Recover, Restore and Re-open: A Stanford Medicine framework for bouncing back from pandemic | News Center

Last spring, as office buildings emptied and local governments ordered residents to shelter in place, Stanford Medicine faculty members and executives sprang into action to understand more about the mysterious new coronavirus.

Even in the early months of the pandemic, it was clear that a return to normal — bringing students back to classrooms, workers back to offices and travelers back to airlines — would take complex and scientifically grounded policies and guidance.

Now, Stanford Medicine has launched a website to advise various segments of society on getting back to healthy functioning. The effort is called Recover, Restore and Re-open, or R3.

“Our experts’ immediate and steadfast response to the pandemic has built a valuable resource that we feel is imperative to share with the broader community,” said Priya Singh, chief strategy officer and senior associate dean for strategy and communications at Stanford Medicine. “We see the R3 framework as a collection of resources that community members — whether you’re from academia, industry or government, or you’re an individual — can use to inform and guide how they adapt to the uncertainties wrought by COVID-19.”

At the onset of the pandemic, experts from the School of Medicine, Stanford Health Care, Stanford Children’s Health, University HealthCare Alliance and Stanford University began building a framework for broad-based recovery. The group considered the needs of the community, such as developing a strategy for expanded coronavirus testing and building a public health surveillance system to track new cases, and used lessons learned from Stanford’s hospitals to inform preparedness for future inevitabilities, such as a surge in cases and a lack of personal protective equipment.

The R3 framework, which was commissioned by Lloyd Minor, MD, dean of the School of Medicine; David Entwistle, president and CEO of Stanford Health Care; and Paul King, president and CEO of Stanford Children’s Health, is powered by more than a dozen Stanford Medicine faculty and leaders. Along with Singh, Bob Harrington, MD, professor and chair of medicine; Mary Leonard, MD, MSCE, professor and chair of pediatrics; and Catherine Krna, MBA, president and CEO of the University HealthCare Alliance, led the R3 committee. Based on the committee’s expertise, the framework is a culmination of the lessons learned while delivering patient care, conducting research and forming policy recommendations as the pandemic evolved.

“Our success in responding so quickly at the beginning of the pandemic was, in part, due to the alignment between the School of Medicine and the clinical enterprises, Stanford Health Care and Stanford Children’s Health,” Krna said. “We would not have been as successful if it weren’t for the joint accountability of our faculty and clinicians and the staff who work with them to care for our patients.”

Guiding current and future response

The R3 framework is a guide to making policy, conducting research and developing treatments, among other things. It’s both a resource for helping communities deal with the pandemic and recover from it. For example, it offers recommendations for protecting vulnerable populations from the virus and safely

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The Economy Can’t Recover With Sick Workers

Even mild cases of COVID-19 have affected workers’ ability to do their jobs and enjoy their lives, sometimes causing miserable knock-on effects on their finances. Benjamin Walmer is a New Jersey chef and architect specializing in kitchen and restaurant design, who contracted a minor case of COVID-19 in March. “I’ve had colds that had worse symptoms,” he told me. Nevertheless, he said, the illness affected his ability to hold meetings, visit people’s homes and businesses, and find new clients. “Relationships are everything in this industry, and there’s a great deal of intimacy around design,” he said. “There were these multiple points of disruption that compounded one another.”

More severe cases have had more severe effects, for workers and the companies that employ them. Yvonne Evans has been a nurse for three decades, and runs a surgical clinic at the John D. Dingell Veterans Administration Medical Center in Detroit. She contracted a severe case of COVID-19 in the spring and is a long-hauler: She still has fatigue and shortness of breath half a year later. “I know what is happening to me; that’s the scary part,” she told me. “I know vasoconstriction when I see it.”

She now uses a mobility scooter to get around the hospital, and struggles to work as she used to. She said she was contemplating retiring early, although that would be a significant financial hit to her family. “Do I need to go on disability? I don’t know,” she said. “I’m trying to see how much damage it has done to my lungs, because the lungs do regenerate tissue.” Losing highly experienced professionals like Evans is straining the health system and the broader workforce. More than 200,000 health workers have contracted COVID-19 this year, and roughly 1,000 have died.

Other essential workers are bearing extraordinary risk, too. Francis Robateau was a veteran night manager for a Southern California grocery store, restocking shelves and managing inventory. Unable to both practice social distancing and keep the store filled with goods, he caught COVID-19. “I started having massive migraines,” he told me, adding that he still struggled with neurological symptoms and headaches weeks later. Concerned that his employer did not take safety protocols seriously enough, he ended up quitting. “I haven’t been making any income,” he told me. “My partner has been taking care of it—her mindset is ‘No, dude, you’re not feeling 100 percent; there’s no reason for you to take a full-time job.’”

For some, sickness has been catastrophic. Paz Aguilar, who worked at two fast-food restaurants in Oakland, California, ended up in a medically induced coma after contracting COVID-19, along with half a dozen of her co-workers. A stroke left her partially paralyzed. “I’d like to go back to work,” she told me, speaking in Spanish. But she cannot imagine doing so. That has put her and her extended family at severe economic risk, and increased the caretaking burden on her relatives.

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