Town Hall: COVID-19 research and education impacts

B. Joseph Guglielmo, PharmD

Welcome everybody to this School of Pharmacy Town Hall. The intent of this meeting is going to be entirely focused upon COVID-19.

And it's going to be very specific to the School of Pharmacy. I will add a few more general things at the beginning here as you'll see, but by and large is going to be really trying to bring you up to date on where things are going.

As you will see, as I go through various sections in this presentation, I will pause and I will ask for help from others who know more about the various subcategories we're going to talk about.

So Stephen, if we can move to the first slide. So the first thing I want you to be aware of is we have a School of Pharmacy COVID-19 updates microsite.

This was developed—literally wrapped up about two hours ago—by Susie Levings and her team. What you can find on this site will be essentially any messages that have originated from the dean, vice dean and frankly, other associate deans, specific to this area.

And if you go to the next slide, please. You will see as an example, you see a number of executive orders and our decision about the commencement ceremony this year as well as a number of other policies that have come from leadership within the School of Pharmacy.

So I want to compliment Susie and her team, and this is a valuable resource. And you'll note that it not only has School-of-Pharmacy-specific feedback here as well, but it also highlights the UCSF novel coronavirus website as well.

So thank you, Susie. Next slide, please, Steven. So I thought it would spend just a little time letting you know what I know about what is at least different today or this was late last night with UCSF.

At the present time in the health system anyway, there are six hospitalized patients, two of them are in ICUs.

Every one of these six hospitalized patients are felt to have originated from the community, so they're community-acquired coronavirus infections.

The second thing you'll see—just some of you know this but many of you may not—it's almost amazing, that UCSF Health was able to do this but they have literally created a 15 Long coronavirus floor.

This opened this past week and they have patients housed up there right now.

And remarkably, because it is the 15th floor, they even created an airflow such that at least at that moment in time it would have complied with the airborne precautions that originally were thought to be associated with this virus.

The third bullet here is that there has been a relatively recent change. Initially, it was felt that this virus was primarily airborne. Now the CDC and the state and now UCSF have changed the precautions from airborne to droplet.

This is important, because, for lots of reasons, number one, the person helping protective devices, one has to wear are much more expensive if in fact we're calling this airborne, as opposed to droplet.

And so this has been enacted, I think it's four days now they've made this change. Now, as I say this, I think today's New England Journal of Medicine had a letter to the editor saying, "Oh, no, we think that it might be airborne as well," but we're going to stick with the CDC at this point.

And that really is a change from this time last week. All you have to do is listen to the TV or radio. But you'll know the testing issue continues to be quite challenging.

Still, it's been quite restricted at UCSF, more now than before. But really, it's something we need to complement the campus coming to the plate here.

CZI, the Chan Zuckerberg [Initiative], has been working on a different test that according to the Chancellor, as of a discussion with his leadership group, Sunday or Monday, I'm forgetting which day it was.

He estimated this one available could increase tests to 1,600 a day. And the thinking is that this will be likely this week. So that's really a little bit in terms of what is going on at UCSF.

If we could move to the next slide, I just want to make sure you're all aware. Tomorrow, March 19, the Department of Medicine has Grand Rounds.

It will be obviously Zoom-only, it's entitled "COVID-19: Understanding the Science, Epidemiology, and Clinical Manifestations." They will have various speakers.

One on the epidemiology and biology, I think it's Diane Havlir. Clinical manifestations will be reviewed by Jen Babik.

Michael Matthay will be reviewing acute respiratory distress syndrome pathogenesis. And I believe Annie Luetkemeyer from Zuckerberg San Francisco General will be talking about current and potential therapy.

So if you are interested, I welcome you to Zoom in to the Department of Medicine site. I think it's being—I think Bob Walker is going to serve as the emcee of that particular conference.

Next slide. I thought I would offer I call it a little bit of optimism. And for those of you might have seen this, as you know where things have really gone sour is Italy.

