Tag Archives: #frontlinestaff

Adopting Impermanence as a COVID Response

“All conditioned things are impermanent – when one sees this with wisdom, one turns away from suffering.”

-Gautama Buddha

In times of chaos and tribulation, it seems wise to refer to the teachings of those who sought to understand suffering. Impermanence is the word that comes to mind, yet humanity finds comfort in permanence. 

At the August 14th Ethnic Media Services briefing on the science behind COVID-19, doctors on the frontlines reaffirmed the motif I had been seeing – a contradictory society seeks change, yet is resistant to it.

This moment of truth in American history requires quick and consistent change. I wonder, can we rise up to the challenge?

Dr. Ashish Jha, Professor of Global Health at the Harvard T.H. Chan School of Public Health and the Director of the Harvard Global Health Institute remarked “America may have the worst response of any country in the world, to this pandemic” and added that we were in the same position, if not worse condition than Brazil, Russia, and Turkey. Further, he stresses that success with outbreak control has nothing to do with imposing government structures, the culture of the country, or the wealth of a nation. 

Government: Russia’s authoritarian government is struggling with containment.

Culture: East Asian and European countries are dissimilar in their cultural practices but both have managed to lower their COVID rates. 

Wealth: Vietnam, a developing nation, until recently, had avoided COVID-related deaths.

“It’s tempting to look for explanations for why other countries are doing better”, cautions Dr. Jha. He logically builds to the conclusion that where we have failed is in deploying ONE action effectively across all states. That is all that is required. With one-third of the U.S. population on the brink of succumbing to the pandemic, one third already fully at risk, and one-third managing to keep the pandemic at bay, mismatched messaging is wreaking havoc. Without a coordinated response from strong federal leadership, the COVID death numbers will not plateau. 

The onus of information dissemination and access to resources lies heavily on those in positions of power but behavioral change can come from the top-down and the bottom-up. 

Impermanence. The ability to adopt thought that lasts for an undetermined period of time. 

No one wants to be in lockdown. No one wants to wear a mask outside. No one wants to continuously get tested.

Just one of these, fully implemented and enforced, could be the key to end suffering. 

Dr. Nirav Shah, Senior Scholar at Stanford University’s Clinical Excellence Research Center and an elected member of the National Academy of Medicine, informs his research from the positive COVID control he has seen in Asian countries where schools remain open. He notes, “Right now there is a false choice between lives and livelihood.” That choice drives contention and spreads misinformation.

What is needed to re-open safely?

Early warning systems, broad & efficient testing, effective quarantine/isolation, adequate treatment capacity, actionable data collection, and vaccines. 

He brings forth antigen testing as the cheaper, faster method to detect COVID. Cost-effective and almost instantaneous results, I am feeling more optimistic as he continues to speak.

Source: U-T reporter Jonathan Wosen

Early warning systems and actionable data collection rely on the immediate transfer of information to an online database to make it accessible. Temperature monitoring using a thermometer linked to the internet would increase the efficiency of detecting COVID hotspots and roll out timely mandates required to limit spread. Dr. Shah’s blend of technology and the pandemic is the obvious way to move forward. Daily reporting is the necessary next step.

Source: Covid Act Now

So why haven’t we already been using this technology?

“We really need to start to think about a fundamentally different approach that protects privacy and lets public health [professionals] do their job”, Dr. Shah frustratedly shakes his head.

He is moving fast and hits a wall with effective quarantine/isolation and vaccines. The U.S. has expended no energy to strategize or provided resources for isolation and most vaccines are a year out still. 

“We are not anywhere close to doing well”, ends Dr. Shah. 

It seems Dr. Shah and Dr. Jha come to similar conclusions – the United States has the resources and the intelligence to rewrite the course we have taken with regards to the pandemic.

A grim message but I leave with positive outcomes. Testing is changing and so is data collection. Mitigation and prevention of COVID is plausible.

Can we adapt? Can we change? Can we make space for impermanence in our lives to end suffering?


Srishti Prabha is the Assistant Editor at India Currents and has worked in low income/affordable housing as an advocate for children, women, and people of color. She is passionate about diversifying spaces, preserving culture, and removing barriers to equity.

