Year In Review 2020
...to enhance the well-being of the community through education and the promotion of public health.
P U B L I C H E A LT H P R O G R A M S & E N G A G E M E N T
Delaware organization named APHA Affiliate of the Year One of APHA’s newest affiliated public health associations has earned the highest honor for an Affiliate: The Delaware Academy of Medicine-Delaware Public Health Association was recognized as Affiliate of the Year at APHA’s 2020 Annual Meeting and Expo. The Delaware organization was chosen because of its approach to addressing community health, its peer-reviewed academic journal and for partnering with other mid-Atlantic Affiliates, Moose Alperin, EdD, MPH, MCHES, chair of APHA’s Council of Affiliates, told The Nation’s Health. Alperin praised the organization’s “unique ability to create a hands-on approach to community building” as one of the reasons it was chosen for the honor. Among its work, the organization engages in the state’s health improvement plan, provides professional education for health workers and works with the state immunization coalition. Tim Gibbs, MPH, executive director of the Delaware Academy of Medicine-Delaware Public Health Association, accepted the award on behalf of the organization during APHA 2020. “This award is a signal that we have to keep doing what we are doing,” Gibbs told The Nation’s Health. “We are one organization with two parents. The expertise of our membership is extraordinarily diverse, and we all work hard to come together for the well-being of the people of our state.” The Delaware Academy of Medicine-Delaware Public Health Association was established at APHA’s 2014 Annual Meeting and Expo. Soon after, it began publishing the Delaware Journal of Public Health. Gibbs said he is particularly proud of the disaster preparedness issues of the journal, which have been used by learning institutions in the state as go-to resources. Delaware is unique among APHA Affiliates because of its position in both APHA and the state’s chapter of National Academy of Medicine. The result is a far-reaching holistic approach to improving Delaware health that marries medical practice and public health, according to organizers. With the Maryland and Pennsylvania Public Health Associations, the Delaware organization is part of the Mid-Atlantic Public Health Partnership, which supports information sharing across the three states. For more information on the Delaware Academy of Medicine-Delaware Public Health Association, visit https://delamed.org. Reprinted with permission from The Nation’s Health, American Public Health Association.
2020 review
Delaware Health Sciences Alliance The Academy/DPHA was pleased to become a member of DHSA in 2020, along with the Philadelphia College of Osteopathic Medicine (PCOM) and Bayhealth. Providing back office support, the Academy/DPHA refreshed the DHSA website (www.dhsa.org), and assisted with planning and registering people for events throughout the year. The Academy/DPHA once again assisted in the planning and implementation of the 2020 Physician Recruitment Event that, due to the COVID-19 Pandemic, existed entirely online. Healthcare institutions throughout the state indicated their position openings and the DHSA made this information available to residents in their penultimate year. The Academy/DPHA also assisted with the virtual 2020 Research Competition, a “Shark Tank” like event in which researchers competed to win $50,000 to support their research into a COVID-19 based population health problem. This October event was also accomplished in a virtual environment. Additionally, DHSA is contracted to the State of Delaware to provide assistance to the Delaware Institute for Medical Education and Research (DIMER). In May, the DHSA attended an online panel discussion geared towards high schoolers interested in applying to medical school. This event was repeated in October. The Academy/DPHA created DIMER’s 50th Anniversary Report, through the work of Academy/DPHA contractor Matt McNeill. In it, all DIMER students – past and present – are accounted for.
FROM THE ACADEMY/DPHA LEADERSHIP “Sorry, I was on mute.” Public Health is often thought of as working silently in the background, but the year 2020 was defined by words and phrases we never thought would become common conversational topics: Emergency Use Authorization, Social Determinants of Health, Pandemic. We pictured a vastly different 2020. Hopes for a year-long celebration of our 90th year of service turned into pivoting our programs online, distributing hand sanitizer, working across state lines with other MidAtlantic partners to provide a supportive environment within which public health professionals could learn (and vent), changing the purpose of two issues of the Delaware Journal of Public Health to focus on COVID-19 in Delaware, and so much more. 2020 was the year that public health and our profession was finally understood by the masses. It was the year that, as a Nation, we came to grips with the depths of racial inequities we still faced, and the disastrous health impacts they impart to so many. With tragedy, there was also a hopeful awakening: extraordinary cooperation in the formulation of multiple COVID-19 vaccines, new treatments for those afflicted with the virus, the advance of telehealth, and the long-awaited realization that broadband access is a social determinant of health, and as important to our everyday life as electricity and potable water. For us, 2020 was also a year of recognition and validation. With the indexing of the Delaware Journal of Public Health in SCOPUS and CrossRef, and in our national recognition as Affiliate of the Year of the American Public Health Association, our mission to enhance the well-being of our community through education and the promotion of public health was strengthened. We created, strengthened and maintained partnerships both within our state and across state boarders; and were a voice of unbiased information for the residents of Delaware dealing with the largest public health crisis in over 100 years. We are grateful for our partners and our strong relationships; we are fortunate in the strength of our bench. And we are excited to look forward, into a future when public health is finally unmuted. Omar A. Khan, M.D., M.H.S., FAAFP President of the Board
Timothy E. Gibbs, M.P.H. Executive Director
P U B L I C H E A LT H P R O G R A M S & ENGAGEMENT
2020 review
