There continues to be a tremendous amount of uncertainty ahead, and we need to prepare for a year like no other in our history. Within a week, I’ve been filled with aching despair and am now cautiously hopeful about how people are coming together around our country and the world, shouting out for justice on behalf of George Floyd and asking all of us to back our words with action. Again, we are confronted with the realities of systemic racism as well as the need for reform within law enforcement. I urge you to watch this Obama Foundation “…conversation with President Obama: Reimagining Policing in the Wake of Continued Police Violence” and to also recognize that the problem is rooted in the fundamental nature of our justice system, rather than the individual behaviors of the vast majority of officers who are motivated by a desire to protect and serve everyone, regardless of color. Additionally, we must remain stalwart in our response to the pandemic and its disproportionate impact on ethnic minority communities as well as in our fiscal restraint, giving our economy a chance to recover. We must be victorious in our efforts to close the divide within our nation, which is driven primarily (in the words of Dr. Martin Luther King, Jr.) by the evils of poverty and racism.
After reading my June 1 message, Speaking Out Against Structural Racism, you might be thinking, “What can members of the UCSF community do?” Here are some suggestions:
- VOTE – not only for the big elections. As we saw on June 3, local elections make a difference.
- Allies, do the work to become more informed and participate in training to learn how to call out racial bias in the workplace. Vice Chancellor Renee Navarro’s remarks about anti-Blackness, given at the May 29 town hall, are a powerful read, and I encourage you to engage with the many resources on the Office of Diversity website to counter racism in all its forms.
- Take an active role in advancing the careers of people of color through your service on recruitment and promotion committees. Be a mentor and role model.
- Support businesses owned by Black Americans.
- Support organizations such as the Equal Justice Initiative or Black Lives Matter.
This by no means is an exhaustive list. A quick way to communicate UCSF solidarity is to use the hashtag #UCSFUnitedAgainstRacism on social media.
And importantly, many of you want to know what UCSF is doing as an institution to advance this cause. I’ll write about that next month.
This month’s topics reflect that each of us has a role in supporting the health of our community through these challenges:
- 50 Years of Pride: Let your pride shine online!
- Recovering Equitably: Bearing witness to each other
- Let’s Get Real: Tightening our collective fiscal belts
- Students Answering the Call: Nursing, caring, and being involved
As always, I welcome your thoughts. Please write me at [email protected].
To your health and well-being,
50 Years of Pride: Let your pride shine online!
The June 3 issue of the LGBT Resource Center’s newsletter states, “Traditional in-person Pride festivities may be canceled this year, but queer solidarity lives on and online. Now more than ever we need to lean on our collective power, courage, resiliency, and unapologetic tenacity to live authentically. Please join us virtually as we celebrate our communities at home and in our hearts.”
This month was to be one of the biggest Pride celebrations to date, the 50th anniversary of the first Pride march in San Francisco, which took place in 1970. An annual occasion that thrives on people showing up to live their authentic selves, this year the in-person experience can’t happen due to the pandemic, but “the spirit and the legacy of Pride has not been canceled,” says Klint Jaramillo, director of the LGBT Resource Center at UCSF.
Pride honors the legacies of Sylvia Rivera and Marsha P. Johnson, transgender activists of color who bravely led the Stonewall uprising. As a response to the extreme outrage and grief over the Black lives lost at the hands of systemic racism, the Resource Center newsletter also implores, “It is our collective duty to maintain and honor [their] history and to speak against Anti-Blackness within the queer community and beyond.”
The team in the LGBT Resource Center has created a diverse program of virtual events for the entire University community. One is reflective: creating community forums for folks to congregate online, through Zoom and social media, to share what Pride means to them. Events will also tap into the festive spirit that’s always been part of Pride celebrations, such as vibrant drag shows and high-energy dance parties. “A lot of people are really craving something that is fun and light-hearted,” Klint says. For more details, check for updates on the Resource Center’s events page.
Also working to mark the occasion is the UCSF LGBTQ Committee, co-chaired by Leslie Kleinberg, an EVCP communications specialist, and James Harrison, an assistant professor of medicine. Currently twenty-seven members strong, the committee, which reports to the Office of Diversity and Outreach, has existed since 1994. Since the physical distancing orders came down in mid-March, they have been meeting regularly by Zoom. “We provide space and visibility, so that LGBTQ faculty, learners, and staff can have their opinions and concerns represented to the committee, and then we send these onto UCSF leadership,” James says. He also adds “the committee has been there through good times and bad times,” in reference to the range of social, cultural, and political events that have shaped the LGBTQ community.
