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Cabarrus Magazine

‘Up Front’ Looks Back at COVID, One Year Later

Mar 17, 2021 10:13AM ● By Jason Huddle

Carolinas HealthCare System NorthEast: The Next Era of Healthcare is Here

This week marks the one-year anniversary of the shutdown to caused this country to come to a complete stop as a result of the COVID-19 pandemic. In this episode we join a panel discussion of frontline healthcare workers as they discuss what they've learned over the past year and where they think we're headed now. Joining us on this panel are: Dr. Katie Passaretti, Dr. James Hunter, Dr. Gary Little, Dr. Jasper Singh, Christian Shulz and Reverend David Carl, all of Atrium Healthcare.

Jason Huddle  00:00

Just a head on Up Front with Cabarrus Magazine, this week marks the one year anniversary of two weeks to flatten the curve. That's right. It's been one year since the COVID 19 pandemic, absolutely shut this country down. This week, we are marking that anniversary by talking to some healthcare workers from the frontlines on what they've learned.

 

Dr. Jaspal Singh  00:20

As much as we gathered together, there was a lot of suffering families were able to come to the bedside, there was a lot of loneliness and a lot of guilt from a lot of my patients who, whose family member think they might have given their loved one COVID and sort of wrestling with all these emotions at the bedside was just really taxing. And I hope that in the future, we can actually if we do get another surge, we can find a way to potentially have more involvement with families, because that was really that's been really hard to watch.

 

Jason Huddle  00:47

Plus, we'll talk about where we are now, and how the new vaccines are slowly getting us back towards something resembling normal. 

 

Dr. Gary Little  00:54

You know, just seeing recently the CDC new new guidelines around people who are vaccinated and what they can do. You know, it's just the beginning of reopening and getting back to our lives. I'm looking forward to that, continuing as we get more people vaccinated.

 

Jason Huddle  01:09

That's all coming up right now on Up Front with Cabarrus Magazine, a presentation of CabCo Media Group and sponsored by Atlantic Bay Mortgage Group, Geico Concord Mills Office, Level Up Realty, and New Hope Worship Center. I'm your host Jason Huddle. Hello my friends, and welcome to Episode 94 of Up Front with Cabarrus Magazine. I am your host, Jason Huddle and as I said in the intro, this is the one year anniversary. It feels like the 10 year anniversary to some of us, but it is the one year anniversary of the shutdown when we were shutting everything down to flatten the curve. Everybody remembers this and it was only the beginning. We thought we would be through this by the end of the spring. And here we are a year later, still wearing masks still dealing with the effects of COVID and still dealing with a pandemic. But nevertheless, things are starting to turn the corner and we have learned a lot. So I wanted to share a conference call that occurred this week with several healthcare workers who have been on the front lines from atrium health. So what you're going to hear is a conversation between these healthcare workers and myself and some of my colleagues in the media as we discuss what they have learned in the first segment of this episode. And then in the second segment, they'll talk about where we are headed now. The doctors you will hear during this episode are Dr. Katie Passaretti. She is the director of infection prevention. Dr. James Hunter. He is the SVP and Chief Medical Officer, Dr. Gary Little is the chief medical officer of the Charlotte region, Christian Schulz is an associate medical director of emergency medicine, and Reverend David Carl. He is the executive director of spiritual care and education. So he's going to give some perspective, from an emotional and spiritual standpoint on the effects of this pandemic. It is very compelling to hear their perspective and I can't wait for you to hear it so I'm going to skip shameless plug time and get right to it right after this break. Stay tuned.

 

Commercial  01:10

 

 

Jason Huddle  01:30

Welcome back to the program. As we jump in on this conference call, the moderator has asked each member of the panel to talk about what they have learned briefly. Over the course of the last year first to speak is Dr. Katie Passaretti director of infection prevention.

 

Moderator  04:16

odeFrom your perspective, as an infectious disease physician, what has been the most challenging part of COVID-19 for you? 