The Immunization Coalition of Delaware www.immunizedelaware.org The mission of the ICD is to bring together local, state, and community organizations and individuals to promote education about vaccine preventable diseases and new vaccines, with the goal of improving access and vaccination rates throughout the lifespan. The ICD works in partnership with its members and their organizations to advocate for policy issues related to childhood, adolescent, and adult immunizations; reduce disparities in adult access to immunizations; and to shape the healthcare process and outcomes for Delaware residents in relation to vaccine preventable disease. In 2020, the ICD turned its focus to educating its members about the novel coronavirus (SARS-CoV-2) first seen in Wuhan, China at the very end of 2019. In January and February, the ICD worked to push out any and all information on the virus to individuals visiting the website, and worked with the Delaware Department of Health and Social Services (DHSS) and the Division of Public Health (DPH) to inform Delawareans. In February, the ICD held its quarterly meeting in Dover, and gave a guest lecture to the University of Delaware’s Introduction to Public Health class on vaccines as a public health practice. In March, the State of Delaware instituted Stay and Home orders, and all gatherings and health fairs were canceled. The remaining three quarterly meetings were held virtually, through zoom, and had a greater turn out than any of the previous in-person meetings. The Coronavirus Pandemic, and COVID-19 were added as a standing agenda item at these meetings, and the ICD is fortunate to have members with access to the latest information. The ICD’s website is http://www.immunizedelaware.org/, and has sections for both healthcare professionals and the public, with links to immunization stories in the news, a Delaware-specific Coronavirus page, a section on the flu season, and other immunization topics. Altogether, the Week in Review was published 49 times in 2020. During the pandemic and ensuing stay-at-home orders, members of the ICD discussed the decreasing immunization rates in Delaware and the nation, how best to catch-up anyone who missed a vaccine due to clinic closures, and the state of potential coronavirus vaccine candidates. On November 9, the ICD was pleased to collaborate with the Medical Society of Delaware (MSD) and the Delaware Division of Public Health (DPH) on the annual Communicable Disease Summit. This summit was heavily influenced by the ongoing COVID-19 pandemic, and included presentations on Delaware communicable disease incidence and prevalence; Multisystem Inflammatory Syndrome in Children (MIS-C); SARS-CoV-2 immune response and vaccine development; the COVID-19 global response; and a panel on COVID-19’s affect on infection control, seasonal flu, and pediatric vs. adult illness.
P U B L I C H E A LT H P R O G R A M S & E N G A G E M E N T Delaware State Health Improvement Plan www.delawareship.org In 2020, The Academy/DPHA completed its contract with the SHIP Steering Committee. The Steering Committee transitioned to a new principle investigator (Dr. Erin Knight, University of Delaware) when the original PI (Professor Rita Landgraf ) was recalled to the State to assist with COVID-19 response efforts. The Academy’s role of general marketing, technology lead, and information gathering was completed at the end of July (and year two of the contract with the University of Delaware). The access and ownership of the SHIP website was transferred to the University.
Delaware Chronic Disease Collaborative http://dechronicdiseasecoalition.org/
D CDC
The Academy/DPHA began reaching out to partners and organizations to create and flesh out the goals and potential actions of the Delaware Chronic Disease Collaborative (DCDC). A student intern researched programs, potential partners and organizations in the State, and these individuals and entities were formally invited to attend a planning meeting to discuss the future of the DCDC. A new icon was created, and the entire DCDC website was updated. Due to the coronavirus pandemic, the planning meeting for the DCDC was not held, but will be rescheduled for a future date.
Delaware Stroke Resources https://delawarestrokeresources.org/ In 2020, the Academy/DPHA continued to assist the Stroke Support Group with both planning speakers and the content of the website (www.delawarestrokeresources.org), and the Support Group held meetings on the first Thursday of January, February, and March 2020. ChristianaCare cancelled all in-person group meetings in April, but the Support Group decided to continue holding virtual meetings, and have done so since May. DSI and the Academy/DPHA again worked together to plan the yearly John Scholz Stroke Education Conference on October 10, which included presentations on treating tobacco dependence, safe driving after stroke, a patient interview, endovascular intervention, and Physician Assistant optics. The keynote speaker discussed racial disparities in stroke affecting Black Americans.
S U P P O RT I N G TO M O R ROW ’ S PROFESSIONALS
2020 review
Student Financial Aid https://delamed.org/education/educational-series/financial-aid/ The Academy’s Student Financial Aid program was established in 1961 to help encourage Delaware students to study medicine and dentistry. To date, over 300 students have received close to $2 million in loans. While the Academy has funds to support both medical and dental students, we have only received applications from medical students for the past several years. Funds are made available through endowments established by doctors, dentists, and other benefactors. The Delaware Academy of Medicine has six separate funds specifically for the purpose of issuing student loans. The program is self-sustaining in that the loans are given based on the amount of money collected annually from the students after they graduate. Any student interested in applying for a loan can submit an application to the Academy by May 15th of each year. To be eligible, students must be Delaware residents enrolled in medicine or dentistry at an accredited graduate school. This year, the maximum loan amount was increased to $12,000 to help with the rising costs of tuition, which increased an average of 3% from the previous year. The Delaware Academy of Medicine approved $48,000 in loans for 4 Delaware students studying medicine in 2020. Of the 4 students, 2 are enrolled at Sidney Kimmel Medical College, 1 at the University of Pittsburgh, and 1 at the University of Miami. To adapt to the changing environment caused by COVID-19, the Academy accelerated plans to move the Student Financial application to an electronic platform. Students were able to upload all of the required documents in one, easy to use application, thus cutting down on the multiple mailings previously required. Once approved, students were also able to sign their legal documents electronically, using the Academy’s Docusign platform. Looking forward to 2021 and beyond, it is our goal to convert the financial apparatus of SFA program to an electronic platform as well. This platform will allow students to make updates to their contact information, make payments, and see real time loan repayment status. We also hope to see Delaware dental students apply to the program.