The committee and the center share many goals and work closely together on a variety of issues, such as teaming up last year to create a website with resources for UCSF’s transgender community. “In the last couple of years, we’ve been trying to focus on centering the voices of trans and nonbinary people,” Klint says. “Although we have seen tragedies inflicted on our transgender community, we have also witnessed their courage, resiliency, and unapologetic tenacity to live true authentic lives. It’s important for us at UCSF to include and take care of our trans siblings, especially during this time of celebration mixed with uncertainty.”
The center and the committee are also focused on building bridges and fostering a culture of allyship at UCSF, which Leslie describes as “recognizing the intersectionality of identities, strengthening communication, collaboration, and support across diverse groups at UCSF, welcoming our allies to upcoming Pride activities, and engaging them to support LGBTQ people on campus throughout the year.” She notes that the committee will soon be seeking new members for next year and encourages diversity of all types, including gender and sexual orientation, race and ethnicity, and UCSF role and location.
The emergence of COVID-19 has generated sobering reminders of the onset of HIV and the AIDS epidemic in the 1980s and the significant loss of lives, not to mention the struggle to learn more toward finding a treatment and cure. The current pandemic “mirrors the fear, stigma, and uncertainty of those times,” James says. “My own reflection is that governments and leaders have responded immediately to COVID-19 when they didn’t to HIV. This brings up a lot of hurt for some members of our community who were there at that time and lost loved ones.”
Klint agrees. “This current situation can be re-traumatizing and re-triggering to folks who are survivors of that particular moment in time, in that history of the queer community,” he says. “It’s also a reminder of how those folks can also serve as mentors and leaders, to show how we as a community come together.”
Pride is in our hearts and cannot be quelled. In honor of the legacies of Sylvia Rivera and Marsha P. Johnson as well as the lives of Nina Pop and Tony McDade – both transgender people of color killed recently – fly your rainbow flag at home for all to see, and join us online as we celebrate the diversity of LGBTQ+ communities and reflect on their resilience and ongoing struggle. The flag is a rallying banner and opportunity to embrace and celebrate queerness, colorfulness, and authenticity.
Recovering Equitably: Bearing witness to each other
Have you had days like this: e-mail catch-up, planning meeting, brainstorming meeting, teach, committee meeting, e-mail catch-up, collaboration huddle, teach, research, grab food (hopefully), patient care, unexpected call, mentor session, committee meeting, grant writing, lesson planning? Now let’s throw in a global pandemic and shelter-in-place orders making you a full-time caregiver or primary school teacher on top of your usual caregiving responsibilities. What’s at stake? A lot. Health and well-being, as well as increased disparity and inequity.
Working from home isn’t the same for everyone. For a lucky few, it’s resulted in some everyday inconveniences or even some upsides, but for many, it’s pandemonium – with few answers and, sadly, without the usual access to resources. Being home all day with children or other dependents is an enormous challenge, and trying to simultaneously meet the expectations of a full-time+ job can test the fortitude of the strongest and most organized among us.
In these early stages of recovery, Chancellor Sam Hawgood and I recently received a proposal calling for an equitable solution at UCSF that is “…a deliberate and transparent recovery strategy that protects our research investments while safeguarding equity across diverse individuals.” I send my gratitude to Drs. Seemay Chou, Tejal Desai, Hana El-Samad, Danica Fujimori, Noelle L’Etoile, Susanna Rosi, and Lauren A. Weiss for advocating on behalf of their larger community. Over 350 faculty endorsed the statement, “I support the inclusion of provisions for employees and trainees who are caregivers in the UCSF recovery plan.” Read more online. The proposal clearly lays out the consequences related to being a primary caregiver trying to meet the demands and high expectations that come with being a UCSF community member.
Below are a few highlights. My main point is this: UCSF must recognize and plan for the impact of attempting to balance the needs of its people and the institution as a whole. The unsustainable reality of having to decide what does and doesn’t get done – between family, work, and self – is unacceptable. We hear you:
- Of particular concern is the need to help our caregivers (faculty, postdocs, trainees, and staff) with limited access to dependent care, such as childcare, schools, day camps, nursing homes, and care for sick individuals. Without support for these needs, faculty caregivers are disproportionately impacted in their ability to return to work, in ways that will have long-lasting outcomes on their careers, funding, and scientific discovery. Staff employees, who also must live up to high expectations, face the same issues, with the added reality of a salary freeze for policy-covered staff.
