A Vaccine Pod Dedicated to Mental Health Patients

From left: Raymond Rene, Office of Mental Health (OMH); Ruth Llanos, OMH Psychiatric Nurse; Paul Michael Avellaneda, OMH Psychiatric Nurse; Michelle Izmirly, DO; Gariy Livshits, OMH Treatment Team Leader

Earlier this year, the New York State Office of Mental Health (OMH) launched a program to bring vaccine doses to mental health patients, as many have trouble navigating the internet or don’t have smartphones and need help facilitating appointments. The OMH program was designed for patients to come to state psychiatric centers, but they were also eager to expand their reach and offered to set up vaccine pods at all OMH licensed clinics across the state. Michelle Izmirly, DO, Medical Director of Ambulatory Psychiatry at The Mount Sinai Hospital, reached out to OMH so that The Mount Sinai Hospital’s clinic could be included as a site.

“We see a very vulnerable patient population, and I knew a lot of our patients weren’t comfortable going to places like the Javits Center,” said Dr. Izmirly. “Some were even crying because they were so scared and so frustrated; often, they lacked internet access or cellular service to navigate the New York State vaccine eligibility website. We’re the ones they know. They know our setting and our staff, and they’re more comfortable getting the vaccine with us. They were so grateful that they had this option.”

It was a true team effort to pull it off. OMH scheduled a site visit to make sure the clinic had the appropriate setup: strong Wi-Fi, a comfortable area for injections, and supportive staff. Rajvee Vora, MD, Vice Chair of Clinical Affairs for the Department of Psychiatry, collaborated with Ania Wajnberg, MD, Medical Director of Ambulatory Care at The Mount Sinai Hospital and Site Lead for Vaccine Operations. They engaged the pharmacy and engineering departments to ensure the clinic had the appropriate equipment to safely store the vaccine.

Due to special efforts by Patricia Lamb, Chief of Ancillary and Support Services, Sue Mashni, PharmD, Chief Pharmacy Officer, and Michael Roche, PE, Senior Director of Engineering, the clinic space was converted to a safe and effective vaccine pod in one week. Eva Bayon, Administrative Manager, and Joan Bell, LCSW, Clinical Director of Ambulatory Psychiatry Services, handled the logistics of confirming and scheduling patients. Alicia Hurtado, MD, Associate Dean for Medical Student Wellness and Student Affairs, arranged for medical students to volunteer to monitor the patients for 15 minutes after they received the vaccination.

On April 8, the team vaccinated 72 patients—10 every 30 minutes starting at 9:30 am. And this might only be the beginning. The vaccine pod was such a success that OMH will return May 6 to reach the patients who were unable to attend their appointment that day. If OMH continues to provide the doses, the clinic could continue to offer it to their patients moving forward.

Cassidy Leverett, a care coordinator at the clinic, believes that the stability for these patients is key. “A lot of people find it really difficult to schedule the vaccine because it can be far from where they live or work, so it’s really great that people can go to a place they’re familiar with and see faces that they know. It’s been a very crazy time so it’s nice to have one stable place where you can go get your vaccine.”

Dr. Izmirly hopes this spreads beyond her clinic to other mental health clinics and practices. “You see so many news stories and research studies about people with mental illness contracting and dying from COVID-19 at higher rates than those who don’t suffer from mental illness,” she said. “We’ve even lost some of our own patients, which was completely devastating. This is an opportunity to help our own patients in our own settings, where we know they’ll feel comfortable.”

 

Enduring Racial Slurs and an Assault, Medical Student Oranicha Jumreornvong Speaks Out Against Asian Hate

Oranicha Jumreornvong, center, took to the microphone at an Anti-Asian Hate rally in March.

The rise in Asian hate crimes—including an assault she experienced herself—has transformed third-year medical student Oranicha Jumreornvong into an outspoken advocate for the rights of Asians in the United States.

In March, Ms. Jumreornvong helped organize an anti-hate rally in New York City on behalf of White Coats Against Asian American and Pacific Islanders Hate. The rally drew an estimated 1,000 supporters, including Senator Charles Schumer, D-NY; New York City mayoral candidate Andrew Yang; and 100 health care workers, including 50 classmates from the Icahn School of Medicine at Mount Sinai. 

