The Covid-19 Response in New York City

Dr. Syra Madad, DHSc, MSc, MCP, CHEP, is an internationally renowned public health leader, biosecurity advisor, and epidemiologist in special pathogens. She serves as the Senior Director, System-wide Special Pathogens Program at New York City Health + Hospitals, and Co-Principal Investigator of NYC Health + Hospitals Institute of Diseases and Disaster Management. Dr. Madad is Core Faculty in the National Emerging Special Pathogens Training and Education Center, and affiliate faculty at the Center for Emerging Infectious Diseases Policy and Research at Boston University. In addition, she is a fellow at the Harvard Kennedy School Belfer Center for Science and International Affairs and Healthcare Simulation Fellow at The Institute for Medical Simulation and Advanced Learning. She has over 100 publications including opinion pieces in major news outlets and is featured in 1 Emmy-nominated and 3 additional public health documentaries. Dr. Madad’s work focuses on all 5 phases of emergency management: prevention, preparedness, mitigation, response and recovery from infectious disease threats with an emphasis on healthcare and public health biopreparedness. Dr. Laura Iavicoli, MD, MBA, FACEP, CHEP, is a Board-Certified Emergency Medicine Physician, Chief Medical Officer for New York City Health + Hospitals/ Elmhurst. As the Senior Assistant Vice President for Emergency Management for New York City Health and Hospital System, she helped lead the health system through the COVID-19 Pandemic response. Dr. Iavicoli interfaced at the local, regional, national, and international level to assist with crafting and implementing Covid-19 response protocols during the Covid-19 pandemic response. She has served on numerous national, regional, and local committees devoted to emergency management. She presents and trains both nationally and regionally on topics pertaining to disaster preparedness. She served as a Disaster relief team member for >10 years for NYC and Federal Emergency Management Agency (FEMA) and is well published in the field. Dr. Iavicoli has worked clinically and as Emergency Management clinical leadership at Elmhurst Hospital, a teaching affiliate of Mount Sinai Medical Center for 20 years, and trains and teaches Emergency Medicine Residents and Medical Students in Emergency Medicine. She is a Fellow of the American College of Emergency Physicians specializing in Emergency Management and is a Professor at the Icahn School of Medicine at Mount Sinai. Dr. Eric Wei, MD, MBA serves as Senior Vice President and Chief Quality Officer for NYC Health + Hospitals, the largest municipal safety-net health system in the United States, serving over 1.3 million New Yorkers every year. He is a Professor of Emergency Medicine through the Icahn School of Medicine at Mt. Sinai and Adjunct Professor for the NYU School of Global Public Health. He is the fellowship director for the NYC Health + Hospitals Clinical Leadership Fellowship. He is a practicing Emergency Medicine physician rotating through all 11 Emergency Departments in the system. Dr. Wei oversees the Office of Quality & Safety, which includes Emergency Management for the system. Dr. Wei previously served as Interim Chief Executive Officer of NYC Health + Hospitals/Elmhurst in 2020 and NYC Health + Hospitals/Harlem in 2021.

Section I: In the beginning
1. Standing up the emergency response in the epicenter of the epicenter
Colleen Smith, Suzanne (Suzi) Bentley, Geoff Jara-Almonte, Veronica Delgado, Phillip Fairweather, Cathy Lind, Ram Parekh, Stuart Kessler and Laura Iavicoli
2. The history of NYC Health þ Hospitals
P.J. Rosenstock, Machelle Allen and Nate Link
Section II: The pivotal moment
3. Emergency Departments spring into action
Jeremy Sperling, Adrienne Birnbaum and Rajneesh Gulati
4. The crisis shifted to the intensive care units
Alfredo Astua, Leon Boudourakis, Marialeah Cervantes, Matthew Langston, Vikramjit Mukherjee, Vito Stasolla and Amit Uppal
Section III: A system surge plan put into place
5. Bringing key players together, standing up incident command, and communicating with everyone
Matt Siegler, Christine Flaherty, Ana Marengo, Menji Indar, Manuel Saez, Priya Dhagat, Christopher Montgomery and Eric Wei
6. The iterations of patient movement throughout the surge: Load-balancing demand through interfacility transfers
Katelyn B. Prieskorn, R. James Salway and David M. Silvestri
7. Supply chain and PPE, the wave 1 dilemma
Priya Dhagat, Syra Madad, Danielle DiBari, Mary Fornek and Keith Tallbe
8. Staffing for pandemic surges in the NYC safety-net health system
Milana Zaurova, Wilbur Yen, Annika Ginsberg, Donna Boyle Schwartz, Jeannith Michelin and Natalia Cineas
9. Fatality management during the worst crisis of our lifetime
Jory Guttsman, Madeline Tavarez, William Fasbender and Stuart Rosenhaus
10. Fine tuning the surge (and flex) plan
Janice A. Halloran, Karen L. Mattera, Robert Faillace and Sheldon Teperman
Section IV: The technical side of the response
11. Situational awareness, going from flying blind to eyes on it all: DnA (Data and Analytics)
Angelie E. Oberoi, Bharti Sharma, Andrew M. Vegoda and Alexander G. Izaguirre
12. IT-coordinating the technology infrastructure of the system
Michael Bouton, Gabriel Cohen and Kim Mendez
13. Donations were a full-time job
Kwame Sheehy, Linh Dang and Freda Wang
Section V: Nuances of a massive health system
14. The correctional health response to COVID-19
Patsy Yang, Nancy Arias, Carlos Castellanos, Maria Creta, Ross MacDonald, Zachary Rosner and Bipin Subedi
15. Alternate care sites including hoteling, a new path in a massive surge response
Leon Boudourakis, Amanda K. Johnson, Nicole JordaneMartin, Floyd R. Long, Jr. Khoi Luong, Matilde Roman and Colleen Vessell
16. Behavioral health and COVID-19
Vladimir Gasca, Rebecca Linn-Walton, Emily Carter and Charles Barron
17. External affairs: Managing communications with regulators and stakeholders
Hillary Jalon, Deborah Brown, Andrea Cohen, Linda Dehart, Brenda Schultz and John Ulberg
Section VI: A light at the end of the tunnel
18. Testing and tracing in the “world’s capital”
Kym Neck, Alex Dobranic, Chris Keeley, Sarah Joseph Kurien, Kathleen Blaney, Andrew Wallach, Amanda Johnson, Steffen Foerster and Ted Long
19. Vaccines and outpatient therapeutics: The race against the variants and the road to normalcy
Andrew B. Wallach and Lee Fiebert
20. Wellness and Helping Healers Heal during the biggest crisis of our lifetime
Jeremy Segall, Omar Fattal and Suzanne (Suzi) Bentley
Section VII: Conclusion
21. The future of public healthcare delivery systems in the United States in the post-COVID era
Mitchell Katz