Coronavirus to Karunavirus

Feeling like the “wrong kind of doctor” (I have a doctorate in organization change), I initially felt helplessly inadequate in my response to the coronavirus pandemic.  Thinking of all the family, friends, and colleagues I knew who were fighting in the front lines of medicine, I questioned my career choice.  With the exponential increase in COVID-19 patients across the globe, what was I doing with my life?  

Instead of consulting, teaching, and writing, shouldn’t I have been practicing?  Thinking of the brave souls who practiced medicine, I wondered about my contribution.  To be sure, for big chunks of my career I had used my biomedical engineering background and my doctoral studies to guide leaders in healthcare, but when I asked myself what would Mother Teresa be doing, I recalled my meeting the saint a month before her death.  A life lesson emerged from that experience:  “We can lead best by serving the needs of our community and by following the lead of those we serve.”

So my heart turned to those I knew in healthcare – at Kaiser Permanente, Sutter Health, UW Health, UCSF, SF General, and Stanford Health Care – and I found my own way of serving them:  with compassionate and supportive listening.  I recalled a review I had written a decade ago about Dr. Abraham Verghese’s Cutting for StoneThat India Currents review, titled “Hippocrates Made Human,” centered on the following question from this empathetic novel:  “Tell us, please, what treatment in an emergency is administered by ear?”

I realized that by being in dialogue with my family, friends, and colleagues, by sharing my words and listening to theirs, I could support those who were fighting the good war.  Finding my voice on email one early morning, I checked in with all those I knew who were fighting the good fight for my own family. Later that week, my wife (Mangla) and I looked beyond our own circle of healthcare providers and sent varying versions of the following email to friends whose children were at the front line:

Hello Friends

We’ve been thinking about you all and praying that all are keeping well.  

Here’s a note that we’ve sent to the many clinicians who take care of our family 

“Thank you for the outstanding care you always provide to our family.  During this time of the coronavirus pandemic, I’d like to also thank you for heroically being of service to all of your patients.  Please take care of yourself and your loved ones.”

We know that each of you has at least one family member or friend who has been similarly heroic.  Of course, we are all so blessed (or at least we hope each of us is) to be taken care of by doctors, nurses, dentists, physical therapists, and the countless others (public health experts, researchers, biomedical engineers, administrators, supply chain clerks, et al) who serve behind the scenes.  A heartfelt thank you to all!

Friendship is truly a lovely word.  And words are keepsakes, keeping us close in good times and distressing ones.

And here is a word from Sanskrit that is always much needed:  karuna.  Given that we can all use more compassion in our lives, you might find of interest this website highlighting compassionate acts: karunavirus.org.

In Friendship … Mangla and Raj

Some responses came immediately as if from next-door kin:  “Thanks for sending this note, Papaji! Yes, [we] are staying healthy.  I’m trying to see the positives. [When we] go on our daily walks, I can’t help but be reminded that Spring is happening all around us. Cherry blossoms are in full bloom, the birds are chirping louder every day, my indoor seedlings are just about ready to be planted outside, and the air is cleaner.”

Some emails read as if they were Western Union telegrams – surgical sentences and grammatical errors suggesting distracted medical battlefield urgency:

  • “Thank you so much my friend … desperately needs this as it has been certainly overwhelming for all of us.”
  • “Will catch up soon … knee deep into COVID-19 as I and in our command center this and next week.”
  •  “So thoughtful of you to reach out … much appreciated … more careful response to follow.”
  • “Doing fellowship in Infectious disease at Stanford … warning … worst is yet to come … brace yourself.”
  • “Thank you … I hope you and the family stay safe.”
  • “In the front line now treating patients and attending on them … but praying and hoping for the best … work has doubled.”
  • “Thank you for this thoughtful note … I’m doing well (on nights right now, delivering babies) and have been in good health.”
  • “Coronavirus is causing a lot of stress for us … Stay safe and wash your hands frequently with warm water and soap for 20 seconds.”
  • “Thanks … that’s very nice of you to say.”
  • “Sorry for not responding sooner … keep waiting for a moment I can put some thought into my response … silly me.”
  • “Thank you very much for the thoughts, the support, and your friendship … hope you and your family continue to all be healthy … hope isolation doesn’t keep you from the grand baby!”
  • “Until calmer days…”

And then there were the responses from Dr. Megha and Dr. Pooja.  In these letters from two sisters whom my wife and I had known since they were little girls in frocks, I could hear the distant thunder of war against an invisible enemy:

Dear Raj Uncle and Mangla Aunty,

Thank you so much for your very kind words and touching email, and for thinking of us during these uncertain times. This has truly been a humbling experience thus far and I can only pray that this is soon behind us with minimal loss….

