Are we prepared for the next public health crisis?


The coronavirus pandemic has humbled U.S. healthcare organizations like few events in history. It is imperative for industry leaders to honestly assess whether we’re ready for the next wave or any future public health emergency. 

Will we apply lessons learned if—and more likely when—the virus spikes this fall and winter? In the years to come, are we prepared for another virus that could be far more lethal? 

At Northwell Health, we have treated more than 85,000 COVID-19 patients since March, more than any other U.S. health system. But our preparations for a pandemic actually began 22 years ago when we began building an emergency preparedness infrastructure capable of responding to acts of terrorism and other large-scale emergencies.

Taking our cue from the military and law enforcement, we established a network incident-command structure. This approach involves the creation of emergency response teams that deploy personnel and resources during a public health crisis. We hired experienced emergency management experts, invested millions of dollars in equipment, and trained thousands of staff members and first responders. Based on our experiences during COVID-19, Hurricane Sandy, the H1N1 pandemic and other emergencies over the past two decades, it’s clear this approach can work for hospitals and health systems of all sizes.

Over the past six months, we have been identifying best clinical and operational practices learned from treating more COVID patients than anyone else in the country. 

We detail some of the most important lessons from the pandemic, including experiences in early COVID hot spots like eastern Queens in New York and western Nassau County on Long Island, in a new book, Leading Through a Pandemic: The Inside Story of Humanity, Innovation, and Lessons Learned during the COVID-19 Crisis. Two of our community hospitals created new critical-care space, but they quickly hit capacity as they saw a wave of admissions and a high prevalence of severely ill patients requiring intensive care. From mid-March through mid-April, our EMS transport service moved 810 COVID-19 patients from overrun hospitals to those that had capacity.
Some of the other lessons are obvious, such as stockpiling personal protective equipment, ventilators and lab supplies needed for testing. Diversifying supply chains to reduce reliance on foreign manufacturers is essential. 

Regulatory flexibility saved many lives. The federal government’s emergency use authorization of telehealth services enabled us to continue caring for thousands of vulnerable patients who could not be seen in person because of the risk of exposure. At the same time, the state’s relaxation of certificate-of-need requirements enabled us to expand inpatient capacity by 50% by putting beds in lobbies, conference rooms and other nontraditional treatment areas.

Here are three other steps health systems can take to be well-prepared for what lies ahead. 

  • Make the physical and emotional well-being of staff your top priority. For front-line staff the fear of getting sick and/or spreading the virus to their families was unprecedented. We monitored the mental health of employees closely and provided an array of supportive initiatives in response. We set up tranquility tents to provide staff with time and space to reflect, meditate or pray. On-site counselors helped ease grief and anxiety. Although our health system suffered financial losses north of $1.5 billion, we gave front-line workers a $2,500 bonus and an extra week of paid vacation to acknowledge their heroic efforts.
  • The network incident-command structure mentioned earlier enables leaders to cut through the organization’s bureaucracy and make rapid, well-informed decisions in real time. We highly recommend adopting this approach for any health system.
  • Finally, it is imperative that health system leaders communicate clearly with staff and the public. This is especially true when many government leaders are sending contradictory and confusing messages. It is a matter of national urgency that the voices of science and reason be heard above all others.

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