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To begin 2021, Oklahoma State University Medical Center is sending a message of thanks through a new advertising campaign. It's #ThanksForReal to recognize those who listen to the health experts and do their part to help support the hospital systems and their staffs in the battle to save lives during the pandemic. 

We featured OSU Medical Center Chief of Staff, Mousumi Som, D.O., as a pandemic hero in July 2020, and with the climbing numbers of cases, hospitalizations and deaths, as well as the deployment of vaccines, we wanted to check in with the hero to hear how they're faring at OSU Medical Center going into 2021.

In a phone interview on Wednesday, Dec. 30, Som also shared her thoughts on why OSU Medical Center's mask ad campaign wasn't effective enough, what needs to happen to ease the burden on hospitals in the new year, and the importance and growing availability of the monoclonal antibody treatment.

Let's start with what you've seen in the hospital recently, as we go into the new year. What's it look like in your hospital nine months into the pandemic, locally?

Region seven, which includes Tulsa and its immediate surrounding areas, have all been stressed by the number of COVID related illnesses as well as non-COVID related illnesses. The bulk of the region 7 hospitals have been running at little to zero ICU capability. The numbers of patients that are being held in the emergency rooms, both ICU patients, as well as medical surgical patients is increasing, and the system has really been stressed.

The literature suggests that if 10% of patient hospitalizations are COVID positive patients, the system will become overwhelmed. We're consistently well over that number. At OSU Medical Center, we've been running anywhere between 30-35%. In short, when you ask what it looks like for the hospital systems, as we're ending 2020 is all the hospital systems are stressed for both COVID and non-COVID related illnesses.

With what you're seeing with the numbers and how they're trending right now, including recent new highs in hospitalizations, and deaths near 2,500. And then we look at what's happening in places like Los Angeles where they're putting patients in hallways or turning people away because they don't have enough oxygen. Is there a concern that we could get to that high a level and Tulsa with the way things are going?

We may not have hallways that are overflowing with patients, but they are stacking up in the emergency rooms. Emergency rooms are not actually designed to hold patients for hours or days. Emergency rooms are to temporize patients, then get them in the right places. When you start seeing these increasing trends of patients being held in the ER, for extended periods of time, it is concerning. We know for a fact that patients that have extended stays in the Emergency Rooms have a tendency to have worse outcomes.

How frustrating has it been for you as a frontline medical professional to see the struggles with getting people to follow ordinances, mandates, CDC guidelines to wear a mask? What is your take on all of this when we're this far into a pandemic? I was told OSU Medical Center is changing their messaging to something positive because they didn't find the mask messaging effective.

I think it's a hard question to answer because you expect the general public to understand everything that I and other health professionals went to school for, for years and years and years, and we're turned around, we're expecting them to understand every single nuance that comes along with wearing masks, vaccines, etc.I understand where the public probably has a little bit discordance.

But just like we are expected to trust in the experts for other areas, engineering, architecture, etc., we ask that they listen to us and understand the impact they could have with even the small things that they do.

We’re so close to the finish line, that now we can make a pretty significant impact. I understand COVID fatigue, it's the same thing that every healthcare professional is experiencing right now.

I understand from the community side of it, how hard it's been to make all these sacrifices with these changes. That's why we have taken the approach of changing the messaging to be something that's more positive.

You've asked parents who are full-time employees to also be full-time educators and full-time parents. You've asked them to balance all of that and you've restricted the ability for people to see their loved ones, whether it be in long-term care facilities or in the hospital. There's been a good proportion of the population that has done that, and they've done that very, very well.

To simply not acknowledge how many people have actually done the right thing, I think is the wrong answer, which is why we've changed our messaging to the thank you for real campaign.

How is the staffing at OSU Medical Center? And how is the morale of that staff?

Staffing is an issue not just to do with OSU Medical Center, it's an issue across our region, and even across our state. We have made modifications to the way we've staffed our facility. We've changed incentive programs. We've changed a lot of things that are not seen to make sure that we're able to care for the patient to the level that we've been doing since the pandemic began.

You mentioned we're getting close to the finish line. There are vaccines being deployed and being administered, but that's still kind of a long process that's going to play out over months. Before receiving one there is something else that some people in the vulnerable populations can do that can help maybe prevent a hospital visit after testing positive, especially the older or more vulnerable population. Let's talk about BAM or bamlanivimab. It's a monoclonal antibody treatment that you provide at OSU Medical Center. How does this work and what's the process?

The monoclonal antibody, or the bamlanivimab, is a monoclonal infusion that is a one-time infusion. It has to occur in a healthcare setting where you can be observed for about an hour after the infusion. It is for that higher risk population which can either be an individual with a body mass index of greater than 35, chronic kidney disease, have diabetes, are on immunosuppressive medications or have an immunosuppressive disease. Or it can be an age greater than 65 years alone. Or it can be age greater than 55 with other cardiovascular disease, hypertension, or any lung related disease.

It’s a pretty wide group that if you actually get infected with COVID-19, and you see a health care provider, and they find that you meet one of those risk criteria, you can be infused with bamlanivimab if you've had the symptoms, and your test was positive within the last 10 days.

What we do know about the infusion so far is if infused at the right time, there is a reduction of you progressing to require hospitalization or an emergency room visit. That's what the studies have shown us.

We are opening that up to the entire community. We have a number provided for those health care providers as well as patients if they are testing positive, and they believe that they're a candidate for infusion. I think that'll help because it'll go outside of our own little silos, and it's actually going to be able to impact the larger community as a whole.

There has been the discovery of another strain of the COVID-19 virus in Colorado, which isn't that far from Oklahoma. What do you know about it so far and what are the biggest concerns?

The strain that was originally identified was identified in the UK, what they're concerned about what that strain is, is whether it could have, essentially a higher R-naught, so meaning is it potentially more contagious than the original strain of SARS-CoV-2? It has been identified in Colorado, as far as its contagion contagious ability, I think it's too new to really make that determination yet. Is that what scientists are watching? 100%.

The most important thing to me from this information is that they still think that the vaccinations that we have available are going to be effective in mounting a response to that particular strain. It would be more concerning to me if the strain had mutated so significantly, that the vaccines were not going to be as effective. But that is not what they're seeing as of right now.

Is there anything I'm missing or that you would like to add that I haven't asked about that you feel is important to say to the citizens of Tulsa?

The biggest thing is, we are so close to the finish line. And when I say finish line, it doesn't mean a finish line is in a week or it doesn't mean the finish line is in two weeks. But with the additional things that we have available to us through the monoclonal infusions, and the ability to start getting vaccinated, if we can reach out to the citizens of Tulsa, reach out to the citizens of Oklahoma and continue to practice some of these social distancing mechanisms, along with those two types of things, my hope is that we can depressurize some of the impact that it's having on the healthcare system.

That's easy for me to say because that's the world that I live in, but when you start thinking about, "Hey, this is your sister, or your child or your mother or your grandmother," it becomes very, very real.

I know everybody talks about "Well, there's only a 1% mortality rate associated with this disease. I don't understand why we are all so worried about it." Well, we're worried about it because we have so much pressure on the healthcare system at this point in time that we need to be able to do something, to make sure that we can continue to take care of all patients. And when that 1% is somebody that is important to you, that 1% very quickly becomes 100%.

So we’re asking the citizens of Tulsa to continue to be mindful of what they're doing and we’re thanking the ones that have sacrificed right along with us.

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