 

Dr. Katie Passaretti  04:25

Yeah, so I've experienced this pandemic, both on the taking care of patients with infectious disease side in the planning and response to the pandemic. You know, the things that have constantly surprised me is just how widely this virus is. As soon as we think we're getting into a rhythm or you know, have control measures and in place, the virus changes something about the community changes and we have to adapt and flex to respond appropriately to that. Along with that is just The tremendous impact that an infectious disease can have not just from my specialty standpoint, like what the infection directly causes, but the collateral impact across really all levels of the healthcare system, across all levels of our society. So you know, it's not just the individual who has COVID, but their family unit, their work unit, you know, just the the rings of impact kind of spiral out time and time again, and remembering that this isn't just an infection, it's that, you know, there are social issues associated with there are issues with people getting health care, in general, their psychiatric impact, you know, that thinking of it just as the infection, you miss the bigger picture of the impact this has had on our on our society. So, you know, definitely tons of lessons learned and, you know, much respect for this virus and the impact it's had on our communities.

 

Moderator  06:01

Dr. Hunter, we'll turn it over to you if you want to give your one minute overview from anything you'd like to share about the past year.

 

Dr. James Hunter  06:09

Thank you very much. So my role is you introduces I'm the Chief Medical Officer for for Atrium Health for enterprise. But more specific to COVID. I played the role of incident commander, and so Atrium early on, organize ourselves through the incident command system. So a well known well proven national system to respond to events and so the incident command role is is a role that I've had. And during that the intent is to organize, communicate, and coordinate, all the different all the different things that are going on all the incredible work that our clinicians did, trying to do that and have communicated consistently across the large atrium, the atrium enterprise so that we don't have variation. We don't have different messaging. And that's been a challenge because theirs was preparation execution. We went down, we had a second wave we had tried to get people who had delayed care in. So there are multiple phases of this. That had to be coordinated, so so very, very most complex thing I've done in my career.

 

Moderator  07:25

Thank you, Dr. Hunter, Dr. Little

 

Dr. Gary Little  07:27

Yes, Good afternoon, everyone. Pleasure to be here. So yeah, as I reflect back, you know, my role has been kind of a couple things, one, leading our medical branch, which, which brings together all of our clinical protocols and guidelines, I provided executive leadership for our testing, when we roll testing out and still continue to test, and more recently, providing that leadership around our vaccination efforts. So it's been a fun time for sure. We we've learned a ton. You know, as I reflect on the things that I'm most proud of, you know, one, it's been our primary goal to keep our teammates safe, is to provide you know, high quality care continuously throughout the pandemic for patients with and without COVID. I'm proud of the fact that we've, you know, really started to highlight some of the inequities and care that exists and how COVID is sort of shed a light on that and how we're addressing, you know, some of those inequities, I'm most proud of just the resilience that that our team has shown throughout this. It's, we've never had anything that we've had to respond to, that's been this day. And so the resilience of the team has just been unbelievable, to watch. And, and, and I'm looking forward to just things getting back to some semblance of normal, you know, to seeing the recently the CDC new new guidelines around people who are vaccinated and what they can do. You know, it's just the beginning of reopening and getting back to our lives. I'm looking forward to that continuing as we get more people vaccinated.

 

Moderator  09:18

(Inaudiable) Thank you, doctor (Inaudiable)

 

Dr. Jaspal Singh  09:22

Thank you. Thank you for being here. And just to add to my colleagues, they've done such a wonderful job preparing and my job is actually on the sort of bedside care. So I'm a critical care, critical care specialist and intensivist. And part of my role and part of my role is actually developing the guidelines that feed Dr. Little's team and the rest of the team as well as the rest of the country. Some of us in Atrium are involved in sort of developing guidelines of what to do with all the information. So I guess my sort of few things that I would take back the maybe bad the conversation is, how challenging it was to sort of to deal with so much information coming at you on certainty and how to pivot quickly how much we needed all our teams, not just bedside physicians, nurses, respiratory therapists, how we needed the our environmental service workers, how much we needed people, our physical therapists, though people that really are on the frontline making all the work happen and we need our administrative partners to really be there for us. And I have to say to Atrium health, we wouldn't, we didn't fret so much about personal protective equipment and other places might have been, I think we've done a I think our leadership is in a phenomenal job with the vaccination program and the idea of being personally safe. But I think the one thing I think I'll leave behind that this year really taught us is the humanity aspect, which is you got to really see people. As much as we gather together, there was a lot of suffering, families at the bedside of families were able to come to the bedside, there was a lot of loneliness and a lot of guilt from a lot of my patients whose whose family members think they might have given their loved one COVID, and sort of wrestling with all these emotions at the bedside was just really taxing. And I hope that in the future, we can actually if we do get another surge, we can find a way to potentially have more involvement with families, because that was really hard. That's been really hard to watch.

