The early days of the COVID-19 epidemic on Long Island were marked by chaos and confusion in search of a wider plan. Nurses and volunteer EMTs scrounged for sufficient masks and gowns. The state, county, local businesses and school systems pondered shutdowns. Nursing home deaths soared. Hospitals were in many ways left to fend for themselves.
The scramble was clear as health care facilities rushed to add capacity. "We outgrew what we historically thought were really good surge plans very quickly," says John D’Angelo, Northwell Health’s chief of integrated operations.
Nassau and Suffolk doctors even looked across the ocean for guidance. "A lot of the information we got was from European doctors’ experiences who were active on social media or in group chats," says Adhi Sharma, chief medical officer at Mount Sinai South Nassau. Early on, "it was this or nothing."
These kinds of smart, if ad hoc moves, make clear that we need a better plan for future disasters, something more comprehensive than the blueprints that hospitals and government agencies and first responders had in 2020. To do so, Long Island needs a regional task force to gather information about lessons learned and to prepare a road map for action when — not if — the next pandemic or crisis arrives.
THE VALUE OF LOOKING BACK
Conferences or reviews like this are common after major events, from Superstorm Sandy to the Ebola outbreak. Some such convenings and after-action reports usually are jump-started by the state or federal government but Long Island, with almost three million residents in Nassau and Suffolk counties — more populous than Chicago — needs its own playbook as well. Albany and Washington should help Long Island with a COVID-19 convening, including funding.
The already-rehearsed lines of communication between emergency management professionals on Long Island were indispensable over the last year-and-a-half. But these can be boosted. And the ongoing challenge of the pandemic and its delta variant demand preparations for extended emergencies, the likes of which local leaders have rarely faced.
One lesson of COVID-19 has been its wide impact across almost all areas of regional life. A successful plan for future pandemic threats should include diverse inputs: such as health care professionals; utility workers; law enforcement and first responders; county and local government leaders; the Red Cross; teachers; business owners; parks staffers; nursing home and medical society representatives; as well as telecommunications and technology professionals; and more.
Sometimes, gatherings of this kind can appear prescient in hindsight, as with Northwell Health’s 1998 conference on weapons of mass destruction, at which current CEO Michael Dowling says a photograph was shown of a man not then familiar to many — Osama bin Laden.
SUBJECTS TO COVER
A regional focus on how to improve Long Island’s experience in the next pandemic could include:
- Better stockpiling. COVID-19 showed the limit of federal, state and hospital stockpiles of crucial materials like masks, gloves, swabs and ventilators. Having enough usable, fresh protective equipment is key. Too much of that equipment is produced overseas, and on the local level, solutions must be found for facilities that essentially rely on just in time delivery. Similarly, authorities need to be ready in all crises to preserve the complex chains that bring food and water to Long Island.
- Clear plans for collaboration. Among the lessons that hospitals eventually put into practice was balancing the load of patients within and across hospital systems, so no individual facility became overwhelmed. That requires good information sharing and cooperation with ambulance networks as well, emblematic of the larger cooperation across systems that needs to quickly snap into place, with sanitation workers, doctors, county contact tracers and more on the same page.
- Embracing technology. Health care workers turned to telehealth in various forms during the coronavirus pandemic for treatment and to help families and patients stay in touch or undergo the wrenching experience of saying goodbye. But durable IT systems also allowed some county, town workers and court employees to operate at least partially from home. Having a playbook for virtual work that still delivers for Long Islanders — from the judicial system to social services — will be crucial in the future.
- Holding down the fort. First responders, sanitation workers, and others who can't work from home need protocols for how to keep government functions operational for months of crisis, including a playbook for who needs to interact with the public and how.
- Knowing when to kick into gear. Our entire civic system needs a better warning light and process for regional leaders to start taking the emergency actions that save lives early on. By the time Long Island’s preparations were lumbering into action, the virus was already circulating. Next time, we should not wait and hope even as other parts of the world start blinking red.
- Distributing the vaccine. Long Islanders need a solid plan for getting vaccines to the vulnerable, including seniors and the immunocompromised, rather than leaving them at first to struggle with apps and new technology to find vaccination sites.
THE END RESULT
We are still too in the thick of things to bring together the key players who kept Long Island running during the pandemic for at least several months, but let's start thinking about how we live with COVID-19 and keep the next threat at bay.
While Long Islanders proved agile at improvising and showed true leadership, we can't afford to be caught flat-footed again.
MEMBERS OF THE EDITORIAL BOARD are experienced journalists who offer reasoned opinions, based on facts, to encourage informed debate about the issues facing our community.