But there's been a little bit of optimism here that basically also strongly suggests that what was decided by London Breed, Mayor of San Francisco, and that almost all the other Bay Area counties have agreed to, was a shelter in place way of thinking for this virus. And while this is an imperfect analysis, you can see here are two regions in Italy, one Lodi and the other one is Bergamo. And what you can see is if you look at the number of cases on the Y Axis, you will see where an intervention took place, which was in Lodi. There seems to be not a big upsurge. You'll see same date March 1, as will seen in Bergamo and what the intervention was, Lodi decided to do essentially do the shelter in place mechanism, which is exactly what San Francisco and the other counties have taken as well. In contrast, Bergamo did not take on this intervention. And so at least gives us a bit of optimism that maybe the, what some feel are draconian, but I think most of us understand is probably the right thing to do, that in fact it may result in hopefully flattening the curve that we've all been hearing about relative to this virus. Next slide, please. So I'm going to go through what I think are the updates at the present time where we set on a few issues and the first thing I want to talk about is telecommuting. When I end up summarizing what I received from Michael Nordberg, I will pause at that point and Michael will chime in on anything else he wants to add to the telecommuting issue, and others are welcome at that time, as was mentioned by Alexa to, to bring in questions as need be, via. the Q&A mode there at the bottom of your screen. So as of Monday's meeting with school leadership, management leadership. OEIS has been using Slack, has created a telecommuting contract and ensured that all staff have VPN and Duo capability. OSCA was fully remote as of literally today and all have telecommuting contracts in place. Most in OSCA are using Zoom, but they are evaluating the possibility of using Slack. Planning and Communication has been using daily Zoom meetings, but it's also using Asana and Slack, depending on what they're trying to accomplish. The both Central and Laurel Heights Dean's Office has been entirely remote and we're planning to give Slack and try now, not at this point, and in the process of finalizing telecommuting contracts. Next slide, please. departmentally from Bill Neely The only thing we have, at this point I know they're short, they were short of some laptops. He has figured out a mechanism by which they would go and get those and ensure that they are appropriately encrypted. And that is moving forward. Clinical Pharmacy has had daily checking on Slack. Everyone has been given telecommuting agreements. For Pharm Chem staff did not have laptops were given loners. Those staff that were comfortable with the practice have forwarded their phones to cell phones. Pharm Chem administration has been doing twice-a-week check-in via Zoom. And QBI. The administration has been working remotely since last week, using daily Zoom and Slack as necessary and then they're organized, separate weekly administration Zoom meetings, with that unit. I think I'm gonna, well, yeah, the last thing I'll say, now you can go back there Steven on the next slide, that'd be fine. One more slide, please. So most of you know, we do have a UCUP guidance document that we just received yesterday, entitled "COVID-19-Related Leave for Academic Appointees and Guidance for Supervisors." We are in the process of digesting this. And I think at this point, I'm going to pause and I'm asked first Michael Nordberg, if you could, to chime in and I think they will be able to unmute you. So you can add anything that I said here and then Alexa, I will ask you if there are questions that have come in on these specific issues, to in fact, move those forward and let us know what those are. So Michael, you first please.

Michael Nordberg

Yeah, so everything so far seems to be going fairly well with telecommuting. There have been a few issues with VPN, even though the campus did increase the capacity for that and Zoom prior to us all going to working remotely. So they added another instance of the VPN. Today at least it seems to be fairly stable, although I have heard some people have a few issues. But one thing is if people are doing things that don't actually require VPN, which if you look on the MyAccess site, anything that requires a VPN has a little VPN next to it, it's better to not be using VPN to leave some of the capacity for other folks who actually need it for file access, or those applications that actually require VPN usage.

B. Joseph Guglielmo, PharmD

Okay, it looks like See chat function there Alexa versus Q&A. I will defer to you to bring forward questions, please.

Alexa Tan

Great. Okay. So it looks like I'm going to be taking I'll be looking at these questions as they come in. So we have one where someone was asking, "Will UCSF try to test all of its employees? This question relates to the second and third waves of the outbreak. It would be good to know who has and has not developed immunity based on who was or is infected."

B. Joseph Guglielmo, PharmD

So I'll try to answer that I there is enormous enthusiasm for that approach. At this moment in time, it is impossible. But we, I think the campus, the Chancellor and all the cabinet are in full agreement that more testing is better and we are still operating in a void. We are certain there are many more cases than in fact, have come up as positive. So yes, we agree in spirit. As I said, the only reason we're going to be able to do an upgrade on the number of tests actually really relates to the contributions of the campus to the medical center mostly through the Chan Zuckerberg Institute.

Alexa Tan

Okay, great. We have another related question here. Is is this kind of a part two here? "Is it known what the lifetime of the virus is on surfaces?" This relates to what we need to do if anything to our work surfaces before folks come back to campus.

