When Los Angeles Mayor Eric Garcetti’s “Safer at Home” order began on March 19, Keck Medicine of USC family medicine physician Jennifer Boozer, DO, knew seniors would suffer.

“When we rapidly switched from office care to telehealth, I immediately understood the impact this would have on my senior patients,” said Boozer, a clinical assistant professor of family medicine (clinician educator) at the Keck School of Medicine of USC. “Having worked with this vulnerable population for over two decades, and having training in gerontology, I knew that we now faced a new barrier to caring for our older patients.”

Boozer knew she wanted to help — a sentiment shared by faculty, staff and students across the Keck School. Spearheaded by then-Dean Laura Mosqueda, MD, the volunteers formed the COVID-19 Advocacy Group to help Los Angeles County residents during the pandemic. The group identified three vulnerable groups: the elderly and frail; domestic violence victims; and asylum detainees.

Helping the elderly

To ensure seniors didn’t miss out on important medical visits, Boozer, together with colleagues and student volunteers, started with a collection drive for used smartphones and tablets. The students streamlined the devices, leaving only the apps patients would need, and created user-friendly instructions for them to navigate telehealth appointments. Students were paired with seniors to provide one-on-one guidance — all done under current public health and social distancing guidelines. Volunteers for the project are Lourdes Baezconde-Garbanati, PhD, MPH, MA, associate dean for community initiatives at the Keck School; Steve Kay, PhD, DSc, University and Provost Professor of Neurology, Biomedical Engineering and Biological Sciences, and Director of Convergent Biosciences at the USC Michelson Center for Convergent Bioscience; Anjali Mahoney, MD, a family medicine physician with Keck Medicine and a clinical associate professor of family medicine (clinician educator) at the Keck School; Victoria Szatalowicz, MD, adjunct clinical assistant professor of medical education; and students Chirag Doshi, Grace Manchala, Mark Phillips, and Lynn Utley.

Utley, a second-year medical student, said being able to connect with senior patients in a meaningful way was a defining moment in her journey to becoming a physician.

“I was moved by the experience of calling and speaking with some of our senior patients and their family members,” she said. “They shared their thoughts around COVID-19 and their uncertainties on how they would receive health care. They were grateful for their children, grandchildren, and neighbors who were stepping up to get them virtually connected. But not everyone had this support, and these were the patients we hoped to help. We did this by listening to their concerns and answering their questions.”

Helping victims of violence

Jeniffer Kim, PhD, MPH, a research manager/biostatistician at the USC Gehr Family Center for Health Systems Science and Innovation and the advocacy group’s project manager, said as pandemic-related shutdowns slowed Keck School operations, clinicians and researchers were quick to volunteer their time and talents.

“Our advocacy group met twice weekly via Zoom at the start of shutdown and continues to meet once a month to brainstorm ideas,” said Kim, who manages the group’s activities with administrative support from Drizelle Baluyot. “We’ve been fortunate to have a really dedicated group of physician and research champions who are going beyond their professional duties and stepping outside their areas of expertise to help fellow L.A. residents.”

The group was particularly eager to help victims of domestic violence, many of whom are trapped at home with their abusers during the lockdown. That work started on campus, with the team’s efforts to expand resources offered by USC’s Relationship and Sexual Violence Prevention and Services (RSVP), and the Violence Intervention Program (VIP) for students, faculty and staff on the Health Sciences Campus.

To help beyond the campus community, the group reached out to USC alumna Bernita Walker, who runs the local domestic violence nonprofit Project Peacemakers. After learning that the organization’s staff needed more personal protective equipment (PPE) to continue their work within the community, Kim led the collection of hand sanitizers, face shields, disposable facemasks, and 100 reusable facemasks donated by the L.A.-based denim brand Just USA. She was assisted by Tanaz Ferzandi, MD, MBA, MA, an obstetrician/gynecologist with Keck Medicine and associate professor of clinical obstetrics and gynecology at the Keck School; Nasrin Esnaashari, CCRN, MSN, CNS, CNP, instructor of clinical neurology; Deirdre Logan, MD, MMM, an obstetrician/gynecologist with Keck Medicine and clinical assistant professor of obstetrics and gynecology (practitioner) at the Keck School; Karen S. Morgan, MD, an ophthalmologist with Keck Medicine and the USC Roski Eye Institute, and clinical professor of ophthalmology (clinician educator) at the Keck School; and Brian Song, MD, MPH, an ophthalmologist with Keck Medicine and the USC Roski Eye Institute and assistant professor of clinical ophthalmology at the Keck School.

Walker said the donation was “extremely helpful” to her staff and clients.

“We are now serving 227 clients each month, combining in-person and Zoom classes, as several of our clients prefer in-person settings due to their situations of domestic violence at home,” Walker said. “The equipment was so perfect as we continue to never turn anyone away.”

Helping asylum seekers

Another way the advocacy group is helping vulnerable community members is pro bono expert testimony by Todd Schneberk, MD, assistant professor of clinical emergency medicine at the Keck School, for the American Civil Liberties Union (ACLU). These cases pertain to the health risks faced by asylum seekers held in immigration detention centers during the pandemic.

In a Medium post published July 14, Schneberk and his colleagues write that asylum seekers, who are already fleeing victimization in their home country, are now at an increased risk of contracting COVID-19.

“Now, with the threat of COVID-19, immigration detention may become a death sentence. Conditions inside detention facilities, coupled with limited access to soap and sanitizing agents, create a high-risk environment for rapid spread of this dangerous virus,” Schneberk wrote.

The advocacy group is penning other articles to bring awareness to the health risks associated with detaining asylum seekers during a pandemic. Other volunteers in this subgroup are Kim; Ricky Bluthenthal, PhD, professor of preventive medicine; and Anamara Ritt-Olson, PhD, assistant professor of clinical preventive medicine.

“The risks are not just to the asylum seekers themselves, but also to staff members who work in the detention centers and the families and communities that these employees go home to,” Kim said.

Kim said the volunteer work is ongoing, and anyone interested in getting involved can reach out to her directly at Jeniffer.Kim@med.usc.edu.

— Sarah Nightingale