It's widely known now that diabetes is one of the high risk populations when it comes to Covid 19. I had a chance to have a chat with Dr. Meera Shah, an endocrinologist at the Mayo Clinic in Rochester, Minnesota, who takes care of diabetic patients. Have a read of our discussion below for more on her thoughts.
Can you tell us a bit about yourself?
I'm an Endocrinologist at the Mayo Clinic Rochester, and have been on staff here for the last 5 years. My husband also works at Mayo and is an Internal Medicine Specialist. We have three children who are all home from school during this time, so managing work and them together has been an interesting experience.
Is Mayo treating Covid patients?
Yes they are. The outpatient clinic has a pretty rigorous screening process on the phone before letting anyone come in. You can read more about their self assessment tool here. If all of the answers on the assessment are negative then they are allowed to come in and see us as elective patients. Mayo has put in place a very good process which is designed to help the medical team stay safe but also the patient stay safe.
That does sound like an effective system. When you go in to work are you in contact with covid positive patients?
No, I should not be in contact with people who have been tested positive with patients. They are in a separate area of the facility and I stay in the endocrinology department taking care of my patients. If patients test positive, then they do not come in for elective appointments (which is the majority of my practice). If it is an emergency then there are processes in place so they can get the care they need with minimal risk to staff.
What is it like for both you and your husband to work at home, and have children to take care of at home?
Well, we are both going in to work but so far it's been ok because I've been mostly able to work from home. The kids have their own school curriculum to follow so they are pretty occupied. In the morning I give them a timetable to follow, midmorning we meet up for a few minutes to ensure that everything is going smoothly, we have lunch together then they go back to doing what they're doing and I get back to work. My mom has been staying with us so that's been really helpful too.
Do you have any tips for working from home with kids?
Create a routine, some kind of schedule. Sticking to structure has helped us a lot.
If possible, set aside a space that's yours (physically separate the space) and make sure the kids respect that. As hard as it is you have to just behave like this is your office it's just not in your office.
What are some unexpected pluses of working from home?
You get to realize things about your children that you don't otherwise see. For example, I could have outdoor soccer time with my son everyday. I would have never had the time, interest and would have been so tired after a full day at the hospital. The family time we are getting now is great. We've pulled out board games that we didn't even know we had. Everyone is a master of Clue now!
What are your thoughts on the best ways to celebrate occasions during this time?
We have had two birthdays in the last two weeks in the family. We actually had one of my daughter's friend's have a drive by birthday. It was really nice because the kids got to see each other. They chatted, laughed, made tik tok videos (this is what 11 year olds do I guess). We ate cupcakes on the sidewalk. It was great! For my husband's birthday we did a live facetiming with his family when cutting his birthday cake. It's ridiculous that we haven't done this in the past with family and friends that do not live near us!
How long do you think all this is going to last?
My prediction is that this is going to be something that we're in for the long haul, 12-18 months of this new normal.
What does that mean?
12-18 months of social distancing, of any sort of ability to get out and do things in big groups. I don't think that's going to happen for a very long time.People are using modeling to predict what's going to happen in 2 weeks, 4 weeks, etc but it's all based on assumptions of things that have already happened. For example, with social distancing we expect X is going to happen in Y time. But if you take away social distancing we don't know how things will really go. The Governor of New York, Andrew Cuomo, has done a good job at breaking it down into pieces of information that are accurate but still digestable. He is one of the ones that had to deal with it hugely at the earliest as New York quickly became a hotspot for covid.
What's the future of travel like?
I don't expect to get on a plane for a year. If you ask me in a month, my answer may be different. Things are changing so rapidly everyday. If you just think about what you were doing in February, it was like a different life. The medical journals were still publishing articles in February comparing this to the flu, no one imagined it would go this big. You learn these things in hindsight. It's so new that nobody really knows what to do about it. We do have some understanding about how it's transmitted, and what can help (social distancing, hand washing, wear masks) and the goal is A to not get exposed, B to not get infected, and C to wait it out until a vaccine or some kind of readily accessible treatment is on the market.
When do you think a vaccine will be ready?
I'm not keeping up with the real time efforts, but I will say that this is very different from any other vaccine. This is a global endeavor. It could absolutely be more accelerated than ever. But as with anything, you want to make sure it's effective, worth doing, and understand the behavior of the virus. These are all the things that the virus researchers are thinking about.
How is the Mayo Clinic supporting the efforts?
Mayo is part of a bigger international effort looking at several medications for treatment. There are at least 7 clinical trials that the team is collaborating on. For example, with regards to Hydroxychloroquine, they are trying to get people who think they might have been exposed to enroll. Click on this link for more.
What do you tell your patients with diabetes about covid?
Patients are concerned, of course, because initially we recognized that diabetes was a risk factor for people doing worse with covid 19. It's a tough one. You don't want to give people unnecessary worry, yet there is some evidence that if you get covid 19 you are likely to do worse. If you look at the American Diabetes Association guidelines they haven't put out anything specifically for covid 19. The recommendations are the same as for everyone else.
But if you live with someone with diabetes, act as if you have covid 19. Don't share utensils, towels, etc. On the flip side you hear about people who are 97 years old that have recovered from covid 19. There's always the average then there is a spectrum. It's not like applying for a visa, it's not like you're eligible or not.
Is there anything that you want to tell the general public?
Everything is propogated in a click of a button and then there's 20,000 people that are reading. It's our responsibility to be careful of where we get information from. Find trustworthy sources and get information from them.
Any final thoughts?
The science will get us out of this eventually. We've built this world with airplanes, cell phones and everything else through science. People had to live with plagues through centuries. They will solve this eventually. We need to trust people who have the skillsets to handle the situation.
Thank you so much for your time and insight, Dr. Meera! I'm sure your information will help everyone that reads this in one way or another.
Interview led by Devi Bajaj
Executive Director of Enliven Services