- Within the research community, we are already witnessing an alarming divergence in productivity between investigators with and those without primary caregiving responsibilities. It is well-documented that women historically take on a greater role in this regard. The exceptional difficulty of caring full-time for dependents renders women, and others doing the same, vulnerable to leaving academia, and this is particularly true for early-career scientists in the midst of a critical stage of their professional development. The erosion of a productive young generation will mean loss of the investment that UCSF has made in their hiring and a downward trajectory in our science and its standing. Compounding pre-existing inequities may further exacerbate the “leaky pipeline” that we have been striving to repair. Since the current situation is primed to continue, those without caregiving duties will be better positioned to maximize creative output and capitalize on the most precious commodity of the moment: time – but at a tremendous cost. Not having our full contingent of UCSF innovators contributing optimally in the coming months will have major consequences for the intellectual and financial health of our research engine and may squander our substantial gains toward equity and inclusion.
- Grant-writing capacity for scientists who are care givers will continue along a downward trajectory, catalyzing a negative spiral that results in diminished funding and research output, as well as reduced potential for long-term success (a recent call for COVID-related research proposals resulted in funding awards for seven UCSF faculty, none of whom were women). Although tenure clock extensions mitigate some of the short-term impacts, this reactive approach alone will not undo the far-reaching effects of severely handicapping research programs for extended periods, while the unencumbered charge ahead.
The proposal outlines several solutions “…to propel UCSF on a recovery transition trajectory that can enable our bright and diverse minds in discovery and translational sciences to work at full capacity.” While only the first step, the chancellor and I had a fruitful discussion with a large group comprising the individuals who prepared the proposal as well as other signatories, including Dr. Katie Pollard from Gladstone Institutes, which is partnering with UCSF to find solutions. We’re now helping to coordinate the work already underway related to dependent care, testing and contact tracing, and academic advancement. Senior Associate Vice Chancellor of Campus Life Services (CLS) Clare Shinnerl is exploring creative approaches to dependent care that include expanded and subsidized services through Bright Horizons, summer camp (a popular UCSF program of years gone by), and infant and elder care. (Check out the resources on the CLS Family Services website. And please be aware that the overall capacity of childcare and summer camps will be limited due to requirements for physical distancing, so sign up as soon as you can.)
The immense challenge of ensuring an ideal recovery plan for our community is tantamount to defeating the pandemic itself. And again, we are all part of the solution. Addressing the challenges holistically is integral to the recovery of the institution and a commitment to our UCSF PRIDE Values. Many of our colleagues and trainees are primary caregivers, and many of them are working out solutions. Please share your suggestions for solutions. Collectively let’s figure out how we can relieve the pressure on caregivers, and work together to take care of our exceptional community.
Let’s Get Real: Tightening our collective fiscal belts
Yogi Berra said, “The future ain’t what it used to be” – an apt reflection for our current situation.
The economic crisis brought on by COVID-19 adds insult to injury on a grand scale. To minimize its spread and save lives, many of life’s activities are curtailed, leading to one of the greatest financial crashes that by many measures rivals that of the Great Depression.
UCSF is not immune to those economic burdens. While we’ve been able to remain operational in response to the pandemic, the next year is going to be difficult. UCSF has faced financial difficulties in the past, and we are leveraging lessons learned during past crises to find ways to manage what will likely be a severe deficit. We’re not in this alone – this is a global challenge, and UCSF is determined to do its part. Every dollar matters.
Mike Clune, our senior associate vice chancellor and chief financial officer, notes that some of the hits have already happened. Remembering that UCSF Health accounts for 65 percent of our overall revenue, when the stay-at-home order landed in March, UCSF Health cancelled nonessential surgeries, cutting the hospital census in half in anticipation of an overwhelming surge. Thank goodness the surge didn’t happen, but for much of April, our medical center lost $5.5 million a day, and the dental center lost more than $600,000 per week. Additionally, cancelled conferences, lost memberships at the Fitness and Recreation Centers, waived parking fees, and some increased costs, like adding signage and boosting cleaning efforts, exacted a deep toll on Campus Life Services. Further, some revenue sources, such as gifts, private research grants, and investment income, may grow more slowly than expected.
State funds support our educational mission and help provide the academic and administrative support needed to run the University. Even though this is a relatively small share of our overall funding, state funds provide critical flexibility to support the campus. Governor Gavin Newsom has already proposed a 10% reduction in state support for UC.
For now, the research enterprise has not been as affected financially (although scientific productivity has been significantly impacted). Researchers continue to receive grant money, but a bigger impact may be in store. Also looming: as the state budget takes a big hit, we may lose a good chunk of our state funding.