 

Moderator  11:11

Thank you, Doctor Singh, Christian Schulz

 

Dr. Christian Schulz  11:14

Hi, Good afternoon. And thank you for having me, I'll echo a little bit of what some of the others have mentioned, as well. I'm a physician assistant by background and have been more and more engaged in our operations and strategic success in emergency medicine over the past few years. First, I can't believe that it's been a year because it feels like it's been three or four years. In my mind, I think when I think back, we started tracking this in about mid January. So in emergency medicine, we kind of knew something was happening, but didn't really know what was going on. And I think to Dr. Singh's point, we were looking for clarity and so one of my roles was, was being placed in a position to be on our em COVID leadership team. And there were four of us that were initially on our primary leadership team to really kind of help assess the situation, identify where our opportunities were in and more specifically, where our gaps were. And one of the things I think I'll say, that I'm most proud of is we literally started every day, with the discussion point of how do we protect our patients? How do we protect our team? And how do we protect our families. And we started that every single day and every meeting amongst our group. And that was important, because I think it helped level set the severity of the situation of the, of the looming crisis of what we didn't know, because the lack of clarity caused a lot of concern amongst our teams amongst our patients and within our communities, we were able to stand up to Dr. Singh's point, communication and information was rapidly coming in. And we were really trying to disseminate that appropriately, limit redundancy, but get factual information to the best that we knew it out to our care teams and align our emergency departments as a collaborative rather than an individual site. And by that work, we were able to stand up several 11 different task forces led by our internal teams, which really helped form our mission readiness, align the team towards, towards success for a common goal, and really move forward collectively so that we all were locked in step, walking together and moving forward. And I'll say I'll probably end here by saying that I've been an employee now for over 20 years here in this organization. And by and large, this is the most, the most work I've probably done. But the most proud I've been of our collective organization and how we've each supported our teams, all of our employees from is actually mentioned, again, from EBS, to our transporters, to our ancillary staff members, our clerical assistants, and a lot of the people who really keep our processes moving. And I'm very thankful for our leadership within our organization and the support that our team has had collectively. Thank you.

 

Moderator  13:54

Thank you and last, but certainly not least, and a little bit of a different perspective, Reverend David Carl,who has been leading the spiritual and emotional response to this crisis, so take it away.

 

Rev. David Carl  14:07

Thank you The it's been my my privilege to serve as a spiritual care leader at Atrium health and to engage the the experts on this call, as well as many others. As we've approached this COVID has been a learning experience that's ongoing. I think that's been said three different ways. What we as chaplains as spiritual care providers needed to focus on is in particular is how to bring healing rituals, even at times of death, how to be with persons who are well, maybe taking their last breath, being able in their mind's eye to as they transition to a next life to be singing in their mind. Breathe on me breath of God fill me with life a new is just connecting people to the spiritual resources. Each brings with them with the the families that was a test for sure. iPads donated have helped a lot allowing them to members as well as area clergy connect up to the COVID patients necessarily restricted with with visitation, then the other big emphasis that we've been involved with has been the support of teammates burnout, compassion, fatigue, all of that certainly existed well before COVID. But I would just say it exploded. So for example, we had planned on in 2020, to have 15,000 interventions multi disciplined to enhance resilience at the unit levels. In 2020, we ended up with 36,000 plus level one interventions to help teammates Remember to practice self care, so they can bring best cares towards others. COVID fatigue was real, and testing a lot of persons endurance. But I'm so proud of the the team here. Having found ways to not only measure that, cope with that, but find ways to even thrive in the midst of that.