B. Joseph Guglielmo, PharmD

This is a moving target at the present time. What we do know are some generalities about the virus, that it likes hard surfaces, less porous surfaces as opposed to more porous surfaces. But at the present time, what I would say since this is still a virus that we are yet to really identify everything we know including how contagious it really is. At the present time, I think you have to take precautions that any place you go that the virus is there, take the usual precautions, assume it's there for the present time until we really have more data to know that we really are centered in our knowledge in terms of how contagious it is. We do, if I can say the following, it with very imperfect data, and mostly from the China experience, if you were to you look at the influenza virus there, and some of you have heard me say this, that there is a figure and it's a 1.2 is the number they use. And what that means is, for every person infected with influenza, you can expect 1.2 individuals more to be infected by influenza. For this Corona virus, it ranges it could be as hi gh as four, 4.0. But I think as we get more data, it's going to be closer to two. We'll see but still two is, you know, approximately twice as contagious as one so it is clearly more contagious than it influenza.

Alexa Tan

Great, thank you. We have another question coming in. "So do you have any information on who will be manning the U.S.N. Mercy and how trained those professionals are? Are they Navy healthcare? Do you think San Francisco will be able to coordinate appropriately given their current filter at place? And the testing you said is going on?"

B. Joseph Guglielmo, PharmD

You don't have an answer to that. My answers will ideally be mostly via the School of Pharmacy. I think this is as you know, this was what was just mentioned, was just announced literally today, so I don't really know how that's going to march out.

Alexa Tan

Okay, we have a question here. "For lab researchers doing bench work, there's no to work remotely is the relief that Napolitano offered applicable to these folks?"

B. Joseph Guglielmo, PharmD

So the relief the fiscal relief is what I assume we're referring to. We are evaluating In that right now, I think what you can assume is that is the plan. Yes, there is. From the campus, the idea was that there is going to be a pot of money that is going to be made available, that in fact, we will try to rectify the fiscal shortfall. So they're going to take place that is the plan, but it has yet to be worked out in detail. So and, Michael, I would ask you, if you do have additional information, you'd like to say, I don't think we have a specificity but that is the intent at this time.

Michael Nordberg

So no. I don't have any additional information at this time. But there are, everybody's looking at that right now as to how we would handle this.

B. Joseph Guglielmo, PharmD

I mean, so I mean, it's, we certainly have to look at that there. They are suffering just like everybody else is on campus who are you know, not able to work, essentially.

Alexa Tan

Okay. Would you like to receive a couple more questions? Or should we move on?

B. Joseph Guglielmo, PharmD

What I would recommend... let's see, we are. I think we can take two more and then we'll move on to the next topic. And what we'll do is Alexa are suggesting you are going to collate those and then they're going to be disseminated to me and I will, especially if I know who actually sent them, we're gonna try our best to answer them individually over the next several days.

Alexa Tan

Correct. Okay, so we'll take two more. Let's see, we have one here. "How can California licensed pharmacy faculty sign up to help? I presume there will be a call from Department of Pharmaceutical Services but wanted to double check."

B. Joseph Guglielmo, PharmD

So I'm going to touch on this the tail end of my talk. The short answer is we don't know at the moment, but there is no doubt we have to answer that question a very proactive way what how exactly is everybody in the school going to improve, dealing with this pandemic as opposed to making it worse. And that means everything: Where can we volunteer in atypical ways as well as typical ways, and I will touch on that a little bit later. So thank you for that question.

Alexa Tan

Okay, and we'll take one last question here for now, from the student perspective, how will this affect IPPEs and APPEs?

B. Joseph Guglielmo, PharmD

We're going to touch on that. I have a section on IPPEs and APPEs moving forward.

Alexa Tan

Okay, great. And if you want to move forward, we can

B. Joseph Guglielmo, PharmD

I think I will. So the next slide, Steven.

So, research, where are we in this regard? And I'm going to ask Andrej Sali, to be prepared to add to what I'm going to say here, and frankly, in the department chairs of math and Matt Jacobson and tasia all and then we saw with the drug research in itself. In a weaker overseas, you're welcome to comment here as well. And then we'll take questions again specific research. But here's what where we are at the moment, as per Lindsey Criswell, both verbally and in writing, and Hal Collard, clinical trials at the moment are only continuing if they are considered critical, life-saving, truly improving the health of patients, otherwise, these are on hold. In terms of wet laboratories, you all have received the memo from the Chancellor that was primarily with co-signatories, David Morgan, who's the Vice Dean for Research for the School of Medicine. Tejal was on that and a number of others, but all those are mandated to shut down. I think it's midnight tonight, as I recall. However, there were some exceptions. One was those labs that are actively working on the COVID-19 virus. And then they also recognize there are a number of long term experiments that require intermittent checking. So, in fact, those who will be allowed to continue on the call that I was on, on this particular issue, the Police Chief Mike Denson was specifically asked, how exactly are you going to handle this? Are you going to have like names of people? Are you going to screen people? And he said, "No, I am not. We're going to just hope that as much as possible, if the campus will voluntarily comply with this, we will assume that those people that know they should be there, you know, they're working with COVID-19, and/or they have long term experiments and absolutely require them to come in otherwise experiment, you know, and some failing going down the tubes because of lack of checking." That is what the police department is going to be doing. So I will pause and I guess I'll first ask for Andrej, for his comments, I think the second person I'd like to hear from if she's on the call is Tejal Desai, because she was a co signatory on the wet lab edict. So, Andrej, could you please fill in or add what you'd like on the research piece?

