School of Medicine’s Heidi Gullett ‘a force for good’ in the region’s coronavirus pandemic response
By Ginger Christ
This article first appeared in a summer publication related to the university’s response to the COVID-19 pandemic. More articles will appear in The Daily and on the university and school social media accounts in upcoming weeks; visit case.edu/together to see more.
On a cold Saturday in March, Ohio’s then Department of Health Director Amy Acton, MD, MPH, took to the podium at the daily COVID-19 briefing that had quickly become must-watch television across the state.
She told reporters they needed to look at local efforts against the pandemic, starting with Northeast Ohio.
There, Acton noted, Cuyahoga County health leaders like Case Western Reserve’s Heidi Gullett, MD, MPH, had created an “amazing five-layered triage system” to investigate cases and gather the data to know how and where infections were spreading.
“You need to tell the stories of these innovators on the ground,” Acton told reporters. “We have to take the recommendations of these modelers.”
No one in the university’s medical school nor her colleagues across the region knew Acton would highlight Gullett, the county’s medical director, that day. Yet the acknowledgment of her leadership in crisis was of little shock to those who know her.
“Zero percent of us who interact with her on site are surprised” by Gullett’s coronavirus response, said Chad Garven, MD, MPH, assistant medical director of medical informatics at Neighborhood Family Practice, a community health center near Cleveland where Gullett is a clinician. “Of course she wouldn’t sleep. Of course she would take on a pandemic.”
In Cuyahoga County, Gullett leads the incident command for the local coronavirus response, overseeing a team of 50 people. Under her guidance, the Board of Health has developed a complex system of contact tracing and cluster identification of COVID-19 cases using board staff and Case Western Reserve University students (see sidebar). And in recent months, it’s a model that has been replicated throughout the country.
“If there ever was a time for public health to rise to the occasion, it’s now,” said Gullett, who holds the Charles Kent Smith, MD and Patricia Hughes Moore, MD Professorship in Medical Student Education in Family Medicine at Case Western Reserve.
Novel leadership
Before the pandemic, Gullett already was a leader in the public health community. In 2011, she joined the faculty at the School of Medicine, where she teaches and conducts research on interventions in primary care. She also is the population health liaison between Case Western Reserve and the county Board of Health; co-chair of Health Improvement Partnership-Cuyahoga, a consortium of 100 community partners to improve health and wellness across the county; and holds positions locally, statewide and nationally to promote the critical importance of public health, with a key focus of her career working with underserved, low-income and vulnerable populations.
But for the past few months, Gullett has focused primarily on the pandemic, working nearly nonstop to curtail the spread of the virus.
“In every part of Heidi’s life, everyone wants her to do more because she’s such a force for good. She’s a hero for me,” said Kurt Stange, MD, PhD, director of the Center for Community Health Integration at the School of Medicine. “Even as the work keeps growing and growing, she’s the one who always gets called and always is the first up.”
Stange likened running the county’s coronavirus response to driving a car down the road and building it as you go. Because the novel coronavirus is, by definition, a new virus, the response has been unprecedented and has had to adapt and change as more is learned.
Gullett helped with the county’s response to the Ebola outbreak a few years ago but said the work fielding calls and monitoring travel was incomparable to today’s coronavirus pandemic.
“It seems like child’s play compared to what we’re doing now,” Gullett said.
Yet her approach has been lauded by health officials and served as a model for other health departments.
Ohio Department of Health Medical Director Mark Hurst, MD, called Gullett “a leader in public health in Ohio,” whose “proactive efforts during the COVID-19 pandemic are an example for others in the state and have undoubtedly saved lives in Cuyahoga County and elsewhere.”
Gullett, though, is quick to note that the local response is a team effort—one that wouldn’t be possible without a group of committed people working together.
“There’s just this amazing culture here of people wanting to save the community,” Gullett said.