“Speaking out is not really an option in Thailand, where I’m from,” says Ms. Jumreornvong, 26, who grew up under military dictatorships and widespread censorship. She arrived in the United States in 2014 as an undergraduate at Stanford University. All of her family members live in Thailand. “Thai people learn to minimize things to try to get along,” she adds. “In the past, I would advocate through research but not by public speaking because it conflicts with my own upbringing of trying not to stir up problems.”

“I think the first step to healing is to recognize there is a problem, and I implore everyone to stop viewing the Asian American Pacific Islander community as a model community of wealthy and educated people and, instead, as a heterogeneous group.” — Oranicha Jumreornvong

But her reluctance to speak out against hate ended abruptly on a chilly morning in February, on the Icahn Mount Sinai campus, at 97th Street and Madison Avenue. That is when a stranger wearing a mask yelled “Chinese virus” at her before following her, kicking her, and dragging her across the pavement, as bystanders looked on. The attacker grabbed Ms. Jumreornvong’s cell phone and ran off. The police have not yet found him.

“I was on my way to get my first COVID-19 vaccine at Mount Sinai before returning to work at the hospital later that day,” says Ms. Jumreornvong. “I had a coat on over my scrubs. I told him, ‘I’m a medical student,’ and at first he seemed okay with that and I thought he would leave me alone. But then he didn’t.” After the attack, Ms. Jumreornvong’s mentors in the Department of Rehabilitation Medicine and Human Performance checked on her via telemedicine and a friend who is a resident in Physical Medicine and Rehabilitation tended to her wounds

Ms. Jumreornvong had been the victim of a bias incident several months earlier, while she was in between shifts at Mount Sinai Morningside. She was alone on a bench eating a granola bar when a woman pushing a child in a stroller told her to put her mask on and go back to China.

Support from friends and mentors outside and within the Mount Sinai community has helped ease her pain. “Mount Sinai has always been supportive emotionally and in terms of advocacy work,” she says. After her assault, Mount Sinai’s medical students started a petition to denounce anti-Asian hate and the Health System quickly embraced it. “I feel like Mount Sinai has provided me with this privilege—this platform to speak out—and that I have to do something, and by helping others I’m also healing.”

Oranicha Jumreornvong, front row, fourth from the left, and her colleagues from White Coats Against Asian American and Pacific Islanders Hate, drew an estimated 1,000 supporters to their rally in Manhattan’s Chinatown neighborhood.

In raising awareness about anti-Asian hate, Ms. Jumreornvong wants the public to view the Asian community as a diverse group of people. There is a lot of poverty among Asian groups, she says, and many are underrepresented in medicine and other professions.

“I think the first step to healing is to recognize there is a problem, and I implore everyone to stop viewing the Asian American Pacific Islander community as a model community of wealthy and educated people and, instead, as a heterogeneous group,” she says. She would like to see the establishment of scholarships that help underrepresented Asian groups and the elimination of health disparities that exist in poor Asian American communities. She would also like the U.S. medical community to recognize some of its own unconscious biases.

After her painful experiences in the United States, Ms. Jumreornvong’s father in Thailand was concerned for her safety. She assured him that she would be all right.

“As an immigrant, I have an American dream too,” she says. “America is so diverse and you see people of different colors and ethnicities come together. I consider this my second home, so I don’t want to leave it. You can choose to weigh yourself down with bitterness. I think it’s easier on the soul to heal through kindness and resilience.”

At Mount Sinai Brooklyn, the COVID-19 Vaccine ‘Pod People’ Treat Everyone Like Family

Barbra Naccash, left, received her vaccine from Kristine Ortiz, RN, who had cared for Barbra’s mother a year ago when the mother entered Mount Sinai Brooklyn with COVID-19.  “Although I could not save her mother’s life, by giving Barbra the COVID-19 vaccine, perhaps I saved hers,” Kristine says.