[Andrej Sali]

On? I think this was a pretty comprehensive summary. I would only add that as you know, we were all asked, all the heads of labs, were asked to identify a couple of key lab personnel. It's possible that only those personnel will be able to access the building, either through manipulating the ID cards, access or maybe just on an honors-based system. I'm actually not sure. And the other thing I'd like to mention very briefly, as an inspiration, perhaps for neighborhoods of research labs, physical neighborhoods, we've had a little bit of a scare on the fifth floor of Beyers Hall over the weekend, because there was one person who might have had Corona virus. And this person was tested and was not. The test came back negative. And in fact, they disinfected the whole floor as well. Sam was involved. The reaction was amazingly rapid. The whole floor was disinfected on Sunday. And the lesson of that is that it may be a very good idea for neighborhoods to stay in touch with each other and inform each other if any group member becomes symptomatic. In our neighborhood we decided 100 degrees Fahrenheit, or higher temperature, for at least two days would trigger an exchange of that information among the neighborhood heads so that we could then act appropriately on that basis. That's all I would point out.

B. Joseph Guglielmo, PharmD

Okay. Thank you, Andrej, Tejal, are you on the call?

[Tejal Desai]

I am. Can you hear me?

B. Joseph Guglielmo, PharmD

Yes, we can.

[Tejal Desai]

Great. Yeah. So I think you did a great job of summarizing it. The other is the thing I would tell all of the faculty or pis that have laboratories is to please fill out the survey, that was the link that was sent in the email communication because we are literally going through lab by lab to look at exceptions. And if you are not, you know either yes or no saying who your essential employees are. We will not be granting permission. So please fill that out. We are trying to work with every lab, making sure that you know these critical longterm experiments are able to continue. But on the other hand, if you are simply doing, you know, things that are, you know, trying to meet a grant deadline or trying to revise a paper, we understand that but that's not considered critical. So that's something that we're all dealing with. So we're gonna go through, so far we've gone through almost 700 labs, so this is quite an undertaking, but we are looking at this quite seriously.

B. Joseph Guglielmo, PharmD

Thank you Tejal. Matt Jacobson if you're on the call. Do you have any comments?

[Matt Jacobson]

I don't have too much to add. I mean, obviously, we have some special issues having to do with keeping the NMR magnets cold and what not, you know, during this period and you know, it's the campus has been very responsive about And so I think everything will work out fine, but you know, there's there's a lot of scrambling, obviously.

B. Joseph Guglielmo, PharmD

Thank you, Matt. And then lastly, Lisa Kroon, did you want to add to the comments on the research piece?

[Lisa Kroon]

Sure. Are you able to hear me?

B. Joseph Guglielmo, PharmD

Yes.

[Lisa Kroon]

Great. So our main research unit is our drug research unit that Fran Aweeka directs and as a 4pm on Monday, they had gone through all their checklist to see how to shut it down and it was shut down. So they everybody is working remotely.

B. Joseph Guglielmo, PharmD

Thank you, Lisa. So I think at this point, Alexa, now we will take questions questions, again from the QA and we'll get as many as we can here and then move on.

Alexa Tan

Okay. Here we are. We have a question in terms of related to lab question. "How and when will labs know when COVID personality skeleton crews will be approved or not?"

B. Joseph Guglielmo, PharmD

I do not have the answer to that. Maybe

[Tejal Desai]

I can I take that? Yeah. So Dave Morgan should be sending out an email. So he sent an email to sort of the first group of labs that responded to the survey. He will be sort of sending out another batch, probably either tomorrow or the next day and then sort of continuing with that, usually with a one to two day lag time.

B. Joseph Guglielmo, PharmD

Thank you. Another question, Alexa.