On the education front, we anticipate an eager cohort of new students entering UCSF in the summer and fall and look forward to welcoming back our returning students to campus eventually. Until then, classes are still online (no final decision has been made yet about the future). The consequences are not as sharp as those for some of our sister institutions with large undergraduate populations; therefore, we need to be prepared should the UC system levy cuts on us in order to help shore up the others.
As for staffing, UC President Janet Napolitano and the chancellors of the ten UC campuses announced in early April that there would be no layoffs through the fiscal year ending on June 30, 2020, and the chancellors are now considering what happens next. While we can’t rule out layoffs at UCSF, we have already instituted a hiring freeze that will extend into June 2021. It’s not a “hard freeze,” Mike says. If there’s a key position we need to fill, particularly in patient care, we’ll fill it. On May 18, President Napolitano also announced a salary freeze for non-represented staff and no increase in faculty salary scales for 2020-21.
We shut down most of our capital projects in mid-March to comply with the shelter-in-place order, but construction activity has resumed on most projects, and we are working with our contractors to determine how to mitigate the six lost weeks of construction and get these projects across the finish line. “At the same time, we’re looking at projects that haven’t started yet,” Mike says. “Is this critical to our core mission? Can we push it off a couple of years? For others, we continue to do the planning work so the project will be ready to go when it’s time, including the new hospital and research/academic building at Parnassus.”
The main thing we all have to ask ourselves – and I know this comes up for me and my colleagues in administration all the time – is, if we are going to do something that will cost money – whether you’re hiring somebody, purchasing supplies, or considering a consultant to work on a project – is it nice to have or is it truly essential? How urgent is it? Can it or you wait? Can you and your team figure out a way to become more efficient? Unselfishly and strategically answering those questions as a community will be the key to our continuing institutional success.
An important thing to keep in mind, Mike explains, is that “we’re all in this together. This is not just a problem in the patient care, research, or education spaces. We need to share the fiscal burden as much as possible. You can’t solve your problem on somebody else’s back, and there will almost certainly be cuts in the short term. They’ll hurt and may not necessarily align with our long-term goals but will be essential for UCSF to get through this.” We’ve already asked people to eliminate travel, staff appreciation events, retirement parties, and other events. This is a temporary situation, and we must work as a community to get through it, even though we don’t know how long it will last.
So, what else can we do? As the immediate crisis tempers, teams across the campus are studying and exploring ways to address our financial challenges. All options are being explored, and we want to protect our people as much as possible. The chancellor has asked the schools and administrative units to identify options for saving up to 10% on internal funding allocations, and over the longer term, we are looking at how we can integrate functions and work better together across the campus as well as how increased working from home will change our work life and culture.
The bottom line: it is virtually certain that we will need to endure significant hardships over the short-term in order to recover financially. But, let there be no doubt – long-term we will succeed.
Students Answering the Call: Nursing, caring, and being involved
International Nurses Day is commemorated every year on May 12, the birthday of Florence Nightingale, founder of modern nursing – and 2020 marked its 200th anniversary. People around the world saluted the selfless way nurses have risked their health and answered the call to serve others during the COVID-19 crisis. At UCSF, with the cancellation of in-person celebrations, we observed the occasion with an inspiring hour on Zoom, in which select members of our nursing community answered the question, “What Would Florence Do?” I’m pretty confident that Florence would be proud of their responses.
Student Taylor Cuffaro spoke of the student-led Street Nursing project to advise people experiencing homelessness (now accepting donations!). Professor Orlando Harris spoke about ministering to people in the sewers of Jamaica, where sexual and gender minorities are compelled to live due to societal and economic pressure. Another faculty member, Carolina Noya, told how she helps empower people in Chiapas, Mexico, to take charge of their diabetes care. These and other presenters were a motivational tour de force, representing everything extraordinary about nurses.
Nurses face enormous pressure in their own lives even as duty calls, and UCSF nursing students are no exception. They often tend to be older than their counterparts in the other schools, balancing family needs with their graduate education, and more than half are working registered nurses.
Meet nursing student Rae Wiest: with a decade of experience as an RN, Rae began the first year of the nursing master’s program this past fall. Rae had come out as a transgender person just before starting the program and enthusiastically joined their community by helping to organize the LGBTQIA+ Health Forum that we had in March, just before shelter-in-place.
On a personal level, Rae experienced the sadness of losing a relative during shelter-in-place when their grandfather died of COVID-19 in Arizona. Simultaneously, Rae had the responsibility of planning for their father – who has been recovering from a stroke – to move to the Bay Area. In the professional setting, the crisis made its way into Rae’s work life, where they had to use the same N95 mask for a couple of months – an added stressor on their capacity to do their best work.
