Wittman discusses the role of Stanford’s Occupational Health Center in response to COVID-19

Rich Wittman and his team at Stanford University Occupational Health Center (SUOHC) may not be household names, but they are key players in Stanford’s response to the COVID-19 pandemic.

As medical director of SUOHC, Wittman works with a team of clinicians to provide medical services to faculty, staff and post-doctoral scholars at on-campus and SLAC clinic sites. The SUOHC team interacts with health and safety specialists while providing care for Stanford employees who sustain injuries and illnesses in the course of their work.

In normal times, much of SUOHC’s focus is proactive and preventive, encompassing a wide range of OSHA and departmentally mandated programs to protect Stanford’s research community and field-based employees. SUOHC offers travel medicine services, coordinates the seasonal influenza vaccination clinics and maintains a forward-looking perspective when advocating for total worker health.

The work of the Occupational Health Center has shifted significantly in the wake of the COVID-19 pandemic. Wittman, who is also a clinical assistant professor of medicine – primary care and population health, discussed with Stanford Report how he and his team have promoted prevention measures, developed policies to combat the spread of the virus and prepared for the eventual reopening of the campus.

 

What are your responsibilities in response to the COVID-19 crisis?

The Public Health Policy Committee plans and prepares for various public health scenarios that could affect the Stanford community, and in mid-January, we began discussing COVID-19’s potential impact. During the pandemic response, I have been working with Vaden Health Services to lead the medical support team as part of the university’s Emergency Operations Committee (EOC), providing updates on new clinical research and epidemiologic data related to the virus as they developed.

One of our key responsibilities in Stanford’s COVID-19 response has been to promote prevention measures and develop policies that could reduce the spread of COVID-19 on campus. We continue to use this lens in every phase of our involvement, from initial public health planning to current COVID-19 response. We are also investigating ways to better protect the campus when we move into recovery mode and members of our Stanford community start returning to work.

In thinking about campus recovery and return to work, Dr. Rajan Puri is leading a number of efforts in this area. In line with our Workplace Health Innovation Lab’s mission to leverage technology to solve problems in workplace health, he has partnered with University IT and a variety of other stakeholders to develop a symptom and exposure reporting tool designed to mitigate the future spread of COVID on campus.

 

In our lifetime, we have not seen a health crisis of this magnitude. How prepared was the Occupational Health Center for something like this?

One of the challenges in responding to a rapidly expanding public health crisis of this magnitude is obtaining epidemiologic and case data in a timely manner so as to guide evidence-based decision-making. For a variety of reasons, this has been particularly difficult with COVID-19, hampering the response on both a national and global level.

Our clinical team benefits from years of experience in governmental organizations and formal training in public health, and we have been fortunate to cultivate relationships with a wide variety of subject matter experts at Stanford and beyond. This, in combination with the strong leadership and talent at Environmental Health & Safety, has provided us with an outstanding group with whom we can collaborate to provide guidance that is ideally a step ahead of mainstream evidence and developments related to COVID-19.

This collaboration enabled Stanford to institute early COVID-19 travel warnings and restrictions to better protect the campus community, often in advance of peer institutions. Our efforts also led to the development of more robust information and guidance on the Health Alerts website, which we were able to share as a resource to other universities that reached out to us in their planning efforts.

 

How has your work shifted since COVID-19? What will be the Occupational Health Center’s role once the Stanford community starts returning to campus?

My team and I continue to treat work-related injuries and illnesses, including those that employees providing essential services might incur while working on-campus during this time. We have transitioned significantly to performing telemedicine services, and as many others, are trying to balance these prior responsibilities while maintaining focus on the COVID-19 response.

We have been providing outreach to the campus community in the form of information sessions and town halls, and we have been working closely with University Communications to publicize medical recommendations and FAQs regarding COVID-19. Our goals include filtering the medical literature for our community members in order to keep them updated with the evolving science and to guide best practices for reducing the risk of COVID-19 transmission and managing risk post-exposure.

When the campus moves into recovery mode and as the workforce returns in higher numbers to campus, we will continue to remain closely involved in screening those returning to work as well as managing COVID-19 exposure reporting and contact tracing.

 

There are many employees providing essential services still working on campus. What efforts are you and your team making to help them stay safe and healthy?

In a more traditional sense, these employees can contact the SUOHC for any work-related injuries and illnesses. Our clinical staff will support their care and coordinate return to work with the workers’ compensation system. We also continue to perform medical surveillance targeting employees who perform clinical or research-based COVID activities, such as those enrolled in the respiratory protection program.

Our efforts, however, have not been limited to responding to employee injury and illness, as we have also been partnering with various campus stakeholders, leadership and the county to reduce the impact of COVID-19 cases on campus.

From a clinical standpoint, the bulk of these activities remain focused around managing those who have COVID-related symptoms, issuing guidance around self-isolation, performing medical risk-assessments and initiating contact tracing to guide return-to-work decision-making.

One of our newest efforts involves collaborating with Dr. Kari Nadeau as part of her research team investigating the immune response to COVID-19. The project hopes to provide longitudinal insight around viral testing and the antibody response. Through this, and our efforts in establishing an automated and scalable framework to respond to COVID-like illness on campus, we are among many groups working diligently to prepare the campus for a staged return from shelter-in-place.

 

The shelter-in-place order in Santa Clara County was recently extended through May and may be extended further. It appears that most people are complying by practicing social distancing, washing hands frequently, cleaning surfaces, etc. From a public health standpoint, what else can we be doing to stay safe and how can we best help our community?

In the short term, it’s important not to underestimate the value of hand washing and wearing a mask. Keep your hands clean, wash them frequently, and if you touch something in common public use, clean your hands again. Use enough soap and water and wash vigorously for 20 seconds – this is the key to disrupt the protective layer around the virus.

Longer term, we need to recognize the importance of staying home when we are sick. The wide range of illness caused by COVID-19, from minimal or no symptoms to severe symptoms, highlights how interconnected we are, and that our practices can impact others in profound ways.

This is a particularly stressful time for many of us, whether due to health concerns, financial issues or the difficulty of balancing home and work life when they are no longer clearly separated. Strive to maintain social contact with friends – in other words, social distancing is physical, but not emotional.

Take advantage of the wide range of resources that Stanford offers focusing on wellness and mental health, including the Faculty Staff Help Center and the BeWell and HIP programs. Set aside time to go outside for a walk or bike ride – exercising is critical for our mood, our immune systems and overall well-being. If you can, take a moment to consider what is important to you and what positive changes you wish to make in your life when the shelter-in-place order relaxes.