Alexa Tan

Yep. So we have another question here. "Do you think that faculty and students will be able to return to campus before the end of the school year?"

B. Joseph Guglielmo, PharmD

That that is more than just a research-specific question, and nobody has an answer to that question. It is at this time, we really don't know where this pandemic is going to go. You make some of you I'm getting off on a tangent from research. You know that some people are estimating that the US, you know, there's a British study, you may be aware of that suggested that, that we would experience on the order of 2 million deaths in the United States. This came from a British study. I just listened to George Rutherford, he should Global Health Sciences, and an epidemiologist and he believes that this is far, far overestimated, he believes it's not going to be as bad he believes the rate of infection is not going to be as bad. So, but the real answer is, we don't know.

Alexa Tan

Okay, looks like based on the questions that we hit most of our research-related questions unless you wanted to move on. We could always circle back to the other more general questions after.

B. Joseph Guglielmo, PharmD

I would recommend that we save those for later if we we'll just take them out. I want to make sure that I get through each of these areas. So perfect. Stephen, next slide, please. So now we want to move into what's the status of Experiential Education? Yeah, I will talk about all the didactic, you know, and the using remote learning and a little bit later here. But the Zooming and all the things we've done to remote learning has gone relatively well. It has been complicated for everybody, but at the end of the day has gone far better than we ever expected. What is much more complicated is what's going on on the experiential side. So I'm going to first give you a little background on where UCSF is on this, where the University of California system wide is, and then a little bit on what has happened since then. So what has happened I have had many, many meetings with my colleagues, Talmadge King, Catherine Gilliss, Mike Reddy, Liz Watkins on how to handle Experiential Education. What we have agreed to in principle are the following. Number one, participation of advanced health profession students is essential to the healthcare response to the COVID-19 pandemic. Number two, and these are also related to calls with representatives from UCSF Health, Zuckerberg San Francisco General, and the San Francisco Veterans Administration. All of us are committed to work together toward a solution to maximize essentially, the use of students in this pandemic. Third bullet: all health professionals will actively manage pandemics in the future and other emergency and crisis situations and therefore we believe this is educationally important as well for our respective students to be active with this. Lastly, health profession students are valuable contributors in an emerging crisis, particularly when the existing licensed health professional workforce needs additional support to manage large numbers of patients. Now, this is pretty much what the consensus is of the Deans. The Chancellor, while he agrees and concept has yet to put something out, or hoping to see something in the very near future, he's verbally agreed with this. Nonetheless, as you will hear, despite the consensus of these Deans, things are happening independent and irrespective of the of the sentiment. So, this is UCSF, but if we could go to the next slide, what about system wide, Stephen? So system wide, we had a meeting Sunday the 15th. And in this meeting, we had the Deans of the five medical schools that two pharmacy schools the two dental schools, public health school, optometry, the four nursing schools. And here were the conclusions of that group. And you'll see a couple slides work on this. So first of all, just as has been the case in our School of Pharmacy, essentially, everybody stated that all didactic instruction has moved or was in the process of moving as of that Sunday to an online or at least remote access format.

