#SCBIpodcast: The Role of Family Medicine in COVID 19 with Dr. Ross Upshur

With the pandemic of COVID-19 spreading everywhere around the world right now, there's a lot of fear, frustration, and anxiety. On the flip side, there's a lot of innovation, connectedness in novel ways and reflection going on. In the spirit of physically distancing ourselves and innovating, we've decided to continue our podcast through Zoom. In this episode of Small Changes, Big Impact, we interviewed Ross Upshur, and discussed hot topics in COVID-19. 

Transcript:

Dr. Upshur: (00:51)
So some of the questions - so the work that I'm doing right now is not so much clinical, but I'm an advisor to advisors. So I'm working with the World Health Organization, with Medecins Sans Frontieres, Public Health Agency of Canada, Ministry of Health, and also doing a lot of work from the point of view of the School of Public Health. So yesterday I was the moderator of a panel where we were looking at new tools that are being developed that allow a better understanding of the evolution of the outbreak in terms of modeling in the community and modeling the demand for hospital services. So I've worked - and so the backstory, uh, is that after - so it would start actually with SARS. So Sunnybrook was - you're asking - I'm already talking -

Dr. Upshur: (01:50)
So in SARS - Sunnybrook was a SARS hospital, so we basically closed the doors to the clinic and started sending people doing house calls. I got seconded out to York Region Public Health because I actually have specialty training in public health medicine and I'm kind of like a pryer, cruder version of Jeff Kwong. I was doing a lot of work on modeling respiratory disease in populations using ICES data. So I started out as a communicable disease modeler. I did work on outbreak investigations while I was a resident and have always kept my foot in that element of public health because during SARS, I went to York Region to do the modeling and figuring out the patterns of spread of SARS in the community, but it never spread in the community. It was a nosocomial outbreak. So I got dragged - I got brought in to be doing medical officer of health work and I ended up being the quarantine enforcer. So that led me to start to think about ethical issues in public health response with colleagues at the joint center for bioethics. We published a paper in the British Medical Journal. We also added a section to the Naylor report and that turned into a white paper called Stand on Guard for Thee, which sets out the kind of principle ethical issues that will be raised in a pandemic. We were thinking about influenza, but they're actually germane to coronavirus. That then became the template of the World Health Organization guidance document. That's how I started working with the World Health Organization. I chaired the working group on health workers' obligations to care in a pandemic. And then we were also - that was around the time I became the director of the Joint Centre for Bioethics, and I was the director of the WHO Collaborating Centre for Bioethics. After I stepped down from that role, I became - still part of the collaborating center, but I've had the lead for ethics and epidemics ever since. So that means I've worked on SARS, MERS to a certain extent, pandemic H1N1 influenza, both Ebola outbreaks, I took a little bit of a pass on Zika, but I was still peripherally involved. And so what we find are the same issues arising again and again. So first issues - and it depends on when they arise. So right now there's a big concern around resource allocation. How do you fairly allocate resources and scarcity? So we had a paper published in the New England Journal of Medicine on Monday that sets out some principles that you might want to think about for allocating things like ICU beds, hospital admissions, and then into personal protective equipment.

Find the full transcript on our website here.