In the wake of the COVID-19 pandemic, many of us are finding new ways to navigate daily tasks in both our professional and personal lives. We are very fortunate to live in the era of electronic platforms that allow us to continue to care for patients remotely via telemedicine. For many of us, while these remote visits are essential to allow continuity of care, it is not the medicine we are accustomed to practicing. We prefer face-to-face patient interactions. We want to make a tangible difference in the lives of those we care for. We are caregivers at our core. Many of us are thinking the same thing; What can we, as members of the podiatric medical community, do to help during the COVID-19 crisis?
Public health experts anticipate that the United States will soon have a shortage of health care workers in many places. Physicians will be stretched thin as hospital beds fill. Many medical centers are putting out the call for volunteers and are even reaching out to retired physicians. Many states are loosening licensing rules to allow volunteers with vital clinical skills to pitch in and help with screening calls, triaging patients and direct patient care. I would encourage my fellow podiatrists to evaluate your vast skill set to determine the best ways in which to answer this “all hands on deck” call.
Personally, I feel very fortunate to be able to piggyback on my decade of wound care research experience to help my institution care for patients during this pandemic. Through the years, my participation in research enabled me to objectively evaluate new therapeutics and serve as a primary investigator in numerous clinical trials. Through my involvement in these research trials, I learned so many important skills that make me a better clinician. I have honed my ability to appraise evidence and think critically about any given situation.
Currently, there is no approved treatment available for COVID-19 infection. At my institution, University Hospitals of Cleveland, a pivotal COVID-19 Phase 3, open-label, multicenter randomized study to evaluate the safety and antiviral activity of remdesivir (Gilead Sciences) has begun. Our institution is one of only two sites conducting this trial in the United States. Remdesivir may be one of the more promising potential treatments for the novel coronavirus. If you have been listening to any of the media outlets recently, you have most likely heard about a barrage of potential “cures” to COVID-19. In this crucial time, the field of medicine is in need of validated clinical trial data on COVID-19 before any drug manufacturer can make that claim.
Recent results from initial testing performed at the Centers for Disease Control and Prevention (CDC) in China showed that remdesivir has potential antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro1 but results of a large clinical trial on COVID-19-infected patients are necessary to validate this benchtop research. Due to my training as a DPM as well as my research credentialing and experience, I am able to participate as a study co-investigator in the aforementioned Phase 3 clinical trial on remdesivir. I will be obtaining informed consent and clinical samples from patients as well as collaborating with the other investigators as part of the multidisciplinary team carrying out this history-making research.
The late Mattie Stepanek, who suffered from significant medical ailments himself, was quoted as saying “Unity is strength. … when there is teamwork and collaboration, wonderful things can be achieved.” There are probably no truer words as the medical community faces this global health-care crisis. I look forward to hearing additional stories about how other podiatrists have stepped up to this all hands on deck call. Stay safe and be well.
Dr. Cole is the Medical Director of the Wound Care Center at University Hospitals Ahuja Medical Center in Beachwood, Ohio. She is also an Adjunct Professor and Director of Wound Care Research at the Kent State University School of Podiatric Medicine.
1. Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Research. 2020;30:1-3.