We recommend it at that time, although this one I will say was debated quite a bit. I actually personally recommended a pause, others disagree. But the recommendation ultimately was that the way that not there not be a formal pause and instruction for clinical clerkships. However, we said students will not be assigned to care for COVID-19 patients. Third point, all schools are working to provide ongoing instruction regarding COVID-19 and training related to the spread and use of PPE and PPE is the profession, the protection, protective equipment for infection control purposes so you don't get the virus. Last bullet on this slide. UC affiliate sites will continue to be assigned students provided the students are not expected to care for COVID-19 patients or those under investigation. So next slide, the last few points from the health profession Dean group, and I italicized this bullet, for any affiliate that determines that students are quote unquote "non-essential personnel" and or who express concerns about the adequacy of their PPE supplies, and cannot assure that there is sufficient PPE for students, there will be a suspension in the use of that site. Last two bullets and I'm going to go back to the italicized one in a little bit, because it will tell you why we have made some changes. On the next board is all students are working to assess student roles and assignments within local context. That's UC and non-UC sites for training, local California Department Public Health, among others. And lastly, school students in all our schools, including this one, have communicated their willingness and commitment to serve in the capacity of their schools and Deans deem appropriate now don't change the slide yet. With that in mind, it also turns out that we were essentially following what the, the double AMC (AAMC) had recommended as well up to that time and, and so we felt quite comfortable as health profession deems that we had a consistent view with (AAMC). And so we felt strong moving this forward. Now, moving to the next slide, hold that thought especially that italicized point that I mentioned. So a few things have changed. So after that, that discussion with all the health profession Deans in the University of California system, that we had a meeting with Associate Dean Valerie Clinard and Vice Dean Sharon Youmans, because we needed to make an assessment of what to do with IPPEs, the Introductory Pharmacy Practice Experiences. So why did we have to deal with this? We felt we needed to deal with for two reasons. One was kind of an obvious one, but another one was, you know, one made the argument in the medical the (AAMC), they were restricting their early learners from direct patient care experiences. But they weren't saying that they couldn't have other introductory like medical, experiential opportunities. So they pulled those learners (AAMC) from direct patient care. But frankly, since our community pharmacy IPPEs, that is less the case you're obviously interacting with people, but the reason we ultimately suspended them effective this week was the following that is, as the NDP was on the line, the only reason they would have come to campus since all the rest of their coursework was remote access, the only reason to come would have been for IPPEs. We felt this did not make sense and may in fact, increase the likelihood that they or others, in fact, could augment the pandemic. So we made the decision and that came out via an email from Dr. Clinard, which is on our UCSF microsite that I mentioned is now up in the School of Pharmacy website. And what we're going to do I'll just repeat what she had in this email. I'm not really providing you anything new here. The school evaluate the same situation the week of April 13, which is the last week of the renal theme for a possible restart an IPPE sites that would start April 20. So we have effectively paused actually, if you think about it on IPPEs, we are definitely have not made a decision as you can see what we're going to do at this point. And lastly, information about any required makeup to the P1 experience will be communicated after our decisions are finalized the week of April 13, 2020. Next slide please.

We also had to make some decisions with APPEs. Despite the fact, in the first bullet and this again, I'm simply taking Dr. Clinard's email that went to both preceptors and students, she reiterated what I'm, I'm telling all of you, we still are under the umbrella of UCOP, you know, the Health Science Deams, as well as UCSF Deans and the Chancellor who will ultimately be coming out with this, that all the health profession Deans support the fact that all of our students are vital members of the healthcare team. However, it gets back to that italicized bullet that I showed you a slide or two before some of our valued sites are unable to have to continue having students on site. And some of those reasons is they don't know if they're prepared to be able to take them on. They don't know if they can guarantee the personal protection needs for infection control purposes. They believe they can appropriately precept because of the chaos taking place. And we understand and respect this difficult decision. And we said exactly those words to those sites. As a result of that, we then decided okay, where is the class of 2020 in terms of total hours and appropriate, you know, filling the requirements from our accrediting agencies. It turns out that we have required more of rotations than most do and such that we were way above the 1400 and 40 hour limit or I should say, what when ACPE says you must get, and therefore most students, we were able to argue we should discontinue all APPE rotations. There are a few outliers that I may ask Dr. Clinard and Dr. Youmans to comment on just a moment. And, but for most all the class 2020 we discontinued all those rotations effective yesterday. This shortened rotation in our analysis will not affect the student's graduation. It will not impact on the minimum ACPE mandated requirements for rotation. And so that's where we are on that particular decision. Let's see. Okay. The last thing is if we have the next slide then well, this is what happened literally yesterday after (AAMC) said they're valuable members, the team, you got to use them, etc. This came out, quote, unquote, "starting immediately, the double AMC strongly supports our member medical schools and placing at minimum, a two-week suspension on their medical school students participation in any activities that involve patient contact." So as a result of this, everybody, all medical schools pulled their students. And interestingly, there are some schools of pharmacy who elected not to, because as long as they could continue supporting the departments of pharmaceutical services, they felt it did not matter what the schools of medicine did. Now, I will say that's the far minority. But I do know of a few schools that in fact, have supported that. So I'm going to pause at this time. And I would like questions to come in. In this case, unless it's obvious that I shouldn't be answering the question I'm actually going to defer to Dr. Youmans and Dr. Clinard to answer any questions relative to both the remote didactic decisions as well as where we are on the experiential part of our coursework. So please, Alexa, if you could ask questions in order but I'm going to defer to Dr. Youmans first, and then she can decide if she or Dr. Clinard are best suited to answer your questions. Thank you.

Alexa Tan

Okay. Have anyone at the moment has any questions related to that tactic or experiential? Please state them now in the Q&A session and we'll go through them as we see them come up. Okay. We have one coming in. "With the discontinuation of APPEs, how does this impact students in the HSPR or Pharm Sci pathway, as they do not have the same eight blocks of ?"