 

Jason Huddle  16:16

Stay tuned when we come back, we'll hear about what these doctors think about the new vaccines and where we're headed next. 

 

Commercial  16:22

 

 

Jason Huddle  16:36

This is Jason Huddle with comparis magazine had a question for Dr. Little, doctor, you said that this pandemic exposed inequities in care. Can you elaborate on that a little bit? 

 

Dr. Gary Little  17:19

Yeah, I think it's it's been pretty widely covered that if you look at the communities most impacted by this pandemic are those communities, communities of color, black, blacks, latinos, represent and stuff most most areas of the country, they represent more actual cases of COVID and in some of those groups, they actually represent a disproportionate number of deaths as well and so what that tells me and tells others is, you know, the the likelihood that they're exposed due to you know, economic or other social factors, living situations, work situations, means that they're getting the disease more often and then, for whatever reason, whether that's the end diagnosed later, or inability to get to care, access to care is resulting in more more deaths in those in some of those communities. And so, I think for, for me that what that highlights is, what we've what we've known all along and other diseases that those same dynamics exists, and they've existed for for decades. And I think what's happening now is more and more health systems, more and more private corporations are seeing this as a call to action. And so, you know, what we've seen from, from our own experiences, is trying to address address those social determinants of health and address health equity head on to really get at the underlying issues that cause these disparities. 

 

Jason Huddle  18:59

Thank you doctor. 

 

Caroline Hicks  19:00

Hi, this is Caroline Hicks with WBTV. I'm just curious, looking back a year is it? You know, pretty impressive to think that we now have three vaccines on the market in just a matter of a year? And how is that changing the game for you all in terms of, you know, having to combat this virus? And then, you know, of course, with Johnson and Johnson coming out as well.

 

Dr. Katie Passaretti  19:25

I mean, from an infectious disease specialist standpoint, it's amazing that we have three very effective vaccines that are available to patients and even in the quantities that they're currently available. We've been able to go much quicker than I think most anticipated, to getting to different groups with the vaccine. So, you know, the fact that the scientific community came together the fact that healthcare systems in regions in the United States kind of work together to educate on this vaccine, get the vaccine out and at equitable way. Absolutely. You know, amazing to me. And, you know, that is one of the big things that I would not have predicted a year ago that we would already have three vaccines available that work as well as they do so. Absolutely. From the infectious disease standpoint.

 

Chloe Leshner  20:17

Hi, this is Chloe with with WCNC, kind of similar on the vaccine front, there are still a lot of people who are either struggling to get an appointment, or maybe they can't figure out like the right place to look at the right time. So do you guys have any like maybe tips or tricks? Or have when they should be looking? Is there a certain time, maybe that you all open new appointments, just so they're not kind of spinning their wheels? And going in circles? 

 

Dr. Gary Little  20:42

Yeah, I can take that one. Yeah, probably, you know, it all depends on how tech savvy someone is or not. We've got avenues for people to go online and actually answer your questionnaire and then it will put them on a list that will inform them when it's their chance based on the eligibility requirements. And so that's one way to do it. There is also a phone number that people can call to help them navigate the system for those who are not, you know, tech savvy, and don't feel comfortable going online. The other pieces, we are starting a program where we actually will have vaccine ambassadors, who are people who who are members of the community who will work with us, and actually go into those communities where we're seeing lower vaccination rates, and actually help them to sign up sort of in a grassroots type campaign, similar to you know, when you sign people up to vote, or registered to vote. And so those are those are the three ways that I would find right now the easiest, easiest ways to do it.