Kristine Ortiz, RN, a Mount Sinai Health System nurse for 11 years, has been at Mount Sinai Brooklyn for three years, and calls it a “hometown hospital.” This is largely because of the camaraderie of the staff and the diversity of the patients. “You hear Chinese, Creole, and Hebrew among other languages,” Kristine says. “I have my ‘bubbes’ who, like all of my patients, I consider family and treat as such.”

Since January, Kristine has overseen the three MSB vaccine pods. Partnering with Philip Repaci, RN and assistant nurse manager Valerie Hechanova, RN, they call themselves the “pod people,” a name coined by Philip. Working the pods has brought them close. “The emotions run high in the pods,” Kristine says. “We laugh and cry with each other and the people coming in for vaccinations, but they are tears of joy, of course.”

Those receiving vaccinations are treated like family, as well. “We have people coming in for vaccines as old as 102 and have to be mindful of their frailty and mental capacity,“ Kristine explains. Patients are grateful for their care; many days Kristine and her team are awash in Dunkin Donuts and coffee.  But, she says, so many staff offer to volunteer—the clergy, nurses from the OR, physicians—that there are many colleagues with whom to share these tokens of appreciation.

One such appreciative patient is Barbra Naccash. In March 2020, Barbra’s mother fell in her apartment in an assisted living community. When she was transferred to Mount Sinai Brooklyn, it was noted she had symptoms of COVID-19. Barbra called every day, and Kristine would get on the phone and update her on her mother’s condition. Kristine also helped Barbra and her mother do FaceTime visits. “I looked at her like a surrogate daughter to my mother,” Barbra says. “She was an angel. Combing my mother’s hair and holding her hand when I could not do those things for her.”

Sadly, Barbra’s mother passed away from complications of the virus. Kristine and Barbra kept in touch by phone, learning about each other’s families and getting to know one another. During one call in February 2021, Kristine inquired about Barbra’s vaccination status. When Barbra and her husband were eligible for COVID-19 vaccine, Kristine helped with scheduling and eventually gave them the shots herself. Barbra and Kristine had never met, so they arranged to meet outside of the hospital that day. The tears flowed during a social distanced “hug.”

“This was a full-circle family experience,” Kristine says. “Although I could not save her mother’s life, by giving Barbra the COVID-19 vaccine, perhaps I saved hers.”

Mount Sinai Brooklyn vaccine pod team members, from left: Kadesia Henry, Desshanai Gumbs, Jacqueline Thomas, Dominique Bostic, and Madelyn Gonzalez.

Students Present Their Latest Studies at Medical Student Research Day

One hundred six poster presentations and four oral presentations capped off new research that was conducted by students at the Icahn School of Medicine at Mount Sinai and featured at Mount Sinai’s Fourth Annual Karen Zier, PhD, Medical Student Research Day, held over Zoom in March.

Participating in Research Day fulfills one of the medical school’s graduation requirements. Eighty percent of the presenters each year are in their second year of medical school.

“Medical Student Research Day is a showcase and an opportunity for students to share the research and scholarship they have done with their mentors with the Mount Sinai community,” says Mary Rojas, PhD, Director of Icahn Mount Sinai’s Medical Student Research Office, and Associate Professor of Medical Education. “It is an early snapshot of the students’ accomplishments.”

Dr. Rojas says that by the time they graduate, more than half of Mount Sinai’s students will have published in peer-reviewed journals. The Class of 2021 has already published more than 400 peer-reviewed articles.

The event exemplifies Mount Sinai’s commitment to fostering biomedical research and introduces students to the intellectual rigors, skills, and collaboration that lead to incremental findings and life-changing discoveries.

Under the mentorship of Tanvir Choudhri, MD, Associate Professor of Neurosurgery, at Icahn Mount Sinai, second-year student Zachary Spiera found that the use of non-steroidal anti-inflammatories (NSAIDs), which diminish inflammation, does not make users more susceptible to concussions and does not worsen their outcomes. This was a subject he had wondered about because he and his teammates had plied themselves with NSAIDs while playing basketball and soccer in high school and middle school.

Before launching his own research, Mr. Spiera searched through medical literature, but could not find an answer. “As a student you look up to the medical community and think there are going to be answers to your questions,” he says. “Then you see something that hasn’t been figured out yet.” He is first author on a study about this subject that was recently accepted for publication in the Journal of Neurosurgery: Pediatrics.

