Editorial: The virus next time and now

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One more startling fact about the coronavirus pandemic is that Northwell Health actually began preparing for it 20 years ago, according to Michael Dowling, the president and CEO of the health system.

The hospital network, now the largest in New York state with 23 hospitals, 800 outpatient facilities and 72,000 employees, actually wasn’t preparing for COVID-19 20 years ago – just large-scale emergencies.

In this case, the attack on the World Trade Center on 9/11.

FBI special agent John O’Neil, then the head of a joint terrorism task force, was sounding the alarm about the lack of preparation by health systems for a large-scale attack in this country.

In one presentation a year before 9/11, O’Neil flashed the picture of Osama bin Laden on a large screen and announced that the al Qaeda leader planned to attack the United States, Dowling recalled.

O’Neil, who would leave the FBI and become head of security for the World Trade Center, died in the attack on 9/11.

Northwell, in the meantime, had begun to build an emergency preparedness infrastructure headquartered in Great Neck.

Perhaps more stunning than Northwell’s prescience in preparing for a coronavirus pandemic is the failure of this country to follow the lessons Northwell and other health providers learned in responding to the first wave of the pandemic that struck the United States in February.

Dowling, who not only led Northwell in tackling  a health threat that no one had seen in 100 years but helped Gov. Andrew Cuomo guide New York state’s response, actually co-authored a book on it, “Leading Through a Pandemic.”

In the book and an appearance at a Blank Slate Media town hall last Thursday, Dowling discussed the response of Northwell and other New York health care providers to COVID-19 and what was needed to rein in this pandemic. And, frighteningly, even more deadly viruses predicted for the future.

Dowling’s recommendations included building an emergency management culture, committing to regulatory flexibility, addressing inequities in access to health care based on race and income, educating the public, protecting the physical and emotional health of the staff, increasing the focus on safety measures in congregate settings and reversing “America’s cultural disrespect for science.”

The recommendations were based on Dowling’s experience in grappling with a coronavirus in its earliest days that health professionals had never experienced before with its ease of spread and its lethality.

Doctors, nurses and other health professionals with years of experience would be confronted by a level of death and suffering they had not seen in hospitals before with room after room filled with COVID-19 patients silent but for the sound of ventilators pumping.

The hospital staff did so despite fears for their own lives and those of their families.

So far, the Northwell Health system has treated 101,000 COVID-19 patients, including 16,000 who were hospitalized, more than any other hospital system in the country.

Thanks to an emergency order signed by Cuomo, Northwell and other health systems drastically altered the ways hospitals operate to permit the quick expansion of beds, moving patients from overcrowded hospitals to less crowded hospitals within a health network and outside a health network.

The hospitals also adopted social distancing, the wearing of protective gear and better treatment for patients, who improved. A shutdown of the state reduced the spread.

Eventually, in New York and other surrounding states, the rate of infections and death dropped.

When Dowling’s book went to press in July, 4.5 million people in the country had been infected and 154,000 people had died.

But as of Tuesday, the number of people infected exceeded 18 million and more than 320,000 had died.  And some scientists now predict as many as 550,000 will die by spring – even with the introduction of vaccines.

What went wrong? Why so many infections and deaths after so much was learned about the disease?

When asked, Dowling picked his words carefully. We won’t.

In what is perhaps the greatest failure in leadership in the history of this country, President Donald Trump refused to lead the fight against the pandemic.  Instead, he became its No. 1 source of disinformation.

As shown in Bob Woodward’s book “Rage,” Trump knowingly downplayed the COVID-19 pandemic to the public, saying it was no worse than the flu, that it would go away quickly.

In his book, Dowling discussed how Northwell was in touch with scientists in
Wuhan, China, thought to be the source of COVID-19, and Italy, the European country most severely impacted by COVID-19.

Those scientists, Dowling said, shared what information they had in the early days of the pandemic.

Asked if Northwell officials had heard anything from the federal government, Dowling said they had not.

Trump just didn’t ignore the science of masks and social distancing, he made following it a partisan issue. He promoted bogus treatments at the expense of viable treatments. He conducted a presidential campaign that featured super-spreader events.

Trump was aided and abetted by social media, Fox News and other like-minded news organizations as well as red-state governors following the lead of their president.

The proof of this malpractice can be seen as the virus has raged across the country this fall and winter – after Trump and others dismissed the second wave of infections predicted by scientists.

There is no question that more Americans would be infected and die from a virus as deadly and easy to transmit as COVID-19.

But tens of thousands of Americans would still be alive and many more would have avoided infection and its potential for long-term effects if the entire country had followed what scientists and health professionals like Dowling had advocated.

And the pandemic is not even over.

New York, like most other states, has seen a large spike in deaths and infections in recent months, but far less than what is being experienced in most places in the country.

It is a frightening fact to consider that the devastation now taking place in other parts of the country is occurring months after they watched the devastation caused by COVID-19 in New York in the spring.

Dowling, who was recently voted No. 2 on Modern Healthcare magazine’s list of 100 most influential people in health care, said he expected it would take six to nine months before 75 to 80 percent of the public is vaccinated – the percentage of people needed to create a herd immunity to allow for a return to what will have to pass for normalcy.

Northwell has been tasked by Cuomo to lead the vaccination efforts on Long Island.

One of its hospitals, Long Island Jewish Medical Center in New Hyde Park, was fittingly the place where the first vaccine in the country was administered last week before a national audience. And an emergency care nurse from Port Washington via the island of Jamaica who works at the hospital was the first person to receive the vaccine.

But those efforts will fall short unless enough New Yorkers follow the science and get vaccinated when it is their time.

And we all will not be safe from future pandemics until we follow the guidelines and science as prescribed by Dowling and other highly respected health professionals.

 

 

 

 

 

 

 

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