As public, academic, school, and corporate library workers have been watching their workplaces close and striving to adjust to self-quarantining, another type of librarian faces additional challenges as a result of COVID-19. As health professionals, medical librarians are sometimes considered essential personnel and therefore required to work, either onsite or remotely. Even if they are staying at home to “flatten the curve”, the information they provide must travel to physicians, nurses, hospital administrators, patients, and the general population. Different medical libraries have developed various strategies to meet these challenges.

The staff members at the Learning Center at University of Texas MD Anderson Cancer Center, with its many immunocompromised patients, are no strangers to taking precautions to avoid spreading germs. According to Senior Librarian Adela Justice, “[t]he library was told that our cleaning practices (wiping down computer keyboards, tables, etc.) were in line with hospital standards, so all this time we’ve been in compliance even though we weren’t sure if what we were doing was enough, at times.”

Justice commented that her hospital had been making steps in response to the outbreak for some time. “In terms of working with cancer patients, MD Anderson Cancer Center was definitely taking this seriously a bit earlier than I began seeing other companies and organizations. We were told to stop having meetings with groups of more than 15 people over two weeks ago, and then we were suggested to start bringing our lunch to work and not congregate in the cafeterias and other public areas. They sent out directives on how many caregivers a patient could bring with them to appointments: no more than two and 18 or over only. Last Thursday [March 12], all employees were told we had to enter the hospital buildings at only selected entrances (no more entering through our other access points, for example, I usually cut through the hotel attached to my building) and this week they started screening everyone’s temperature.”

As of March 18, she felt “relief that we are closed. It was impossible to maintain a 6-foot distance from our library users in many situations, such as when helping them make copies, send faxes, check out books to them, and help them with their MyChart on their devices. I’m also very grateful that as a cancer hospital, we were taking this seriously early on, because it rubbed off on me. I was definitely an early adopter in my personal life and practices, when public figures and people on social media were still saying it was a hoax or not a big deal.”

Temple University Medical School’s Simmy and Harry Ginsburg Library also closed on March 18, but the workload did not cease. Jenny Pierce, Temple’s Head of Research, Education and Outreach Services, Health Sciences Libraries, and Head of Science, Technology, Engineering and Biomedicine Research and Instructional Services, Charles Library, explained, “All of the librarians have liaisons assignments with education responsibilities. We have been in contact with faculty, residents, and staff that had planned library instruction about moving that online as well. We have already scheduled some noon conferences as synchronous sessions. They will be recorded for residents to view any time.” In addition, the librarians provide patrons reference help via texting and teleconferencing.

Duke University’s medical librarians are also working remotely. “We had a conversation of the library counsel, chairs, and department heads in the library and other library administrators a few weeks ago,” recounted Beverly Murphy, Assistant Director, Communications and Web Content. It was decided that everyone would need a laptop for remote work. “Staff can badge in. We would be available remotely. All of our classes are online. I’ve had four calls today for various things today.” As the outgoing President of the Medical Library Association, Murphy had planned to fly to Hawaii for a chapter conference scheduled for March 25. However, after the second scheduled speaker canceled, the conference was postponed.

Coronavirus has not slowed Western Michigan University Homer Stryker M.D. School of Medicine (WMed) usage. Indeed, as Library Director Elizabeth R. Lorbeer wrote, “Being that the medical library is all-digital, with no physical print collection, the librarians regularly perform their work within the learning community and clinical setting. We are used to working in a non-traditional environment and can set up shop anywhere. Right now, we are working from home using Microsoft Teams, email, and the phone to communicate. The librarians noticed earlier this month an increase in the number of users requesting library support through established online channels, so we were already in the process of making adjustments to provide rapid response to informational needs.”

Some librarians, such as Helen-Ann Brown Epstein at the library Informationist Health Sciences Library at Virtua Health, worked online already, so their transitions have been very manageable. “I needed to curtail my clinical outreach during this time, but just took my library home with me and can access it remotely. That part of my job has not changed.”

In contrast, Trinitas Regional Medical Center in Elizabeth, NJ, is still open for in-person visits, Elisabeth Marrapodi, Director, has noted fluctuating foot traffic. “We have zero foot traffic,” Marrapodi said on March 17. “Yesterday, we had a full house…. I’ve actually appreciated that it’s quiet here today so I can gather the COVID-19 information.” Onsite usage of later increased. On March 23, Marrapodi wrote, “Actually our foot traffic increased and today we are issuing restrictions to a patient care related only business model with a five patron limit within the physical library in order to maintain social distancing in a very small library.”

OTHER DUTIES AS ASSIGNED

In addition to their normal work, WMed Lorbeer noted that Dr. William Fales, the State Medical Director for the Michigan Department of Health & Human Services, Division of EMS and Trauma, requested that WMed librarians “provide regular briefings from the peer-reviewed medical literature on potential treatments for the coronavirus. The Director recommended a fourth-year medical student, with a degree in public health, to assist us with synthesizing the research into daily briefings. The WMed librarians delivered the first briefing on Tuesday.”

The WMed librarians have been consulting the CDC’s website for authoritative, up-to-date COVID-19 information and recommend their patrons do the same. “In addition,” Lorbeer added, “the librarians review daily the content posted on the local and state government public health web sites for the latest information affecting our community.”

In addition to supporting Trinitas’s medical administration, staff, nurses, and patrons, Marrapodi has been supporting consumers around the world through the 3-D virtual reality program Second Life.

Second Life ’s host site, Whole Brain Health within Second Life, aims to keep people over fifty-five mentally active. “People have this stereotype that senior citizens can’t handle a smart phone,” Marrapodi commented, but over 20,000 people have seen Marrapodi’s virtual displays. She enjoyed receiving a thank-you email from a research scientist in Singapore for her efforts educating consumers on the coronavirus.

One challenge for Marrapodi on this project is finding up-to-date COVID-19 information in Spanish to include in the program. “I’m finding there’s not much material that’s been translated into Spanish.”

STAFF SELF CARE

The demands of managing information during a pandemic can seem daunting, but some medical libraries have found ways to help their staffs handle the stress. In the guide that Temple’s medical librarians created to help each other and their co-workers provide information on the coronavirus, there are links on self-care as well as COVID-19 prevention and testing. “We added self-care because there is concern about the effects of prolonged isolation and cabin fever on library staff,” Pierce wrote.

WMed also has plans to help librarians to handle the recent increase in patrons’ information needs. Lorbeer explained, “[W]e came up with a plan to stagger the times we are available online throughout the day to give each other wellness breaks. Taking a few minutes to practice mindful meditation or to take a walk will help us remain sharp. The disaster preparedness training the WMed librarians received through the National Network of Libraries of Medicine and the Medical Library Association has given us the ability to plan more effectively for the unknown. We attend year-round wellness workshops offered at the school to mitigate symptoms of distress and burnout. Our morale and outlook remain positive because we know that together as a team, we will overcome challenges.”

“The good news,” said Murphy, “is we know what’s going on. A lot of us are not panicked. We know where we’re going to get information…Where we’re torn is how we can help our doctors and our nurses.”