 

This spring, Jordyn Feingold will receive a joint MD and Master of Science in Clinical Research, before continuing at Mount Sinai for her residency in Psychiatry. At Research Day, she presented her work on the psychological impact of the COVID-19 pandemic on 2,579 front-line health care workers at The Mount Sinai Hospital. She and her mentor, Jonathan Ripp, MD, MPH, Dean for Well-being and Resilience and Professor of Medicine (General Internal Medicine, and Geriatrics and Palliative Medicine) recently published their findings in the journal Chronic Stress.

One of the study’s key takeaways, Ms. Feingold says, was the high prevalence—39 percent—of COVID-19-related post-traumatic stress disorder, major depressive disorder, or generalized anxiety disorder that existed among the hospital’s front-line health care workers at the peak of the pandemic last year. The “greatest driver of those symptoms was being burned out, which is significant,” she says, “because it was happening well before COVID-19 and it is something that can be addressed.” Her research also found “the greatest modifiable protective factor was feeling supported by hospital leadership.”

The COVID-19 pandemic provided a springboard for student research by others, including second-year students Cynthia Luo, Alexander Kalicki, and Kate Moody, who also presented abstracts of their studies on Research Day.

Ms. Luo studied resilience among her fellow medical students during the pandemic under the mentorship of Craig Katz, MD, Clinical Professor of Psychiatry, Global Health, and Medical Education, at Icahn Mount Sinai. She divided students into two groups: those who responded to a survey by saying the COVID-19 pandemic had been their most traumatic life event, and those who responded by saying they had experienced earlier life traumas, such as the loss or illness of a loved one. Ms. Luo then measured their responses on a resilience scale that was created at Mount Sinai. “Students who indicated a non-COVID-19 impactful life event had significantly higher resilience than those who indicated COVID-19,” says Ms. Luo. “To me that demonstrates that having prior stressful life experiences was, in some ways, protective for managing COVID stress. Potentially, these experiences helped students grow and develop their resilience behaviors before COVID-19.” Ms. Luo plans to finish compiling her research and submitting it for publication in the coming months.

 

Mr. Kalicki and Ms. Moody are co-authors on a study that was just accepted by the Journal of the American Geriatrics Society (JAGS), which examined the barriers to video-based telehealth access that older homebound adults faced during the pandemic. Mr. Kalicki worked as a software engineer before entering medical school and says his passion for using technology to improve health care delivery led him to pursue the project under the mentorship of Peter Gliatto, MD, Professor of Medicine (General Internal Medicine), Geriatrics and Palliative Medicine, and Medical Education at Icahn Mount Sinai. Katherine Ornstein, PhD, MPH, Associate Professor, Geriatrics and Palliative Medicine, also served as the students’ mentor.

Ms. Moody says she was drawn to the subjects of process improvement and providing a high level of health care to a population that is difficult to access. Both students helped design a survey that was completed by physicians in the Mount Sinai Visiting Doctors Program and conducted the data analysis for the study. They also created a data collection sheet for Mount Sinai’s Epic electronic health record system to systematically record information about patients’ previous telehealth use, as well as structural barriers patients may face, such as access to the internet or the capacity to pay for cellular data. The students hope that a better understanding of these barriers will help inform future interventions that are designed to reach patients with limited access to care.

Match Day 2021: Graduating Medical Students Receive Their Residency Matches

Mount Sinai’s Class of 2021 received locked boxes that contained sealed envelopes with the names of the residency programs they had matched to. At noon on Match Day, they were given the code to unlock their boxes.

One-hundred forty-five students at the Icahn School of Medicine at Mount Sinai learned what the next phase of their career path would be at Match Day 2021, when each of them opened a carefully sealed envelope that revealed the U.S. residency program they had “matched” to and would be attending this year following graduation. The suspenseful moments leading up to their collective and coordinated noontime “discoveries” were shared over Zoom on Friday, March 19, with 400 participants, including family, friends, and Mount Sinai faculty and staff who supported the Class of 2021 with smiles, cheers, and words of encouragement.

