Pandemic Preparedness: COVID-19 Lessons Learned in New York's Hospitals: COVID-19 Lessons Learned in New York's Hospitals

Department

Administration

Document Type

Article

Publication Title

The Joint Commission Journal on Quality and Patient Safety

Abstract

As the SARS-COV-2 pandemic ravaged the world, the United States saw more than 60 million cases and nearly 850,000 deaths directly due to the virus as of January 10, 2022.1 In addition, there were an estimated 198,000 or more excess deaths not caused directly by COVID-19.2 The first peak surge in spring 2020 occurred in Washington State, California, and New York.

In spring 2020, New York City was an epicenter of the global COVID-19 pandemic, with 203,000 confirmed cases between March and May3 (and a peak of >1,500 new hospitalizations per day.4 In March 2020 alone, both Columbia University Irving Medical Center hospitals in northern Manhattan admitted 1,150 adult COVID-19 patients, of whom 203 required mechanical ventilation and 101 died.5 By April 8, 2020, all 23 Northwell hospitals had over 3,500 COVID-19 patients, with more than 800 on ventilators.

The challenges presented by COVID-19 in downstate New York during the initial surge were much more daunting than in other areas of the state. For example, in a one-month timeframe between March 1 and April 4, 2020, one large 12-hospital system in the New York metropolitan area admitted more than 5,700 patients with COVID-19.6 Some hospitals had over 1,000 patients with COVID-19 admitted during that timeframe. Thousands of patients required intubation and mechanical ventilation, extracorporeal membrane oxygenation support, proning, high flow oxygen, and various modalities of dialysis support (continuous veno-venous hemodialysis, continuous veno-venous hemofiltration, sustained low-efficiency daily diafiltration, intermittent hemodialysis, and rapid initiation peritoneal dialysis).

This first surge stretched the ability of New York's hospitals and other providers to deliver care to their communities, despite regulatory waivers issued by the state and federal government early on to provide increased flexibility to enhance capacity and staffing.

Longstanding inequities in healthcare were exposed during the pandemic, leading to greater spread within at-risk communities, increasing the likelihood of an overwhelmed healthcare delivery system.

In preparing for further pandemics, health care providers and administrators have been meeting to explore lessons learned. A critical part of emergency management is the after-action report. Additionally, multiple articles have been published retrospectively analyzing the approach to this pandemic, both in the United States and globally.

In view of the enormous number of cases in the New York metropolitan area in the spring of 2020, when less was known about the virus, analysis of the New York experience will help inform and prepare us for the next surge or future pandemics, and provide lessons for other disasters.

First Page

475

Last Page

491

DOI

10.1016/j.jcjq.2022.06.002

Volume

48

Issue

9

Publication Date

6-10-2022

Comments

See full list of authors at journal website.

PubMed ID

35794059

Link to Full Text

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