Early lessons could help in future crises
The COVID-19 pandemic tested the nation’s health care system in ways never imagined, and officials say the lessons learned have left the state better prepared for the next one.
“We will be so much better prepared just because of the recognition of how important public health is,” said Greg Buller, chief medical officer at Bridgeport Hospital.
“Our health systems have been overused and we have begun rebuilding our public health infrastructure and looking at what to expect when the next pandemic hits,” Buller said.
A variety of health care officials said the ongoing COVID battle brought both success and failure. And while most agreed the state’s health care system is better positioned, they said challenges remain.
“We are undoubtedly better prepared, but the proof will be in the pudding,” said Jonathan Siner, director of intensive care at Yale New Haven Hospital.
“Does this mean operations have changed across the board?” Siner said. “I don’t think that where we are — if we just walk away now — we should walk away without a more specific plan.”
Siner said that plan “will require a lot more coordination and the government could defray some of the costs.”
COVID presented — and continues to present — a crisis of unprecedented proportions, officials acknowledged.
“We have seen what didn’t work over these past months, and what did work,” said Lawrence Santilli, chief operating officer for Athena Health Care Systems, which operates 48 nursing homes in Connecticut, Massachusetts and Rhode Island.
“Only by learning those lessons, and acting on them, will we truly live up to the sacred trust we have to care for those who need it most during these difficult times,” Santilli said in a recent statement.
Nursing homes
The Nursing Home and Assisted Living Oversight Working Group, a bipartisan coalition formed by Gov. Ned Lamont, released a series of recommendations
last week designed to help nursing homes deal with the next pandemic. The facilities were hard hit last year and deaths among residents account for nearly 60 percent of the state’s overall fatalities.
Ideas include renovating nursing homes to reduce capacity, changing layouts, replacing obsolete HVAC and air circulation systems, updating minimum staffing mandates and creating loan programs to help cover upgrades.
“There is a real opportunity here to bring our nursing homes up to date,” said Patrick Coll, a working group member and medical director for the Seabury Life Care Center in Bloomfield and Pilgrim Manor nursing home in
Cromwell.
“This effort will hopefully make that happen,” Coll said, referring to the working group’s recommendations.
State Rep. Jonathan Steinberg, D-Westport and co-chairman of the public health committee, said money is going to be the biggest challenge, noting the state is facing deficits.
“It requires money, and we are in tough shape,” Steinberg said.
Steinberg said other shortcomings were also exposed by the pandemic.
“This is a public health crisis that exposes the fact that we made a lot of sacrifices (over the years) due to budget restraints,” Steinberg said, referring to funding for the public health system. “I hope this gives us renewed commitment to help third party providers and have adequate reimbursements for critical life-saving activities and communicate to people about health and safety.”
Hospital lessons
John Murphy, chief executive officer for Nuvance Health, which owns the Norwalk, Danbury and New Milford hospitals, said hospitals initially faced an onslaught of misinformation that has now been cleared up.
“What struck me is how many things we were told early on — kids don’t get the disease, it’s not airborne, steroids should be avoided and vaccines will take years to make,” Murphy said, pointing out that none of those turned out to be true.
“We had prominent officials say masks are not necessary,” he added.
Several health officials said the pandemic also exposed the disparity within communities and how unequal access to health care can produce different results, such as the high death rate among Black people.
“The thing we really learned is health disparities and socioeconomic disadvantage has big impact on who gets sick,” said Siner, the Yale New Haven Hospital ICU doctor.
Another lesson, Siner said, is that there needs to be better coordination between local and regional hospitals, and even across state lines.
“The U.S. health care system is fragmented,” Siner said. “In the spring, if there was more ability for New York City to send patients elsewhere they might have been better off.”
There was some sharing of capacity, at least within Connecticut, several hospital officials said. Stamford Hospital, for example, was able to seamlessly “offload” patients to other hospitals when it was overwhelmed by the virus.
Murphy added the huge amount of supplies needed during a pandemic remains a challenge.
“Stockpiling personal protection equipment is going to be business as usual,” Murphy said.
“We have meetings where critical leaders come together on a weekly basis,” Murphy added. “Even now, with a playbook available, people need to know where to look for it and where things have changed.”
Anne Diamond, president of Bridgeport Hospital, said planning for disasters has changed.
“We planned and drilled, but that was for a short duration disaster — a snowstorm, a flood or electrical outage,” Diamond said.
“Although we had the foundations, we had to modify it for a pandemic response,” she said.
Diamond said Bridgeport Hospital also became more efficient at managing patient flow and keeping COVID and non-COVID patients apart.