B. Joseph Guglielmo, PharmD

Actually Yeomans.

[Sharon L. Youmans]

So, Val, you want to go ahead and take that question?

[Valerie Clinard]

Sure. For the class. Oh, can you hear me? Okay, great. So for the class of 2020 the HSPR students are done at the same time as the Pharm Care pathway. For the Pharm Sci students. There are a number of those students who we are working with to complete the spring one and with the anticipation that they will graduate at the same time that was previously planned.

Alexa Tan

Okay, and we will move on to our next question here. "What about the class of 2021P and 2021T for a APPEs that are scheduled to start soon?" I believe you touched upon a little bit Val, in case you wanted to add anything extra?

[Valerie Clinard]

Sure. So we are continuing to monitor the situation and we'll continue to communicate next steps for both of those cohorts.

Alexa Tan

Okay, and there are a couple of students who are also asking about general the graduation date and how that will be affected with these changes.

B. Joseph Guglielmo, PharmD

This is Joe, I do not have an answer to that question at this time.

[Sharon L. Youmans]

Okay. So, Joe, I'll just chime in, I mean, with the changes and the things that are happening are a moving target. And our ultimate goal would be to do what we can to make sure that people can graduate on time that can't be guaranteed. But with any recommendations that we make, we're keeping that in mind.

Alexa Tan

Okay, we have a question related to financial aid. "How will financial aid be handled in order to pay for tuition for housing?"

B. Joseph Guglielmo, PharmD

I will, I think I would have liked to have Cindy on to Cindy's on to answer but we are at the entire campus is working on this issue. We completely understand. There's going to be some financial issues that we're going to have to address. But Cindy, if you are on, if you want to add to that, I would appreciate that.

[Cindy Watchmaker]

Hi, this is Cindy. We are actually working with Student Financial Services. And so any student that has a question about his or her aid is welcome to email me. But any changes to the program, we are working to minimize any impact to your aid.

Alexa Tan

Okay, so we have a question here in terms of IPPEs "If we reach out to our IPPE preceptors and they are able to ensure a safe space potential PPE equipment, PPE equipment, no patient contact adequate precepting and no one could get to the sites, and one could get to the site safely, is it possible to continue IPP? Yes. Otherwise I'm interested in transparency about what makeup may look like right now."

[Valerie Clinard]

Sharon, you want me to take this one? Yes, please. Yeah, sure. So, no, I think we talked a little bit about this that we're putting all of the IPPE's at this moment. And we understand that there is some questions about makeup, that makeup completely depends on when we're able to start back. So if we are able to start back, there will not be any makeup and if we are unable to start back, we'll work to make sure that that makeup is not going to interfere with other activities that were already in place and could include some simulation-type activities.

Alexa Tan

In the interest of time, if we take one more question, I will still save your questions for those who are coming in and inputting their responses here Dean Joe...