 

Katie Peralta Soloff  21:53

Hi, this is Katie Peralta Soloff  along with Axios of Charlotte, I have a question for really anyone at Atrium who's able to address this. A few days ago, we saw South Carolina, roll back some restrictions, namely the mask mandate, I know that they've also, you know, increase the mass gathering limit, for instance, and push back the late night alcohol sales and other such measures that do remain in place in North Carolina. Are you guys concerned, given our location in Charlotte being so close to the border, that we could start to see spillover from South Carolina and an increase in our own infection rates due to people you know, crossing the border either to get tested or to come to work or to visit family or whatever the case may be?

 

Dr. Katie Passaretti  22:36

I can take a stab at that from the infectious disease standpoint. So you know, certainly, especially with adjacent states having different public health measures in place that can create confusion and impact on the adjacent state if they kind of take a different approach. So, you know, certainly in the past, we've seen impact of spillover from South Carolina, on some of our facilities in North Carolina. So certainly something we're watching closely. You know, I am a big believer that for now, the mask mandate is still very important. So glad that and, you know, the majority of our area that's, that's still in place to protect people as we kind of learn more and see how the upcoming months play out. 

 

Dr. Christian Schulz  23:20

Yeah, and this is Christian, I'll speak from the emergency medicine side, you know, certainly from the service line perspective, we, we track our volumes and our facilities capacity very regularly and are very aware of, of situations that may cause challenge in care delivery. And I think we pivot very assertively when needed to address things that we're seeing, you know, kind of popping up on the horizon. I think we're well positioned. Now, I think, you know, in emergency medicine, we know that we're oftentimes the gateway into the hospital, you know, for an emergency from an admissions perspective for patients that are symptomatic or having any emergency condition apart from COVID. And that's certainly one of the things that we've been focused on in emergency medicine as COVID has been a big issue for all of us in our community and in health care. But we also have our finger on the pulse of other conditions to have our stroke patients of our victims of violent crime of our pediatric trauma, cases of things that are arising within our community. And so I think that we we definitely pivot and adapt well, and I think we're well positioned and understand really how best to provide care given different circumstances that might arise.

 

Caroline Hicks  24:32

Hi, this is Caroline Hicks with WBTV again, can you guys talk about I know this week, Atrium is able to offer some more mass vaccination sites, Bank of America stadium and then I think this weekend at Johnson C. Smith University. Can you talk a little bit about how the additional J&J and other doses are helping you guys to be able to do this and just some more info on that?

 

Dr. Gary Little  24:56

Yeah. I think you know, as supply increases from the state increases to the vaccine administrators, which were one of. And when that happens, especially when it coincides with a new group being eligible, that's it's really helpful because there's typically a lot of pent up demand. And when those groups open up, they're looking to get vaccinated. So our ability to match, you know, our supply of vaccine to that new demand is crucial to getting people vaccinated as quickly as possible. So as long as you know, right now, the limiting factor is still vaccine availability. You know, hopefully over the next several months that that will change as more vaccine becomes available. But there's still a lot more people that that need to get vaccinated, you know, so it, it's just trying to keep match those waves of eligibility with with vaccine availability. So, we've been fortunate that we've been able to keep up for the most part.

 

Jason Huddle  26:03

Stay tuned, we'll be back to wrap up the program right after this message.

 

Commercial  26:06

 

 

Jason Huddle  26:46

As we close out the program this week, I just want to thank all the health care workers and everyone who's been involved on the front lines over this past year dealing with COVID we cannot thank you enough for your sacrifice and your selflessness in dealing with this pandemic. That being said, no matter where you stand on masking or safety protocols or anything like that, the truth of the matter is the only way we get completely through this situation is together. And so I implore you to keep supporting each other, keep supporting those that are helping other people get through this. And I dare say it looks like the light at the end of the tunnel is finally visible. And I don't believe it's an oncoming train. Maybe that's the optimist in me I don't know. You have been listening to Up Front Cabarrus Magazine, a presentation of CabCo Media Group and sponsored by Atlantic Bay Mortgage Group, Geico Concord Mills office, Level Up Realty and New Hope Worship Center. It is hosted and produced by yours truly Jason Huddle until next week. Keep fighting the fight y'all!

Episode 94: COVID-19, One Year Later

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