P U B L I C H E A LT H P R O G R A M S & E N G A G E M E N T Student Internship www.delamed.org/programs/student-internship/ The Academy/DPHA has mentored many students interested in public health. Since 2016, an internship with the Academy/DPHA allows students to research a public health topic of their choice, utilize a public health theory to inform the creation of a theoretical program to fill a need within that topic, and create a logic model to inform the implementation and evaluation of such a program. This internship is open to any student (high school, undergraduate, or graduate) interested in the field of public health. In 2020, four undergraduate students completed their projects. Brenna Halligan was an undergrad at Notre Dame University. Her project aimed to boost confidence and empower adolescent girls through physical activity and teamwork, while providing education on healthy lifestyles and mental health.
Hadja Toure was an undergraduate at the University of Delaware. Her project investigated the impact of perceived racism, specifically life experiences with racism and living in segregated areas, affected the rates of pre-term birth in Delaware.
Emilee Maull was an undergraduate at the University of Delaware. Her project aimed to increase human papillomavirus (HPV) immunization rates in the State of Delaware through education and communication to the public.
Jade Williams was an undergraduate at Delaware State University. Her project explored the different factors (including race, ethnicity, socioeconomic status, LGBTQ+ identification) that create health disparities, and examined potential causes for such disparities.
S U P P O RT I N G TO M O R ROW ’ S PROFESSIONALS
2020 review
Mentor Highlights Izza Zaidi is a field researcher at the New York City Department of Health (NYC DOH) working on the CDC Overdose Data to Action surveillance project, which aims to gather information to inform overdose prevention efforts. Izza interests are related to climate health, communicable diseases, NCDs, and social determinants of health, but is passionate about working with/for vulnerable populations especially. She previously worked at the Maine Center for Disease Control and Prevention as a Data Specialist in the Environmental Public Health Tracking Department doing projects related to radon and heat illness and as an Intern at the World Health Organization analysing country presence data. She has her MPH in Global Health from Imperial College London (’18) and a BA in Sociology from Colby College (’17). Mr. Tim Gibbs and I met through the mentoring program within the International Global Health Section of APHA. I applied to be a mentee in December of 2019 and was matched with Tim. By the time we first spoke on the phone in mid-January, I had just accepted my first full time job at the NYC DOH a huge life change and often overwhelming. The project was new to me and I found myself at times struggling to process my ideas about improving the project or how best to think about my task at hand. Every two weeks, Tim would ask me about the project and have me explain my ideas for questions based on the literature I’d read, what stage we were at in the data collection, what may be an interesting avenue to explore in terms of analysis, all while never having seen the survey himself. Having a space away from my colleagues to discuss my work gave me a fresh perspective. It was also beneficial for me to speak to someone on the other end of their career about major global health issues and solutions.
CDC Overdose Data to Action Surveillance Project Overdose Data to Action (OD2A) supports jurisdictions in collecting high quality, comprehensive, and timely data on nonfatal and fatal overdoses and in using those data to inform prevention and response efforts. OD2A focuses on understanding and tracking the complex and changing nature of the drug overdose epidemic and highlights the need for seamless integration of data into prevention strategies. CDC launched the multiyear OD2A cooperative agreement in September 2019 with 66 recipients (referred to as jurisdictions) comprising state, territorial, county, and city health departments. In partnership with CDC, jurisdictions focus on some or all of the following strategies: Surveillance Strategies Morbidity Data Mortality Data
Innovative Surveillance Strategies Prevention Strategies Prescription Drug Monitoring Programs (PDMPs) State and Local Integration Linkage to Care Provider and Health Systems Support Partnerships with Public Safety and First Responders Empowering Individuals Innovative Prevention Strategies Peer-to Peer-Learning
D E L AWA R E J O U R N A L O F P U B L I C H E A LT H 2 0 2 0 2020 has also been a year of success for the Journal. The Journal is now indexed in CrossRef and SCOPUS, and our application with PubMed is pending. This means that the articles, research, and authors of previous issues are now internationally accessible, a key step towards dissemination of information. At the end of 2019, the Journal staff laid out the framework for the upcoming issues in 2020. The original 2020 issue themes had been: health education and workforce development, current research in Delaware, racism, OneHealth, and disabilities. The timing could not have been more serendipitous for the topics that were front of mind for the journal staff, and that had been selected as journal themes. We could not have anticipated how our theme focus areas would align with some of the events that have thus far shaped 2020, including the outbreak of a global pandemic, and a changing conversation about race in America. We amended our 2020 lineup to align even more with events, and to provide our authors and guest editors a platform to continue current national conversations with a more local focus, specific to Delaware. The Journal published the following issues in 2020: Health Sciences Education/workforce, From Cells to Society: Research in the time of COVID, Parts A and B, and Libraries and Public Health, with the final two issues of 2020 being Racism and Public Health, and OneHealth. 2020 has enabled The Delaware Journal of Public Health to continue showing its adaptability and commitment to delivering a quality publication to readers, covering a range of timely public health issues. We look forward to continued success and preparing the issues for 2021!
Delaware Journal of
Public Health
2020 review
A publication of the Delaware Academy of Medicine / Delaware Public Health Association
https://djph.org The Delaware Journal of Public Health is the official journal of the Delaware Academy of Medicine/Delaware Public Health Association. We have been in continuous publication since 2015 and on a bimonthly basis, publish 5 issues a year. Notable themes over the last year have been: Volume 6 | Issue 5. Racism & Health (November) Volume 6 | Issue 3. Public Libraries & Public Health (September) Volume 6 | Issue 2B. From Cells to Society: Research in the Time of COVID-19, Part 2 (August) Volume 6 | Issue 2A. From Cells to Society: Research in the Time of COVID-19, Part 1 (July) Volume 6 | Issue 1. Health Science Education (April) We follow a model which facilitates the best of Delaware-based, regional, national and international material to be included in the Journal. Each issue is led by the core leadership (see below), with a Guest Editor who selects content most appropriate to that particular theme issue. In the last 12 months, Guest Editors have included: Neil Jasani, M.D., M.B.A. Mia A. Papas, Ph.D. and Steven Stanhope, Ph.D. Annie Norman, Ed.D. Marsha’ T. Horton, Ph.D. and Jacqueline A. Washington, Ed.D., M.S. All issues of the Journal feature a particular theme, and also other general content which has been submitted. We are proud of our partnership with Delaware’s health systems, who provided us material of general interest to the public, which we are pleased to disseminate. We leverage our national partnerships with the National Academy of Medicine and the NIH’s Fogarty International Center, and host (with permission) content from their publications. In 2019, we started our affiliation with the Trust For America’s Health and started to carry selected content from them as well. To our knowledge, we are the only journal to have this unique feature for the benefit of our readership. The Journal is led by: Editor in Chief: Omar Khan, M.D., M.H.S., FAAFP Publisher: Tim Gibbs, M.P.H.
