Cloquet graduate has COVID-19 in her sights

Cloquet native Dr. Kelly Cawcutt is an assistant professor of medicine and board certified in critical care medicine and infectious diseases with an academic and clinic practice at University of Nebraska Medical Center in Omaha. She is a 2000 graduate of Cloquet High School and is the daughter of Daryl and Doreen Hendrickson of Cloquet. She is married to Carlton native Michael Cawcutt.

Kelly graduated from the University of Minnesota Medical School and completed her residency in internal medicine there in 2008. She then completed critical care and infectious diseases fellowships and a master's of clinical and translational science at Mayo Clinic in Rochester.

She holds national positions with the Infectious Diseases Society of America, the Society of Critical Care Medicine and the Society for Healthcare Epidemiology of America.

The Pine Knot News recently asked Kelly about her work as it is central to the current COVID-19 pandemic.

Q In the heart of this pandemic, what is your daily schedule like?

​A My schedule varies from day to day right now. I am working primarily administratively to write protocols that help us continue to do lifesaving procedures for patients with COVID-19 infections so that we can continue to provide the highest level of care in the safest environment for patients and healthcare workers for as long as we can. All of this, of course, is balanced with limited resources like PPE (personal protective equipment) and testing.

Q This coronavirus outbreak falls right into your specialty. It's one thing to study it, and surely another to experience it. What has surprised you the most?

A This definitely falls into my niche of specialty. Personally, it has been amazing to be able to use my training in such a synergistic way to help educate patients, the public and colleagues from other specialties.

The speed of medical research and collaboration among clinicians has been stunning. There is rapid speed of innovation and implementation that is unprecedented, which is both surprising and amazing. The other thing I find inspiring is the dedication of health care workers. In the face of fear, inadequate supplies and resources - and with the knowledge that we have colleagues falling ill and dying - there is clear commitment to our oaths. We will continue to show up and be there to take care of our patients, which is also why we want everyone to stay home for us.

Q Was this something you expected to hit at some point, given the regional and worldwide outbreaks we've seen in the past decade or so?

​A Yes, although we certainly cannot predict an event in full. I am not surprised that we have seen an outbreak like this. SARS, MERS, H1N1 influenza and Ebola were all clear global threats. Eventually one was going to spread like this.

Q Do you feel we were prepared for something on this scale? How have things gone in Omaha compared to other places we've seen in news reports, like New York or even Italy? ​

A No, overall, I think it is nearly impossible to prepare for this level of scale. To have the level of equipment, never in use, would have led to expirations and discarding of supplies. The public health infrastructures in general are not as well funded in many areas and were not prepared. Many hospitals where I have colleagues did not have robust pandemic plans or expertise for highly infectious diseases such as this.

Here at UNMC, we are national and global leaders in highly infectious diseases and have an ever-ready biocontainment unit and multidisciplinary team. We had Ebola patients here in the past, and patients from the Diamond Princess (cruise ship) with COVID-19 were here more recently. With the expertise here and early patients, we started our pandemic planning and preparedness very early. We have readily published protocols for others and have served as a national source of expertise with content cited by several organizations, including the Centers for Disease Control.

Despite this, we still are facing the same struggles others are with trying to ensure we have adequate PPE, testing, ventilators and more. I am incredibly proud of the ongoing efforts here to be as prepared as possible for these patients. Thus far, we have not been in scenarios such as what we are seeing from Italy or New York, but we are certainly in touch with colleagues in some of these areas and learning from their experiences.

Q We are likely only in the beginning stages of this. How long do you think it will be before things can get back to a semblance of normal? Does this forever change how we might go about our daily lives?

​A I think the ripple effect of this will forever change us. There will be greater understanding of infectious diseases, public health and other acute general health issues. The impact on how health care is delivered will also likely never return to the exact way it was before.

As far as how long this can last, in general, we can see pandemics go through two waves lasting up to 18 to 24 months. For this first wave, we expect likely eight to 12 weeks through each community, with this being greatly impacted by mitigation strategies such as social distancing. I am cautiously optimistic that we can enjoy some semblance of a normal summer, but I honestly am prepared for that to not occur until July or later.

Q You are also a parent. How are you handling things at home while staying on the front lines?

​A I am a parent of two young kids. My job has always been demanding with long hours, missed holidays and events. Hospitals never close, and that takes its toll. Right now, I am working more than I ever have and even if I am not caring for patients on a given day, my hours are longer and I do not take days off.

If my husband was not carrying a huge load, including home schooling, we certainly would have some unraveling happening at home. Family and friends have supported us with having items delivered, which has been a blessing.

From a COVID-19 perspective, we have hand sanitizer at our entrances, the kids no longer have play dates and we take social distancing incredibly seriously. Ethically, I feel we need to set the example and find alternatives in these times: connecting online, video calls with family, a birthday parade of classmates in cars honking for my son this month. It's different, it's hard, but it's what it takes right now.

Just like everyone else, we simply do the best we can. Yes, the house may not be as clean as we like. No, I have not gotten all the laundry done. We may have some dust bunnies celebrating Easter with us. It is OK. We all need to extend grace to each other, and ourselves, to get through times such as these.

Q What has communication with friends and family back here in Carlton County been like?

​A It has been amazing. So many people have reached out via text, calls or social media to ask questions, share a story, or even say thanks for a Facebook update on COVID-19. There is a lot of anxiety and fear everywhere and Carlton County is no different. From hundreds of miles away, I am still proud of all of the efforts I see to take care of that community with helping each other stay safe, stay home and get care when needed.

Q Do you recall a moment or time frame when you knew you wanted to go into medicine?

​A That's a great question. I had a lot of medical issues of my own as a child and that sparked my interest. I remember looking at the anatomy posters in doctors' offices and likely asking too many questions. I loved science, teaching and interacting with people so it was something I entertained, but I did not truly commit to medicine until college.

QHow did you end up choosing critical care and infectious disease specialties?

​A I loved the energy and unpredictability of the intensive care unit. You have to keep your skills up in all of medicine, as you never know what will come through the door on a given day. Any organ can be affected at any time. This is also true of infectious diseases - it is complex and requires excellent overall medicine skills. The combination of the two made complete sense.

Q Do have any words of advice for people in Carlton County or in general as we continue to wade our way through this crisis?

​A As hard as it is, stay home and social distance until public health tells you otherwise. It is not just about you getting sick, as people without symptoms can still spread this virus, but it is about preventing others from getting sick and not overwhelming the hospitals in your area.

Reach out and check in with others. If you have to go out shopping for essentials, offer to drop off for someone else in need. There has never been a greater need for communities coming together to help each other.

Finally, get your information from reliable sources: CDC, World health Organization, local public health or expert physicians in your area.

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