Best wishes,

Megha

*******

Dear Raj Uncle and Mangla Aunty,

Thank you so much for reaching out to me. 

That passage was really beautiful.

It made me feel hopeful about the future.

I am working in the ICU for a month and am grateful for the opportunity to learn from this pandemic and care for patients.

I am especially inspired by nurses and respiratory therapists, as they have the most contact with patients. 

Their bravery, compassion, and selflessness inspire me every day.

Wishing you and your family all the best now and always!

Pooja

*******

Gentle reader, even if you are not a doctor or planning a career in the caring profession, as a consumer of medicine you may be wondering about that question from Cutting for Stone:  “Tell us, please, what treatment, in an emergency, is administered by ear?”  Perhaps we can all embrace this universal response — “words of comfort.”

Dr. Rajesh C. Oza, a Change Management Consultant working with clients across the world, has written this for all of those in healthcare, including his nephew, Avinash, the first MD in the Oza Family.

An Open Letter to Hoteliers

“Tough times never last but tough people do” – Rev. Robert H. Schuller

In these tough times, Prince Organization, run by fellow Indian Sunil Tolani, has stepped up and applauded his hotel staff for their work on the frontlines. Frontline staff encompasses a multitude of industries, yet hotel staff seem to be lost in the bevy of healthcare-related professions. Here is an open letter to those in the hotel industry, providing a safe space for the homeless, vulnerable, and sick populations, for little to no compensation. Thank you for all that you do!

Dearest Prince Organization Team/ Hoteliers,

I hope this message finds you healthy and safe during these trying times of dealing with fundamental uncertainty. For the first time in modern history, the world is at the mercy of a virus that knows no rank and no title. The world is united in our shared experience of pain. But during all this sorrow, I really believe the entire world is also united in a shared prayer praying for relief and going through something that is globally profound.

We live in unprecedented times when, for the first time in over 100 years, the country is almost shutdown. Over 275 Million Americans are at home. Times like these tests one’s spirit and fortitude as those of us that are in the hospitality industry face challenges we have never seen before. We have managed through the recession of 2008-2010 but this is unlike any economic enemy we have dealt with in the past. This health crisis has created an economic catastrophe of historic magnitude. We are in a deep freeze and it is bone-chilling. The US was on a good roll and then came March.   

At LAX airport on January 21st, I heard the morning news of the first coronavirus case in the U.S. and the first words were “Oh, No—Holy Cow,” March began with a booming economy riding an 11-year economic expansion with unemployment at 50 years low and the #1 worry for employers was finding employees to fill positions. The Dow Jones was flirting with 30000.

March 3rd, the federal government announced an emergency rate cut. March ended, ravaging personal and professional lives, bringing the economy to a standstill. A new reality was gripping the nation: 10 million jobs were lost, the Dow at 21917, airlines on the verge of bankruptcy and American icons of commerce shutting down, and countless small enterprises failing.

As of this weekend, over 20,000 Americans were dead with the toll expected to increase exponentially in the coming weeks. Retail centers and malls, restaurants, gyms, parks, schools and universities, places of Vice and Worships, and millions of other “nonessential” businesses shut down, movie theaters dark, professional sports suspended, and the Olympics postponed. A couple of months ago, we were afraid if we saw somebody with a mask on, now we are afraid if they do not have the mask on. The buzzwords were communal, sharing, and now the word is social distancing.

The nation has made a call to us Hoteliers, essential businesses, to remain open. On the frontlines, you are doing a fantastic service to the country. You agreed on “what can we do to help here” driven by your faith and sense of duty preparing for the worst-case scenario but hoping for the best-case scenario dodging the coronavirus bullet. THANK YOU for doing your part in supporting your community. Providing medical and emergency personnel with FREE rooms and at deeply discounted rates to keep your hotels humming along with positivity. Unlike others, we did not shut down or walk away nor cut fast and cut deep. The communities value and admire your commitment and dedication.

