No COVID-19 playbook was sitting on Pennsylvania’s hospital leaders’ shelves when cases began to spread into the Commonwealth last year. It had to be built through collaboration between hospitals and first-hand experience.
The most cases of coronavirus in the midstate arrived near the end of the year but hospitals in the region had been learning, preparing and treating for the virus for months at that point. Today, those systems are in a very different place than they were in March 2020.
“It’s hard to believe that a year ago the virus was just arriving in our region,” said Lou Baverso, COO at UPMC Pinnacle and president of the Central Region. “It seems like much more time has passed, as we’ve come so far since then. We have learned so much about this virus, yet there’s still so much we continue to discover.”
UPMC had already prepared for a crisis like the pandemic with an expansive contingency plan so, during the pandemic, its hospitals were prepared to lower exposure among staff and patients and allow for continued access of care, he said.
York-based WellSpan Health’s leadership kept a close eye on the virus and first began tracking the pandemic early last year. Anticipating that the Novel Coronavirus would be reaching Pennsylvania, WellSpan created a supply chain command center to monitor potential impacts on the system’s personal protective equipment (PPE).
“In early March, we went to full command center mode and immediately knew our communities could be vulnerable to a significant risk if the virus began to spread,” said Dr. Roxanna Gapstur, president and CEO of WellSpan.
The learning curve
Hospitals had a difficult road ahead of them early on. It took weeks to fully understand that someone with a loss of taste or smell, or with flu-like symptoms all could have COVID-19, said Jan Bergen, former president and CEO of Penn Medicine Lancaster General Health.
“The first part of our work was to become better educated and informed about what someone may look like that is presenting with COVID-19,” she said. “There was a lot of collaboration among the systems within the county to share info with one another.”
At Penn State Health, dozens of Milton S. Hershey Medical Center workers already had special pathogens training thanks to the Hershey-based system’s designation as an Ebola Treatment Center in 2015. Dr. Peter Dillon, chief clinical officer at Penn State Health, said there was still much information for the system to learn about caring for COVID-19 patients.
“The special pathogens training included best practices for keeping equipment sterilized and protecting patients and themselves from deadly germs,” he said. “While that work was certainly applicable to our organization’s response to COVID-19, the pandemic also required some specific adaptations”
Organizations like Penn State Health took advantage of their expansive buying power to develop relationships with supply chains and keep a steady flow of PPE coming into their facilities. Dillon said that the system not only formed partnerships with its supply chain, but partnered with its colleagues at Penn State to design and 3D print PPE.
WellSpan was prepared regarding infrastructure in its supply chain, finance, communications, philanthropy and human resources, said Gapstur. Where the system was unable to secure PPE, it created its own supply chain by working with York County manufacturers.
WellSpan’s largest vulnerability was its rapid growth over the past seven years, said Gapstur.
“We were still in the process of integrating some of the new partnerships,” she said, adding that her team swiftly realized it would need a system-wide incident command structure rather than allow each hospital to address its own needs.
Health systems and their providers had to resort to mostly telehealth services last spring as quarantining kept patients from coming in for exams, unless their symptoms were severe enough to warrant it. This was compounded by the fact that hospitals were unable to offer non-emergent services from March to June.
By the summer, hospitals began reopening their services and saw fewer cases after a peak in April. But the reduction didn’t last as infections increased in the fall.
Lancaster General Health saw a peak of 160 inpatients with COVID-19 in the late fall and Penn State Health saw 230 patients between Holy Spirit Medical center, Milton S. Hershey Medical Center and St. Joseph Medical Center on Dec 29
“In all the communities UPMC serves, COVID-19 cases were relatively low through the first half of 2020, but numbers drastically spiked in November and December,” said Baverso. “The ebb and flow of COVID-19 cases made constant communication with the public essential, as guidance changed almost daily.”
Early 2021 marked a decrease in cases, and by then midstate hospital systems were well into the next chapter of the pandemic– getting vaccinations to the community. By late March, Penn Medicine Lancaster General Health had fully vaccinated 60,000 people and partially vaccinated 51,000. Across all of its hospitals, UPMC had administered more than 297,000 doses as of March 26 and WellSpan provided more than 177,000. By early April, Penn State Health had administered more than 100,000 doses from four dedicated vaccination sites as well as a series of pop-up vaccination clinics for underserved populations in Harrisburg, Lancaster and Reading.
Test of leadership
The past year acted as a test on all leadership teams but for health systems providing care for their communities while looking to protect their staff, 2020 was particularly taxing.
But despite the unprecedented nature of the crisis, Dillon said it’s up to systems to continue to provide care to their communities, even more so after many patients delayed their care for routine checkups and other health conditions.
“We have a responsibility to be in touch with the psychological and emotional well-being of our communities and that has never been more apparent than this past year,” said Bergen.
Baverso highlighted the need for constant, clear and adaptable communication, adding that it was crucial for UPMC to always be in touch with the community, providers and employees when new information was available.
“The adversity of the pandemic is not yet over – but the glimmer of recovery is within our reach,” said Gapstur. “Our gratitude shines for the many team members who walked as a trusted partner alongside our communities.”