B. Joseph Guglielmo, PharmD

I think we, I think we'll proceed. Okay, I'm gonna do my best to leave some time at the end. So next slide, please. So, I want to be a little bit upbeat now for a couple of slides. And I want to say, I believe it's important to be proactive, vibrant, during a very reactive time. And I would argue, I'm gonna give you two of many examples, and in fact, demonstrates that we are doing that. And that would be, first of all, you know, we are learning to maximize telecommuting, something that we probably should have done a while ago, which is good for the environment. You know, and so this is something, maybe we're going to get a few of the flies out of the ointment and decide how are we going to really handle this in the future. So, in a way this baptism of fire of sorts, is a very good thing and I am really impressed by the proactivity of this entire group to go in at going after that. For those of you that read the New York Times, you will know that QBI was featured. I find this to be impressive. This is a time that QBI under the leadership of Nevan Krogan and Jacqueline Fabius and their team, they have put together some 22 laboratories, a very large number of which are in the School of Pharmacy, the rest are in the School of Medicine, but what they have done, they have been looking for proteins in cells, where the Corona virus uses to grow, and what they have done, they as a project that using is Nevan's quote, essentially, that might you take two years, this working group of 20 something laboratories has completed this in a matter of a few weeks. Nevan had told me a day or two ago that I'm, in fact, they expected to further completely complete the map of the coronavirus genetically. And I don't know if that was completed the plan was in fact, they had one more thing to do the night before last, I believe. But what's the upshot of this? They... the real emphasis is going after all kinds of drugs that already exist. And there have been a few emails going out about hydroxychloroquine. And frankly, this is going on all over the place, you know, kaletra, retarivar, combination protease inhibitor, but they have come up with 50, promising candidates, almost all of which already are approved. And what they have been doing, including last Thursday, they sent the top 10 of the 50 to New York to be tested in a lab that actually is growing the Corona virus. So I call this being proactive during a reactive time and you know, quite pleased that QBI has been so successful. Next slide. I do want to say that, and it's unclear at the moment, but in spirit we have to get creative and go How can we support the greater healthcare system wherever possible, we need to support UCSF health but perhaps in very different ways and at the present time. Most people are not sure what way that would be the to do here is going to be we do need to get together with UCSF health pharmaceutical services and truly have a sit down with them at the highest level. And try to sort out ways that we can support them. Especially if this pandemic takes off the way it might take of. The Health Care Center at UCSF, they sent a ... that Lisa Kroon is aware of because I responded to it ... they sent something to the state. And they said the following they said that we need to maximize the contribution of our students and faculty practitioners. And they what they argued is we must practice at the top of our respective licenses. And I strongly agree with that, or we still will have to get creative and get appropriate workgroups together to rapidly decide how to do this. But in fact, you should. And the last thing is in light of the multi-county shelter in place, orders and the continued availability of community pharmacies, we have to figure out creative approaches how faculty, students, etc are able to help essentially and maximize utility of these pharmacies. Now. Each of the things I just recommend, there's a reason not to do it. There's legal reasons, there is bureaucratic reasons, and it goes on and on. All I know is this School we need to proactively take the blinders off and decide how are we going to do it? How will students and faculty residence fellows be part of this solution? Particularly if the healthcare system has a strain that very well could happen? And then lastly, the last slide I'm going to try to finish with a little bit of levity if we can change that. So first of all, I would argue not don't start it yet, Stephen, that Corona virus has actually jumped started flipping the classroom for the PharmD curriculum. You know a lot it's it's made us think about the way we tape our lectures how some of those lectures look. I forwarded the Zeke Emanuel editorial in JAMA from last week to a number of people, I would suggest all of you that have strong interest in this that you read that because independent of the Corona virus he is strongly suggesting, what we've been starting to do in this school, in fact, is a very good thing. And in a very ironic way, this virus has actually helped. Now, with that said, talking about remote teaching of curricula, I wanted to share a YouTube video that is a little corny, but it's pretty relevant. And if you can, Stephen, please let everybody see this.

[Musical number]

To canvass all the time, but I spent so many nights Hello,back, students, as all my colleagues tried to figure out how they're gonna get along, I should have kept up with not skip that class on force design. If I didn't know for just one second. I've been teaching online Oh, now go. I've got to figure out how to lecture using an [?]. He gave me two days to adjust to move everything online if you think oh, as long as I know. I know. I'll be my students and my paychecks Not too late to man the pieces. feeling sorry for myself. I used to cry. But now hold my head up high and you see me but just don't cough into the money or angry I will be on you. I can't hear you. You're on mute. your camera's black. Are you still there? We've got some issues to work out. My grading scheme is bad. Now go walk out. Try and get this lecture done on tape for now the network has gone down and I'm all out of whack. Oh, as long as I know, I know I'll be sued and my paychecks.

B. Joseph Guglielmo, PharmD

Thank you. Thank you, Stephen. And the comments from others said, This guy is obviously a liberal arts professor. So. We have a few minutes for any questions. Alexa, I and we'll we will stop on time. So please, any other questions that you'd like to send to the group?

Alexa Tan

Okay. And just in the interest of time and consideration of others, oh, in terms of kind of post-meeting, where can we access this Town Hall recording to be later if we missed the beginning? Where can folks can work in the access this?

B. Joseph Guglielmo, PharmD

I believe the plan is we're going to put it on the Susie's, the one, we talked about the COVID microsite, that's where you can expect that.

Alexa Tan

Okay, so stay tuned for further announcements on that. And in terms of questions that we didn't get to today, as well, I will be collating this in the backend. And as Dean Joe mentioned, we'll try to be able to address those as soon as possible.

B. Joseph Guglielmo, PharmD

I think it's four o'clock, so we probably should stop on time. I want to just close by thanking everybody, students, staff, faculty. These are challenging times. And it's almost tried to even say that but I have to say how impressed I am with the can do the rolling up the sleeves and each of them Every one of you have provided. I am grateful and honored to be serving as your dean during these times. So thank you. Please enjoy the rest of your day.