“January. MD Anderson (MDA) began working on the covid19 pandemic in the third week of January with the assembly of a covid19 Incident Command Center. We planned for the protection of our cancer patients, an immunocompromised group with multiple risk factors for this infection. Hospital wards were identified as potential sites for covid19 care. A communications strategy was created to keep patients and employees informed. Physicians, mid-level caregivers, nurses, and operational areas such as pharmacy and laboratory testing were explored as potential resources to face the possible epidemic and protect patients.  

“February. MDA began daily electronic leadership discussions which created a constant review of needs and actions. This discussion involved 600-700 leaders at all levels of healthcare. These leaders made sure every employee stayed informed. Travel restrictions were put in place for employees. Review of personal protective equipment (such as masks and gowns) occurred. Individuals who could work remotely or serve as alternate employee resources (manning hospital entry points as an example) were encouraged to do so.

“March. Unheard of things began happening. Restrictions on visitors, including family members entering with patients were activated, sometimes involving personalized approaches. Employees were required to provide their badges at entry, have their temperature taken and use hand disinfectants and later were required to wear surgical masks at entry. Covid19 testing began. As actual covid19 results began appearing, specific hospital wards were identified for covid19 patients and those possibly infected with covid19. These patients were treated by a special covid19 healthcare team. All healthcare institutions in the Texas Medical Center talked daily to coordinate care giving and provide as much protection and care as possible.  

“April. The pandemic is still progressing significantly. Healthcare employees are at the "tired" stage of maintaining constant vigilance. It is a lonely time, as they engage daily with the requirements for working in this environment. And it is a time when caregivers can feel very alone even when interacting with family, wondering if they will be next to get sick. They know what the illness looks like, which can also be fear-inducing.
 
“Houston staged a night of "Blue," with major sports arenas, buildings, and bridges lit with blue light thanking healthcare employees. It was fantastic! Even at the employee entrance, messages of encouragement and thanks in colored chalk appeared on the sidewalks. We haven't seen the end yet. But I believe "Houston Strong" will live up to its message again in 2020.
 
“So few people know how much their own city’s hospitals are doing to assist with Covid-19. I think all Houstonians and regional folks should feel really good that we have a coordinated Texas Medical Center response. It is a terrible, terrible infection. And because people die out of sight even from their own families, it is hard to help everyone see what is happening.
 
“As a resident in San Francisco I saw the HIV pandemic and watched many young men die alone. Now another pandemic at the end of my career and again people are dying alone. We need to make sure we keep our humanity in the face of grief and death.”