Everyone is stressed. Everyone is tired. But they all remain immensely committed “to ensuring the public’s safety. … Even on the hardest days, that’s what gets us through.”
At Gullett’s urging, her team pauses to focus on gratitude twice a day—at 9 a.m. and at 3 p.m.—to remain grounded amidst the upheaval in their world.
“We remember it’s OK to be sad; it’s OK to be stressed. The only way to survive is together,” Gullett said. “Our interdependence has never been more on display than now.”
For Gullett, there has been a personal toll. She’s missed out on time with her two children—ages 8 and 11—and, for a long time, her husband, an emergency room physician, lived separately from the family as a precaution until he received proper personal protective equipment.
“It was awful,” Gullett said.
She shared her personal situation during one of the county’s regular press conferences because she wanted people to “understand the gravity” of the pandemic, and how seriously health officials and medical workers are taking it.
An eye toward the future
Now, the Board of Health is creating a long-term plan to handle the pandemic. As more testing is done and people are less cautious about physical distancing, the number of new cases—and deaths—is expected to climb, said Cuyahoga County Board of Health Commissioner Terry Allan, MPH, who created with Gullett the county’s COVID triage system.
“Deaths keep coming. This is not a time to take your foot off the gas,” he said. “We’re planning for the possibility of a very tough fall.”
For her part, Gullett plans to “stay focused on the big picture” and make sure no one gets left behind in the response, especially vulnerable populations.
“There are moments where the gravity of the situation is a lot,” Gullett said. “I try to stay level headed and mindful.”
Heeding the call
Case Western Reserve University School of Medicine students have faced a pandemic in a classroom.
Now, they’re responding to one in real life.
In one of their first exercises as medical students, each incoming class faces a mock flu pandemic. They assume roles as government or health officials, members of the media and civilians, and figure out how to manage the outbreak.
Then, in March, as classes moved remote and clinicals were cut short, more than 175 medical, public health and physician assistant students stepped up to help manage COVID-19 hotlines at the Cuyahoga County Board of Health, Neighborhood Family Practice and University Hospitals (UH) as part of a new telemedicine elective.
“This is a crash course in being flexible … realizing medicine is a lot of unknown—and [then] figuring out how to be comfortable with it,” said Anastasia Rowland-Seymour, MD, an associate professor of medicine in the School of Medicine and an internal medicine physician at MetroHealth Medical Center.
At the Board of Health, medical students performed contact tracing, answered COVID-19 hotline calls and managed clusters of positive cases.
“It’s been really rewarding to be part of the experience—to see how things are run, how successful we’ve been and how hard-working everyone is,” said Andrea Szabo, a third-year medical student who worked at the Board of Health 60 hours a week supervising students and calling people with their diagnosis. “I’ve learned how to say things better and more clearly, comfort people, and build a rapport over the phone.”
Their work was recognized by former Ohio Department of Health Director Amy Acton, MD, MPH, during Gov. Mike DeWine’s daily press briefings.
“Most of them have done far more hours than they have needed for their electives,” said Heidi Gullett, MD, MPH, associate professor at the School of Medicine and medical director for the county Board of Health. “This has expanded our understanding of what our residents and medical students can do for the community in the midst of this crisis.”
Faculty member Debra Leizman, MD, also a general internist at UH, brought students in to UH after trying to connect with the hospital system’s internal hotline, which was flooded with doctors trying to find information about COVID-19 or get patients tested.
Before students started staffing the hotline, wait times were more than an hour. By the end of the students’ first day, callers waited just one minute, said Jacqueline Wang, a third-year student.
“It definitely gave us a sense of agency that was missing for a while,” Wang said, “wanting so badly to help but not knowing how.”
Their assistance was critical for both wait times and the overall experience. “The medical students have such great energy,” Leizman said. “They’re in health care, and they wanted to give back and help. It was really phenomenal to watch.”
—Ginger Christ
This article was originally published July 28, 2020.