Managing Editor: Elizabeth Healy, M.P.H. Copy Editor: Kate Smith, M.D., M.P.H.
DJPH by the Numbers: The DJPH is direct distributed to email addresses in our database representing healthcare, public health, state, philanthropy, and the general public. A link to the Journal is also posted on the following locations: 1) Our website: www.delamed.org 2) Our facebook page: www.facebook.com/delamed1 3) The State of Delaware library listserv 4) Various intranets Of our readers, 70% view the Journal on their desktop computer, 5% on their tablet, and 25% on their mobile device. Each issue has an average of 1,250 reads, and since inception, over 440 “link-outs” have occurred from within the publication to other references, resources, or agencies. All issues are provided on an open-access basis with no publication or subscription charges.
PROVIDING
April 2020 Health Education is all about the future we must create together: the future of the Delaware region’s health and wellbeing, through talented individuals and teams that serve our neighbors and communities. Editorial note: The articles in this issue were written prior to the COVID-19 pandemic. The work herein thus reflects programming prior to the global disruption caused by the pandemic.
Continued from July 2020:
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Volume 6 | Issue 1. Health Science Education 3 | In this Issue Omar A. Khan, M.D., M.H.S. and Timothy E. Gibbs, M.P.H. 4 | Guest Editors’ Welcome Neil Jasani, M.D. M.B.A, Omar A. Khan, M.D., M.H.S. 6 | From Wuhan to Delaware: Tracking the Spread of COVID-19 Katherine Smith, M.D., M.P.H. 12 | Exams May be Cancelled, but Humanity is Not: A Medical Student Perspective on the COVID-19 Pandemic Elizabeth Avakoff, M.P.H., Omneya Ayoub, M.S. 16 | America and Delaware Need Investments in Public Health Now More than Ever Timothy E. Gibbs, M.P.H. 18 | University of Delaware Center for Health Profession Studies David Barlow, Ph.D. 24 | Undergraduate and Graduate Public Health Programs Need Changes to Teach the Public Health Workforce of the Future Jennifer A. Horney, Ph.D., M.P.H., Abby Heath 28 | The Workforce Development Program at Delaware Technical Community College Mark T. Brainard, J.D. 32 | Global Health Matters Fogarty International Center 46 | Training for Tomorrow: A Century of GME at ChristianaCare Brian Levine, M.D. 52 | Advanced Practice Clinician (APC) Fellowships: A Strategic Approach to a High-Quality, Stable APC Workforce Lisa Maxwell, M.D., M.H.C.D.S. ,Jennifer Painter, D.N.P. 54 | Innovations in Residency Training in Community Hospitals Robert Monteleone, M.D. 56 | New Rankings Show Healthiest and Least Healthy Counties in Delaware County Health Rankings 58 | Nurse Residency Programs: Providing Organizational Value? Amy Sutor, M.S.N., R.N., C.C.R.N.-K., N.P.D.-B.C., Jennifer Painter, D.N.P., A.P.R.N., C.N.S., N.E.A.-B.C., N.P.D.-B.C., O.C.N.,A.O.C.N.S., L.S.S.B.B. 62 | DIMER at 50: Delaware’s Best Value for Medical Education Sherman L. Townsend, Omar A. Khan, M.D., M.H.S. 64 | The Community Benefits of Graduate Medical Education Brintha Vasagar, M.D., M.P.H. 66 | Flexibility and Adaptation: Key Elements for Preserving Research Continuity During the COVID-19 Pandemic Mindy George-Weinstein, Ph.D. 68 | CORONAVIRUS Lexicon of Terms 69 | CORONAVIRUS Resources 72 | Index of Advertisers
96 | Delaware COVID-19 Homeless Community Outreach Partnership 2020 Rita Landgraf, Susan Holloway, Renee Beaman, Ray Fitzgerald 102 | Global Health Matters Fogarty International Center 114 | Delaware COVID - Lexicon 115 | Delaware COVID - Resources 122 | Index of Advertisers
2020 review
July 2020 On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. Globally, nationally, and locally, one of the most effective prevention measures is to wear a mask.