We are grateful for the bravery and sacrifices of our hotel staffs, women are over 70% majority. We are not doctors, nurses, firefighters, or policemen but like them, we too are on the front lines to help and offer comfort and solace, shelter at the hotels. It is way economical and makes total financial sense to shut down our hotels, but we are open for our communities, keeping our neighborhoods running and making our guests feel like home. The pandemic has dramatically enlivened our company’s workforce. The word is proud. We feel enormously proud of what we are doing.

Hotels are open 24 hours a day, seven days a week, 365 days a year. We are a symbol of our people’s resilience, as we never close. This is a very unsettling time – both physically and emotionally. We are concerned about our health and that of our family, friends, and co-workers. We are uncertain of when this will end and what the future will look like. We are also uneasy because in hospitality what we do is take care of guests and we are virtually unable to do that now with limited services. We do our best as we dig deep within ourselves and muster all the perseverance and grit, we can. We must continue to live our values of being humble, caring, and kind, and apply them to our new circumstances and to the team members. Every day you are at your Hotels, you contribute with pride and purpose. 

The devastation that coronavirus has rained on the world, from a business perspective, is something we have never experienced. Local restrictions combined with the nearly complete drop in business levels require the temporary suspension of brand standards at many of our hotels franchised hotels. The financial loss to continue to operate these hotels will be anyone’s guess and extremely severe to cause even more damage to the company long-term. While there is much uncertainty remaining on how long our lives and business will be disrupted and what the recovery will look like, we do know the economic hit to the company will be significant. That is why we are taking aggressive steps to manage controllable expenses limiting operations and managing expenses as well.

We are making the tough decisions needed to weather the storm that is wreaking havoc on our country by waiting longer to pay suppliers, shutting down floors, saving electricity and utilities, ordering in limited supplies, and re-evaluating capital investments. These decisions do not come easily, but it is our belief that by making these decisions now it will allow us to be properly positioned for recovery after the war on this enemy is won. Almost every variable is changing and the disastrous negative impact on our business in so many ways cannot yet be fully quantified. Simply put, we need to watch our cash management as we did not budget for a close to a zero-revenue scenario.

Of course, none of the excellence, passion, and grit in the face of the adversity brought on by the virus surprised me. That is simply our character, and the pressure we already deal with on a day to- day basis not only reveals it; it forged it. Through the sheer power of our perseverance and with our collective character as a guiding light, that is exactly what we will continue to do as long as it aligns with our three North Stars — the health and safety of all team members and our valued guests.

Thankfully, we are not aware of any of our team members who have contracted the virus. Our thoughts and prayers are with those who are experiencing the virus themselves or who have family or friends with it. I am grateful we have no cases of this insidious disease. We will see this through. One lesson from the virus is the realization of how connected we all are. While we find ourselves physically separated from each other, it is with a sense of community that we will meet these challenges and overcome them. We will continue to care for each other, and when people start to travel again — and they will — we will do what we do best — welcome them like family. Treat them like family, Once again.

We could not be any prouder of the character, generosity, and resilience exhibited by our team members over the last four weeks. Let us pray and look forward with positivity to a day where Coronavirus is a distant memory, a day when our hotels are filled with traveling guests and your break rooms are filled with laughter.

Dear heroes of the frontlines – continue to be strong, positive, and kind. Our spirit will prevail. History tells us that we will survive. Let us pray, stay calm, and stay true to our true values to weather the storm. I can feel the purpose-driven nature, the camaraderie, and the coming together of our company. You are playing a vital role with government employees, social workers, medical workers who are coming into your towns to stay with you and depend on your hotels. I have come across many noble acts of public service that you are performing at your hotels. Your true character reveals for what you are and have always been: HERO’s. 

I am foregoing my entire salary for the rest of 2020 and even 2021. In a time of crisis, we have to transcend and come together for the greater good. Please continue to take care of yourselves and your loved ones. The journey is painful and we hope in the years to come, you will be testing the limits of a new world, as each and every one of you will be able to take pride in how you responded to this crisis. I am hanging in there with you all, PRAYING.

Sunil Tolani

Sunil “Sunny” Tolani is the CEO of Prince Organization. His passions include charity, empowering youth with educational and vocational training, humanitarian work on sexual harassment and domestic violence, prison reform, wage equality for women, and LGBT rights.