Each year, the matches are orchestrated through the National Resident Matching Program (NRMP), which uses mathematical algorithms to align the preferences of applicants with the preferences of residency programs available at teaching hospitals across the nation. Match Day 2021 was the largest in the NRMP’s history, with more than 42,000 applicants.

Almost two-thirds of Mount Sinai’s students will be entering residency programs at the nation’s top 20 hospitals, including Massachusetts General Hospital, Brigham & Women’s Hospital, Johns Hopkins Hospital, the Hospital of the University of Pennsylvania, Barnes Jewish Hospital, and the Cleveland Clinic. The Class of 2021 will pursue specialties such as Emergency Medicine, Anesthesiology, Pediatrics, Psychiatry, Otolaryngology, Obstetrics and Gynecology, General Surgery, and Internal Medicine—the most popular discipline, which drew 33 students.

Sixty-seven Icahn Mount Sinai students will enter residencies at the Mount Sinai Health System, which runs the largest residency program in the country. These Mount Sinai alumni will be joined by newcomers to the Health System—including students from 18 of the nation’s top 20 medical schools—all of whom will begin their programs in July. Residents from leading medical schools in countries such as Argentina, India, Ireland, and Japan will be among them.

James Blum, who matched to the Emergency Medicine program at Boston Medical Center, said, “I am so excited to be heading to Boston to care for patients at an incredible institution that values health equity, where I can continue the work I started at Mount Sinai to expand access to health care.” As a medical student, Mr. Blum assumed progressive leadership roles with Mount Sinai’s East Harlem Health Outreach Partnership (EHHOP), a student-run, physician-supervised free clinic that conducts more than 1,000 patient visits annually for people who live in East Harlem.

Students Chloe Getrajdman and Jonathan Pan were excited about their next steps, too. Ms. Getrajdman will be specializing in Obstetrics and Gynecology as a resident at Mount Sinai. The time she spent working at EHHOP’s Women’s Health Clinic, she says, “has inspired me to continue working with the East Harlem community and alongside physicians who are passionate about providing care to underserved populations.” Mr. Pan, who also held leadership roles in EHHOP, will be pursuing a combined Internal Medicine and Pediatrics residency in Houston, at Baylor College of Medicine.

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, congratulated the students on their “fantastic” match results. He said the COVID-19 pandemic had posed enormous challenges for the entire medical community and that Mount Sinai’s students had played an important role in helping the Health System. He said they had also become more resilient along the way.

“This has been a year like no other,” he told the students. “You will never forget your fourth year in medical school and that is a good thing because you have grown to become not only outstanding physicians but also resilient individuals. When you meet challenges later on in life you will look back on this year with pride and say, ‘I can overcome this obstacle.’”

A Photographer Provides a Unique Look Inside Mount Sinai Brooklyn During the COVID-19 Pandemic

Last fall, an accomplished freelance photographer working for The New York Times was given access inside Mount Sinai Brooklyn to document the care being provided to COVID-19 patients.

One of the images recently appeared in a lengthy photo essay titled “A City Ruptured” showing the changes to New York’s economy due to the pandemic. And the photographer, Ashley Gilbertson, a New York City resident known for his photographs of wars in Afghanistan and Iraq, shared additional images.

The black and white photos are dramatic and moving, and they provide a rare glimpse of a hospital doing what is necessary to care for patients and serve its community during a time of crisis.

“As I look at these images, what I see is staff, nurses, techs, and doctors, providing care for very sick and fragile patients,” says Peter Shearer, MD, FACEP, Chief Medical Officer and Vice President, Medical Staff, at Mount Sinai Brooklyn.

He adds, “One year into this pandemic we only have a few, modestly effective new medications for COVID-19. What keeps these patients from dying is the endless care that staff provides: care is encouraging confused patients to keep their uncomfortable oxygen masks on; care is helping a patient spend time lying on their belly; care is ambulating patients so they don’t weaken during their stay.  Providing this care is hard work, and these people have been doing it day and night for over a year. The staff also provides care to co-workers, and that sense of community keeps us going.”

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