Volume 6 | Issue 2A. From Cells To Society: Research in the Time of COVID-19, Part 1 3 | In this Issue – Omar A. Khan, M.D., M.H.S. and Timothy E. Gibbs, M.P.H. 4 | Guest Editors – Mia A. Papas, Ph.D., Steven Stanhope, Ph.D. 6 | Coronavirus through Delaware’s Computational Microscope Carolina Pérez Segura, Nidhi Katyal, Ph.D., Fabio González-Arias, Alexander J. Bryer, Juan R. Perilla, Ph.D., Jodi A. Hadden-Perilla, Ph.D. 10 | Rapid Development and Validation of a Novel Laboratory-derived Test for the Detection of SARS-CoV-2 James Saylor, Jennifer Mantle, Leila H. Choe, Alana Szkodny, Vipsa Mehta, Alaina Meadows, Cynthia Flynn, Leslie Taylor, Abraham Joseph, Brewster Kingham, Kelvin H. Lee 16 | Validation and Use of Point-of-Care Lateral Flow Chromatographic Immunoassays for Early Diagnostic Support During the COVID-19 Pandemic Richard M. Pescatore, D.O., Lisa M.G. Henry, M.H.S.A., Rebecca D. Walker, Ph.D., J.D., M.S.N., William Chasanov, D.O., M.B.A., Christopher M. Gaeta, Crystal Mintzer Webb, M.P.A., Camille Moreno-Gorrin, M.S., Paula Eggers, Frederick P. Franze, M.T. (A.S.C.P.), Sergio Huerta, M.D., Christina Pleasanton, M.S. Molly Magarik, Karyl T. Rattay, M.D., M.S., Kara Odom Walker, M.D., M.P.H., M.S.H.S., Rick Hong, M.D. 18 | The Importance of Research in Addressing the COVID-19 Pandemic: Focus on the Use of Serology Testing – Vicky L. Funanage, Ph.D. 20 | Perspectives on molecular diagnostic testing for the COVID-19 pandemic in Delaware Erin L. Crowgey, Mary M. Lee, Brett Sansbury, Eric B. Kmiec 26 | Rapid COVID-19 Prognostic Blood Test for Disease Severity Using Epigenetic Immune System Biomarkers – Adam G. Marsh, G. Mark Anderson, Erich J. Izdepski 32 | Engineering Preclinical Tools and Therapeutics to Understand and Treat COVID-19 Catherine A. Fromen, Jason P. Gleghorn 36 | Multisystem Inflammatory Syndrome in Children (MIS-C): an emerging immune mediated syndrome in children associated with COVID-19 – Deepika Thacker, M.D. 40 | Assessing the Impact of COVID-19 on Children and Youth Lee M. Pachter, D.O., Cynthia Garcia Coll, Ph.D., Norma J. Perez-Brena, Ph.D., Lisa M. Lopez, Ph.D., Linda C. Halgunseth, Ph.D., Rashmita S. Mistry, Ph.D., Gabriela Livas Stein, Ph.D., Gustavo Carlo, Ph.D.
42 | Epidemic Meets Pandemic: Treating Opioid Use Disorder in the Age of COVID-19 Kimberly D. Williams, M.P.H., Lee M. Pachter, D.O., Scott D. Siegel, Ph.D., M.H.C..D.S. 44 | Mental Health Crisis: Depression, Anxiety, and COVID-19 Bernard Shalit, Marina Gettas, Dr.P.H., M.P.H. 48 | Courage, Cancer and COVID – Carol Kerrigan Moore, M.S. 50 | Design of Clinical Trials Evaluating Ruxolitinib, a JAK1/ JAK2 Inhibitor, for Treatment of COVID-19–Associated Cytokine Storm Peter Langmuir, M.D., Swamy Yeleswaram, Ph.D., Paul Smith, Ph.D., Barbara Knorr, M.D., Peg Squier, M.D., Ph.D. 60 | The Power of Public Health Surveillance Rick Hong, M.D., Rebecca Walker, Ph.D., J.D., M.S.N., Gregory Hovan, Lisa Henry, M.H.S.A., Rick Pescatore, D.O. 64 | A Need for Contact Tracing Research – Stephanie Shell, M.S.S. 66 | Mapping the ChristianaCare response to COVID-19: Clinical insights from the Value Institute’s Geospatial Analytics Core Madeline Brooks, M.P.H., Chenesia Brown, M.A., Ph.D.(c), Wei Liu, Ph.D., Scott D. Siegel, Ph.D., M.H.C.D.S. 72 | Social Determinants of Health, From Assessment to Action: A Review of 3 Studies from the Value Institute at ChristianaCare Cecelia Harrison, M.P.H., Madeline Brooks, M.P.H., Jennifer N. Goldstein, M.D., M.Sc. 80 | Race as a Social Determinant of Health: Lessons from the Coronavirus Pandemic in Delaware Daniel G. Atkins, J.D., David P. Donohue, M.D., F.A.C.P., Robert L. Hayman, Jr., Leland Ware, J.D., Maija Woodruff 88 | Addressing COVID-19 Health Disparities Through Community Engagement Marshala Lee, M.D., M.P.H., Jacqueline Ortiz, M.Phil., Jacqueline Washington, Ed.D. 92 | Engaging Community Health Workers and Social Care Staff as Social First Responders during the COVID-19 Crisis Alicia L. Salvatore, Dr.P.H., M.P.H., Jacqueline Ortiz, M.Phil., Erin Booker, L.P.C., Nora Katurakes, M.S.N., R.N., O.C.N., Christopher C. Moore, Carla P. Aponte Johnson, M.S., Alexandra M. Mapp, M.P.H., Alex Waad, M.A., Michelle L. Axe, M.S., C.H.E.S.
PROVIDING
August 2020 On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. Globally, nationally, and locally, one of the most effective prevention measures is to wear a mask. In This Issue we welcome you back to Part B of the DJPH Current Research and COVID-19 issue. This second part further explores both COVID-19 research and that taking place in other areas including VAPING, HPV, and Hepatitis C. As always, we appreciate your readership, and the contributions of our many talented expert authors. Omar A Khan, M.D., M.H.S. Timothy E. Gibbs, M.P.H.