On the education front, Rae considers themselves lucky. Clinical hours are a degree requirement for nursing students. Many received a blow this spring when the virus caused their clinical sites to suspend placements, in an effort to reduce potential coronavirus exposure and allow the preceptors to focus on COVID-19 cases. (Students in the other schools also have encountered this problem.) The school scrambled to get students placed and has succeeded in finding alternative clinical placements for most students, with priority going to second-year students to ensure they graduate on time. Luckily, Rae had two clinical placements before the coronavirus. One fell through, but the other picked up the hours, so Rae is set in that regard.
Another student, Genesis Vasconez, feels fortunate that while her placement this spring ended, she had completed sufficient hours last summer and fall. She’s another incredible student, who somehow finds time for a multitude of activities: co-editing Synapse: UCSF Student Voices, serving on the board of directors for UCSF’s homeless clinic, teaching health to inmates at the San Francisco County Jail and, since the pandemic hit, serving with the UCSF COPE program, which offers mental health services to staff affected by stress associated with the virus.
Genesis has been at UCSF for five years, starting as an employee researcher and going on to complete the intensive coursework required to sit for her nursing license and then complete her MS degree, with a specialty as a psychiatric mental health nurse practitioner. She’s working two jobs, which were hard to find; one is per diem work at a skilled nursing facility, the other is full-time, administering COVID-19 wellness screenings to employees at a private company.
Genesis and Rae’s stories gave me such a high that I decided to check in with Jeannine Cuevas, director of communications for the Graduate Division and Student Academic Affairs, who described many students and postdocs who are helping in creative ways.
Hats off to these efforts (by no means a complete list):
- Fabian “Fabi” Hernandez, an MD/PhD student in medical anthropology, is working with both Clínica Martin Baro, providing COVID-19 testing and services to undocumented people, and with the Do No Harm Coalition, fighting for the “de-carceration” of inmates in jails in San Francisco and Alameda counties.
- About 20 global health students are working to translate important scientific publications into 10 different languages for frontline health workers.
- Students and postdocs in the Shokat Lab are making and distributing hand sanitizer to prisons and jails.
- About 100 UCSF students sprang into action to help develop the capability to test for COVID-19 at the Chan Zuckerberg Biohub, greatly expanding the Bay Area’s ability to run tests.
- Larissa Maier, a UCSF postdoc, is working with UN75, the group marking the 75th anniversary of the United Nations (established in San Francisco), in consultation with health professionals around the world, as COVID-19 demonstrates the critical importance of working across borders.
- PhD student Carlos Martinez is working with Refugee Health Alliance and Clínica de Herida to provide hand sanitizer, hygiene kits, and COVID-19 testing for asylum seekers sheltering along the U.S.-Mexico border.
I am in 100% agreement with Jeannine that while highlighting the ways these individuals have decided to answer a call to action, we are not pressuring anyone to do more than they’re capable of doing. “A lot of students are feeling a moral obligation to help people,” Jeannine says. “It’s important that we support all of our students and trainees and remind them to put their oxygen masks on before assisting others. They have to look after their own physical and mental health first. If they don’t feel able to volunteer right now, that’s okay. They can wait, or not do it. Being a student or postdoc has its own obligations. The required studying and training they do is all for the greater good.” Indeed, the same goes for everyone.
Here’s to our learners – our next generation of educators, researchers, and clinicians. Kudos!
Dan’s Tip of the Month
An artist’s duty, as far as I’m concerned, is to reflect the times – Nina Simone
Music was my refuge. I could crawl into the space between the notes and curl my back to loneliness – Maya Angelou
Music celebrates our happiest moments and lifts us from our darkest days, so amidst these tumultuous times, Bobby Carter from NPR’s Tiny Desk concert team curated ‘Hope, Rage And Cries For Help’: 5 Essential Tiny Desk Concerts to promote black artistry and give voice to songs of protest, cries for help, and messages of hope and rage. Each concert is 15-20 minutes long. And closer to home, Tracy García and Melisa Bautista, the assistant directors at the LGBT and Multicultural Resource Centers at UCSF, compiled A Vibe for Community Care & Rest – over four hours of music that provides solace as well as reinvigorates your spirit. As Nelson Mandela said… Music is a great blessing. It has the power to elevate and liberate us. It sets people free to dream. It can unite us to sing with one voice. Such is the value of music.