Michael Dowling: COVID-19 put my system through hell and back

I am not exaggerating when I tell people that my organization, Northwell Health, has been through a war. What other metaphor even comes close? 

We've experienced the slow growth of COVID-19 and the phenomenal growth of COVID-19. We've seen the fast progression of this virus and the extraordinary amount of death it causes. We fought many battles, including those to create hundreds of new beds per day, secure personal protective equipment and ensure we had the right staff ready around the clock. 

Northwell treated more than 50,000 COVID-19 patients — over 16,000 were inpatient. Much has improved over the past few weeks. We have been in a downward trend, with fewer new cases and dramatic reduction in hospitalizations. We are in recovery while ever cognizant of the possibility of a resurgence, especially as we observe the opposite trends in much of the rest of the country. 

We have been through an exceptional and unique experience, and we have an unusual vantage point as we witness what is going on in hospitals around the country. It serves as a stark reminder of how bad the pandemic was and how rapidly the situation deteriorated. It will get worse in these states, and they have to be prepared. 

As the leader of the health system that cared for more COVID-19 patients than any other organization in the U.S., I offer a few general points of guidance. 

1. Masks work. If you work in healthcare, you must wear a mask — when working and when not. It's that simple. Set an example for your organization, family and friends and the community. People that do not wear masks are essentially saying they are not concerned about others. 

2. Take exceptional care of your staff. Much of the public's focus and yours will be on adding beds, increasing ICU capacity and acquiring PPE. The safety and morale of your staff, however, is by far the most important. Be visible, communicate constantly, and provide all the necessary physical and psychological supports. They are the troops who do the work. 

3. Get ready for a financial hit. Northwell is estimating a multi-billion revenue loss by 2021. Did I dwell on this as a priority during the crisis? No. In a crisis like this, you throw the budget out the window and do what is good for your community and your people. Deal with it when the surge subsides — which is what we are now doing and which will continue for the next few years. 

4. Keep positive. We are so fortunate to be in healthcare — we are the essential asset and the safety net when situations like these occur. We save lives and we make a difference. We are in a position of great responsibility. While the financial impact on us is great, think of those other businesses who may never again reopen and families whose lives have been forever changed. Some have lost everything. In that context, we are fortunate. Perspective matters.

5. It does not end with a vaccine. A vaccine, when it becomes available, will resolve part of the problem caused by the pandemic. It helps solve the medical issue, but not the overall economic and social dislocation. That will be a work in progress for the next five to 10 years, so plan on difficult years ahead. We all face circumstances we can't control. It's how we react to them that defines our character. 

6. Keep learning. We don't yet know the long-lasting effects of COVID-19 on its survivors. To have been hospitalized and discharged is a feat. These were some of the brightest moments we experienced at Northwell, celebrating more than 15,000 patients who returned to their families after recovering in our hospitals and ICUs. But the fight doesn't end there. Health systems will need to spend time and resources on unresolved healthcare issues that may result from being a COVID-19 patient. The demand on our organizations is still unclear, as there is still too much we do not know. But as we continue to learn, our communities and patients will look to us for answers. 

7. Resist division: Unify. The initial surge of this virus brought much distress and despair, but the sense of unity we experienced in responding is perhaps the only thing I wish I could have bottled. Everybody came together. It must carry on. COVID-19 unified us in ways we had not seen in a long time, joining us in a fight against a common enemy regardless of political persuasion, religion or ethnicity. As politicized as the country remains, we have an opportunity on the good that has come out of the pandemic. We should not be arguing, for example, about wearing a face mask. It is not a political statement, it is a necessity. As leaders, our ability to resist divisive rhetoric and meanness is being put to the test every single day. Remain vigilant. Rise above. The coronavirus doesn't care who you vote for. 

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