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Volume 6 | Issue 2B. From Cells To Society: Research in the Time of COVID-19, Part 2 4 | Guest Editors Mia A. Papas, Ph.D., Steven Stanhope, Ph.D. 6 | Reflections from Physician Scientistson the Front Lines of COVID-19 Jennifer N. Goldstein, M.D., M.Sc.; David Chen, M.D., M.P.H.; Vishal Patel, M.D., M.B.A.; Stephanie Guarino, M.D., M.S.H.P.; Navin Vij, M.D., M.S.H.P. 10 | Toolkit for Emotional Coping forHealthcare Staff (TECHS): Helping Healthcare Workers Cope with the Demands of COVID-19 Julia Price, Ph.D.; Nancy Kassam-Adams, Ph.D.; Anne E. Kazak, Ph.D., A.B.P.P. 16 | Well-being Among Healthcare Personnel During the COVID-19 Public Health Crisis Maureen Leffler, D.O., M.P.H. 20 | Humility: a virtue critical to both successful COVID-19 research and patient care Michael T. Vest, D.O. 22 | A Social Network Analysis Approach for Contact Tracing in the Hospital Setting Mina Ostovari, Ph.D.; Lee Pachter, D.O.; David Chen M.D., M.P.H. 26 | Addressing Health Disparities in Delaware by Diversifying the Next Generation of Delaware’s Physicians Kristyn Mitchell; Franklin Iheanacho; Jacqueline Washington, Ed.D.; Marshala Lee, M.D., M.P.H. 36 | The HensNest: Mass Manufacturing a General Use Face Mask Here in Delaware Catherine Fromen; Whitney Sample; Ajay Prasad; Jenni M. Buckley 40 | Utilizing Partnership Flexibility and Strengths: Key Elements for Driving 3D Printed Face-Shield Production During the COVID-19 Pandemic Tim Mueller, Ph.D.; Tariq Rahman Ph.D.; Vicky Funanage Ph.D. 42 | Innovation and Rapid Mobilization Bring New PAPR Hood to Healthcare Workers on the Frontlines ILC Dover 44 | Overcoming a pandemic: How engineering and modeling techniques are used to inform a health system from preparation to recovery from the COVID-19 pandemic Tze Chiam, Ph.D.; Mia Papas, Ph.D. 50 | Quarantine bubbles – when done right – limit coronavirus risk and help fight loneliness Melissa Hawkins, Ph.D., M.H.S. 52 | COVID-19 and the Vulnerable Sherry A. Maykrantz, Ph.D., C.H.E.S.; Erica H. Weiss, M.P.H., M.S.U.P.; Francine Baker, B.S. 54 | Short Story – Mukta Bain 55 | Teaching Public Health During a Pandemic Jody Gan, M.P.H., C.H.E.S. 56 | Epidemiology of Hepatitis C in Delaware Deborah Kahal M.D., M.P.H., F.A.A.C.P.; Gale H. Rutan, M.D., M.P.H., F.A.A.C.P. 62 | Delaware’s HPV vaccination rates rise with evidence-based intervention implementation Lisa Gruss, M.S., M.B.A.; Lori Saul, R.N., B.S.N.; Sarah Toborowski, B.A.; James Talbott, M.P.A.; Paul Hess
68 | Vaping Among Delaware Youth Rachel Ryding; David Borton, M.A.; Meijse Scales, M.P.H., C.P.S.; Dana Carr, M.P.H.; Helen Arthur, M.H.A.; Lisa M. Moore, M.P.A.; Sharon Merriman-Nai, M.C. 80 | I Signed Up for This Kayla Morrell 81 | COVID-19: An impasse between livelihood and health Karthi Jayakumar 82 | CareVio and Coronavirus: The Front Line for Delaware Medical Students Thomas Marconi 84 | Public Health Implications for the Future: Unifying a Fragmented System Sky Prestowitz, D.O. 86 | A Grief All Its Own Mary Blumenfeld 88 | Delaware COVID - Lexicon 89 | Delaware COVID - Resources 104 | Index of Advertisers
2020 review
September 2020 Public libraries are free and accessible to all and are centers of community engagement and education, making them logical choices as partners for improving population health. Library staff members routinely assist patrons with unmet health and social needs.
Volume 6 | Issue 3. Public Libraries & Public Health 3 | In this Issue Omar A. Khan, M.D., M.H.S., and Timothy E. Gibbs, M.P.H. 4 | Guest Editor Annie Norman, Ed.D. 6 | Libraries Play Key Role in Transforming and Keeping Delaware Connected The Honorable Bethany Hall-Long, Ph.D., R.N.C., F.A.A.N. 8 | A Culture of Commitment to Delaware’s Children Tracey Quillen Carney. B.A. 12 | Libraries and Pediatricians Team Up to Improve Literacy and Health for Delaware’s Children Jennifer Noonan, M.L.I.S., Stacey Garfield Fox, MD., F.A.A.P. 16 | Delaware Public Libraries in the Forefront of Health Initiatives Mary Grace Flaherty, Ph.D., M.L.S., M.S. 20 | Delaware Department of Health and Social Services Library Profile Anne Hiller Clark, M.S., L.I.S., M.S. 22 | Community Partner Support Unit Introduction Natalie Christopher 24 | Libraries as Public Health Partners in Times of Crisis Pat Young 26 | Key Strategic Partnerships Create Greater Impact and Build More Resilient Communities! Peggy Geisler 30 | Mapping Delawarean’s Basic Needs: Asset Mapping Shows Need and Opportunity for Streamlined Service Provision Leann Moore, Dabney Brice, Kelly Sherretz 36 | Unite Delaware: Seamless Connections to Address Social Determinants of Health Erin Booker, L.P.C., Katie W. Coombes 40 | Closing the Gap: Public Libraries and Public Health Noah Lenstra, Ph.D., M.L.I.S., Mary Grace Flaherty, Ph.D., M.L.S., M.S. 46 | Developing a Model Policy for Public Libraries to Address Homelessness & Mental Illness Mariekie Barone, Stacie Fifelski, Alexandra Stocker, Thomas Worm, Ashley Patterson, Jessica Braamse, Robert S. Lathers, M.S.W., L.M.S.W. 54 | Partnerships for Health: NNLM MAR and Delaware Partners Make a Lasting Impact Kate Flewelling, M.L.I.S., Erin Seger, M.P.H., Tess Wilson, M.F.A., M.L.I.S. 58 | How Data from the Institute of Museum and Library Services Describe Ways Public Libraries Provide Health and Wellness Information Services Lisa M. Frehill, Ph.D., M.A., B.S. 68 | Global Health Matters Fogarty International Center 80 | Library - Resources 87 | Index of Advertisers
PROVIDING
November 2020 Health indicators have improved for most Americans; however, Black/ African Americans and other minorities are not having that same experience. Couple that with systemic racism manifested in quality of care and you have a reality that’s hard to miss. Black/African American Health needs to matter. If Black/ African Americans are not well, then the health of all Americans is compromised.
