients, such as dedicated units. Family medicine physicians in Phase 1a1 include our hospitalists (full time, those who regularly round on their inpatients, and those temporarily covering inpatient), residents, as well those who cover L and D. We have confirmed a list that includes all these clinicians. We have also asked that our APPs who provide a lot of respiratory evaluation be included in this group but don’t yet have confirmation of this. 
2. As an ambulatory provider, what group am I in?
• Outpatient primary care providers are in Phase 1a2.
3. How do I register for the vaccine?
• Registration for the vaccine is done on the hub only after you receive an invitation. The invitation will be sent to each individual. 
4. What do I do if I registered before I got an invite?
• If you registered without an invite, there is nothing to do. Going forward, this should not be possible, but you do not need to cancel.
5. How do we schedule to avoid >25% of a unit getting the vaccine at the same time?
• It is recommended that vaccination among a group of providers be staggered. There is a chance that symptoms may limit working the following day. We strongly encourage scheduling your vaccine before a day off, and at least not before you are scheduled to cover a vital clinical service such as inpatient or L and D. This will be especially important when scheduling the second dose when the likelihood of significant side effects is somewhat higher. 
6. Will there be enough vaccine?
• The expectation is that we will continue to receive shipments on a regular basis. Availability of appointments depends upon confirmed availability of vaccine. If our vaccine allocation from the state remains stable, we could potentially have all caregivers fully vaccinated by early to midFebruary 2021.
7. Is the vaccine required?
• Vaccination for COVID-19 is highly recommended, but not required.
8. What do we know about side effects?
• After the first vaccine, mild reactions are common. There is a larger proportion of individuals with moderate self-limited reactions after the second dose. You cannot contract COVID-19 from the vaccine. According to the CDC, the most common side effects associated with a COVID-19 vaccine are:
• Pain at the injection site
• Swelling at the injection site
• Fever
• Chills
• Tiredness
• Headache
• Other side effects have been reported. 
(Please report any side effects to your physician and to the institution)
9. Should you wear N95 on the service all the time?
• Although a great idea, the practice of wearing N95 in every clinical area is not the current practice. The hospital has prepared for adequate PPE based on the current practice. Currently we cannot give a formal recommendation wearing N95 as a protection “all the time”. While we appreciate the effort, we cannot give a department statement that mandates constant use of the N95 in all clinical environments.  

Wellness Resources
  • Wellness Rounds have resumed on Monday, Tuesday, Wednesday, and Thursday evenings from 5:45 - 6:30 via Zoom, hosted by Dan Mullin, Ethan Eisdorfer, or Shahida Fareed. Everyone should feel free to drop in as often as they like.

  • The Caring for the Caregiver Program provides resources such as the Caregiver Support Line (508-334-HELP) and The Employee Assistance Program (EAP) which offers a variety of services and supports (including virtual peer support and wellness tips. EAP can be accessed at 866-263-3525, or, [company code UmassMemorial]. More information is available on the Caring for the Caregiver page.

Working on Wellness
Yoga Classes with Dr. Liz Erban

Please join department members for early morning gentle yoga via Zoom. Much appreciation to Dr. Erban for hosting these outstanding classes that started November 11.
Zoomba with Dr. Anna Zheng
Please join department members and get moving via Zumba and Zoom. Much appreciation to Dr. Anna Zheng for hosting these outstanding classes that started October 31.