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Volume 6 | Issue 5. Racism & Health 4 | In this Issue Omar A. Khan, M.D., M.H.S., and Timothy E. Gibbs, M.P.H. 5 | Press Release Timothy E. Gibbs, M.P.H. 6 | Guest Editor Marsha’ T. Horton, Ph.D. 8 | Guest Editor Jacqueline A. Washington, Ed.D., M.S. 10 | A prevailing problem of pretrial sentencing of DUI offenders: Impact on health & rehabilitation Hon. Nicole Alston-Jackson, M.Ed., B.A. 12 | Repeated, Ongoing, and Systemic Incidents of Racism and their Harmful Mental Health Effects: Addressing Trauma in the Lives of African Americans Kimeu W. Boynton, J.D. 16 | Red, White, and Bruised How systemic racism emotionally and physicallybruises Black people in America. Andre Lamar 18 | Structural racism as a fundamental cause of health inequities in Delaware and beyond: What does the evidence say? Cassandra Codes-Johnson, M.P.A. 28 | Addressing the Trauma of Racism from a Mental Health Perspective within the African American Community Angela M. Grayson, Ph.D., L.P.C., B.C.-D.M.T., N.C.C. 32 | To Be Seen and Heard: The BIPOC Experience in STEM Cecelia Harrison, M.P.H., Alexandra Mapp, M.P.H., Dominique Medaglio, Pharm.D., M.S. 34 | We Must Act Now: Building Trust and Increasing Minority Participation in COVID-19 Clinical Trials Marshala Lee, M.D., M.P.H. 36 | I t Don’t Take Much to Piss Off a Cop: A Commentary on Systemic Racism in Policing Warren A. Rhodes, Ph.D. 40 | Connie’s Story: A View Inside Constance Malone 42 | “Enough Is Enough.” An Historical Perspective: Long Lasting Health Disparities in the African American Population in the Midst of the COVIID-19and the George Floyd Incident Marlene Saunders, D.S.W., M.S.W., L.M.S.W. 62 | T h e Impact of Racism and the Influence of Faith on the Mental Health of African Americans W. James Thomas, II, B.S., M.Div., D.Min. 66 | Racism as a Stressor Impacting the Health of African Americans Zollie Stevenson, Jr. 74 | Towards a More Healthy America: Reallocation of Health Care Resources in an Inequitable Health Care System Carole Guy, M.D., F.C.C.P. 77 | From the history and archives collection 78 | Advancing Racial Equity: Leading, Learning and Unlearning Tia Taylor Williams, M.P.H., C.N.S. 80 | The Traumatic Impact of Structural Racism on African Americans Gwendolyn Scott-Jones, Psy.D., M.S.W., C.A.A.D.C. 84 | Black Health Matters in the United States Timeline Dr. Lori Crawford, M.F.A. 86 | Global Health Matters Fogarty International Center 100 | Racism and Public Health - RESOURCES 102 | Racism and Public Health - LEXICON 103 | Index of Advertisers
A RC H I V E S
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2020 review
Delaware Academy of Medicine Archives 2020 Report Sharon Folkenroth Hess, M.A., collections manager https://delamed.org/programs/archives-and-history/ The COVID-19 Pandemic effectively shut down the archives and history project for a good part of 2020. However, there was significant background activity. Our intern from the University of Delaware worked on two primary projects: 1) researching, cleaning, and cataloging objects from our physical collection and adding records to our collections management database; and 2) preparing an exhibition for the Ammon Center lobby. During her internship, Abby Manganiello received training in best practices in care and handling, collections management procedures, and PastPerfect 5.0. Her exhibition on forensics was installed in September 2019. As of October 2020, the archives processed and displayed the following collections: mortars and pestles; optometry; post-mortem instruments; homeopathic medicines; bloodletting instruments; microscopes; new acquisitions, and the Dan Preston art collection. Work on the dentistry collection began in early 2020 but was put on hold during the Covid-19 shutdown. The Archives has switched focus to technology following the decision in Summer 2020 to remove the portraits of past presidents from the wall in the Ammon Center. In mid-2021, there will be a new touchscreen kiosk in the Ammon Center lobby. This kiosk will provide interactive information display, providing a history of Delaware Academy of Medicine, and the Presidents with biographies. This same kiosk will also be used to augment the physical exhibitions in the lobby with supplemental displays. The Archives currently serves as a repository with public engagement and access limited to Ammon Center visitors. To better serve the Academy’s mission to enhance the well-being of our community through education and the promotion of public health, the Archives intends to create an online collections portal and a virtual museum. This website will provide worldwide access to our holdings and feature scholarly exhibitions on topical healthcare matters. Additionally, the online portal will also be used to provide information about artifacts on display in Suite L-10.
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Mid-Atlantic Public Health Partnership Founding Member Institutions: We formed the Mid-Atlantic Regional Public Health Partnership in late 2019 after the APHA Annual Conference and Expo held in Philadelphia, Pennsylvania. We recognize that public health challenges do not observe state lines and coming together can do more to move the needle on common public health opportunities and threats as a coalition rather than tackle this individually. The Delaware and Pennsylvania affiliates were already working together on several initiatives and adding on Maryland, an APHA Region 3 partner, helped to further strengthen our regional focus. We hope other APHA region 3 affiliates consider joining us in the future. When the COVID-19 pandemic started, we quickly pivoted to collaborating on hosting a regional “Public Health Hangout,” a public health forum that brought public health professionals together to share practices, ideas, and solutions on the COVID-19 crisis. With zoom conference technology, these hangouts gained popularity among participants to support each other and harness the collective public health expertise in the three states on one of the most significant public health challenges in history. The inaugural regional conference was titled “Empowering Communities to Address the Social Determinants of Health.” The day and a half educational activity was “COVID-19 informed,” which is to say that each track and section of the conference addressed a given public health challenge, but all tracks referenced the impact of COVID-19 on that topic area.
C O N F E R E N C E S A N D E D U C AT I O N A L A C T I V I T I E S For Professionals: Communicable Disease Summit with the Delaware Division of Public Health John Scholz Stroke Education Conference with the Delaware Stroke Initiative Inaugural Mid-Atlantic Public Health Partnership Conference with the Maryland and Pennsylvania Public Health Associations COVID-19 and Transportation Virtual Summit with Delaware Chapter of the American Planning Association PrEP Summit with the Delaware HIV Consortium Frank M. and Robert R. Hoopes Medical/Dental Lecture with the Delaware State Dental Society
For Consumers: Osher Life Long Learning Institute Series Mini Medical School Series with ChristianaCare Summer Health Career Collaborative with ChristianaCare
WO R K F O RC E
I N I T I AT I V E
2020 review
Delaware Health Care Workforce Initiative Even before the COVID-19 pandemic, healthcare and public health policy makers understood two things: • Population demographic changes, such as an aging population, translate into needing a different health care workforce composition for the future, and • Existing reports highlighted only retrospective deficiencies in health care workforce, including primary care, geriatric medicine, mental health, and pediatrics. Since the COVID-19 pandemic was declared, tectonic changes and stressors have occurred in our public health and healthcare infrastructure. These changes and stressors are both complex and rapidly evolving. They are understudied and unmanaged and lack current data to support policy and decision-making. They may ultimately result in poor outcomes; expensive investments that miss their intended goals; and poor health outcomes and associated burdens to individuals, communities, and fiscal considerations. The Delaware Academy of Medicine / Delaware Public Health Association (Academy/DPHA) and the Delaware Health Sciences Alliance (DHSA) partnered to investigate the numbers and types of physicians in Delaware who attended either of the DIMER partner schools: Sidney Kimmel Medical College at Thomas Jefferson University or the Philadelphia College of Osteopathic Medicine. This work was later expanded to include all types of health care providers regardless of their terminal degree, or where they attended school. The original body of work was conducted for Delaware Institute of Medical Education and Research (DIMER), a program of the Delaware Health Care Commission. After assessing these findings, the Academy/DPHA and DHSA made the strategic decision to continue to support the continuation and expansion of this investigation. As a Social Determinant of Health (SDoH), health care and the access to it are modifiable components, given appropriate resources and solid data for decision-making. In addition, changes in population demographics, scope of practice, telehealth, and the recent COVID-19 pandemic have accelerated the need to take a fresh and ongoing look at the nature of health care delivery in Delaware. Leveraging technology and institutional relationships, we are creating a dynamic up-to-date database to look at our health care workforce in detail against a range of demographic data sources using state of the art data visualization tools. We anticipate this work to be a critical, ongoing source of information on which to base sound policy decisions.
image credit: https://www.kff.org/coronavirus-covid-19/issue-brief/implications-of-covid-19-for-social-determinants-of-health/
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ACADEMY BOARD OF DIRECTORS
Officers Omar A. Khan, M.D., M.H.S., President S. John Swanson, M.D., Vice President Lynn Jones, F.A.C.H.E., Acting Secretary David M. Bercaw, M.D., Treasurer Daniel J. Meara, M.D., D.M.D., Immediate Past President Timothy E. Gibbs, M.P.H., Executive Director, Ex-officio
Directors Stephen C. Eppes, M.D., At-Large Member Eric T. Johnson, M.D., At-Large Member Joseph F. Kestner, Jr., M.D., Bylaws Committee Professor Rita Landgraf, At-Large Member Brian W. Little, M.D., Ph.D., Chair, History and Archives Committee Arun V. Malthora, M.D., At-Large Member John P. Piper, M.D., At-Large Member
C O U N C I L S
EMERITUS MEMBERS OF THE BOARD Robert B. Flinn, M.D. Barry S. Kayne, D.D.S. INVESTMENT ADVISORY COUNCIL 2019 Scott Gates Richard L. Laird, Jr., M.C., B.A. Martin G. Mand, M.B.A. H. Rodney Scott ASSET MANAGEMENT Brown Advisory DPHA ADVISORY COUNCIL Louis E. Bartoshesky, M.D., M.P.H. Gerard Gallucci, M.D., M.S.H. Richard E. Killingsworth, M.P.H. Erin K. Knight, Ph.D., M.P.H. Melissa K. Melby, Ph.D. Mia A. Papas, Ph.D. Karyl T. Rattay, M.D., M.S. William J. Swiatek, M.A., A.I.C.P.
Suite L10 4765 Ogletown Stanton Road Newark, DE 19713 302-733-3900 www.delamed.org www.delawarepha.org