A Connecticut healthcare system’s response to the COVID-19 pandemic

2021 ◽  
Vol 16 (3) ◽  
pp. 195-202
Author(s):  
Jane Keating, MD ◽  
Lenworth Jacobs, MD, MPH, DSc, FACS, FWACS ◽  
Daniel Ricaurte, MD ◽  
Rocco Orlando, MD ◽  
Ajay Kumar, MD ◽  
...  
Keyword(s):  
New York ◽  
New England ◽  
Emergency Management ◽  
Adult Population ◽  
Herd Immunity ◽  
Healthcare Systems ◽  
Emergency Operations ◽  
Scarce Resources ◽  
The Public ◽  
At Risk Populations

Connecticut was impacted severely and early on by the COVID-19 pandemic due to the state’s proximity to New York City. Hartford Healthcare (HHC), one of the largest healthcare systems in New England, became integral in the state’s response with a robust emergency management system already in place. In this manuscript, we review HHC’s prepandemic emergency operations as well as the response of the system-wide Office of Emergency Management to the initial news of the virus and throughout the evolving pandemic. Additionally, we discuss the unique acquisition of vital critical care resources and personal protective equipment, as well as the hospital personnel distribution in response to the shifting demands of the virus. The public testing and vaccination efforts, with early consideration for at risk populations, are described as well as ethical considerations of scarce resources. To date, the vaccination effort resulted in over 70 percent of the adult population being vaccinated and with 10 percent of the population having been infected, herd immunity is eminent. Finally, the preparation for reestablishing elective procedures while experiencing a second wave of the pandemic is discussed. These descriptions may be useful for other healthcare systems in both preparation and response for future catastrophic emergencies of all types.

scholarly journals SARS-CoV-2 (COVID-19) Vaccine Development and Production: An Ethical Way Forward

2020 ◽  
Vol 30 (1) ◽  
pp. 59-68 ◽  
Author(s):  
KENNETH V. ISERSON
Keyword(s):  
Vaccine Development ◽  
Herd Immunity ◽  
Vaccine Safety ◽  
Healthcare Systems ◽  
Moral Concern ◽  
The Novel ◽  
Production Methods ◽  
The Public ◽  
Current Vaccine ◽  
Vaccine Testing

AbstractThe world awaits a SARS-CoV-2 virus (i.e., COVID-19 disease) vaccine to keep the populace healthy, fully reopen their economies, and return their social and healthcare systems to “normal.” Vaccine safety and efficacy requires meticulous testing and oversight; this paper describes how despite grandiose public statements, the current vaccine development, testing, and production methods may prove to be ethically dubious, medically dangerous, and socially volatile. The basic moral concern is the potential danger to the health of human test subjects and, eventually, many vaccine recipients. This is further complicated by economic and political pressures to reduce government oversight on rushed vaccine testing and production, nationalistic distribution goals, and failure to plan for the widespread immunization needed to produce global herd immunity. As this paper asserts, the public must be better informed to assess promises about the novel vaccines being produced and to tolerate delays and uncertainty.

scholarly journals Modeling Megacity Medical System Response to a CBRNE Event

2016 ◽  
Vol 4 (2) ◽  
pp. 131-148
Author(s):  
Kenneth McDonald ◽  
Tyler McLees ◽  
Shane Connolly ◽  
James McNulty ◽  
Leah Wasserman ◽  
...  
Keyword(s):  
New York ◽  
Emergency Management ◽  
The United States ◽  
Problem Definition ◽  
Maximum Efficiency ◽  
System Response ◽  
United States Department ◽  
Medical Department ◽  
The Public ◽  
Medical Response

The collaborative effectiveness of the public health system (PHS) and the Army Medical Department (AMEDD) is limited in the case of a 10-kiloton (kt) nuclear event on a megacity due to an overall lack of knowledge and understanding among agencies. This study details an exhaustive analysis of the current medical response system using New York City as a case study. Through the problem definition phase of the Systems Decision Process (SDP), this report identifies operational gaps existing at different levels within the system. Identified operational gaps existed at the local, state, and federal levels in the areas of resources, communication, and planning within the following agencies: Sloan Kettering Memorial Hospital, the Office of Emergency Management (OEM), the Federal Emergency Management Agency (FEMA), Health and Human Services (HHS), and the United States Department of Veteran Affairs (VA). Evaluation of the operational gaps illustrated the areas which were most vulnerable. The current analysis suggests that the system in place requires adjustments of the identified gaps so that maximum efficiency can be achieved.

A research agenda to explore the emergency operations center

2020 ◽  
Vol 18 (6) ◽  
pp. 525-534
Author(s):  
Paolo Cavaliere, PhD ◽  
Zachary Cox, MA ◽  
James Kendra, PhD ◽  
Aimee Mankins, BA ◽  
Michael Michaud, MEd ◽  
...  
Keyword(s):  
Emergency Management ◽  
Research Agenda ◽  
Public Support ◽  
Extensive Literature ◽  
Emergency Operations ◽  
The Public ◽  
Emergency Managers ◽  
Emergency Operations Center ◽  
Research Questions ◽  
Operations Center

Objective: The emergency operations center (EOC) is an essential component of modern emergency management. Traditionally understood as a place where officials communicate with the public, support coordination, manage operations, craft policy, gather information, and host visitors; there has been little recent research on their structure, operations, or work procedures. EOCs may in fact be, as we argue here, places where emergency managers come to find workarounds, delegate tasks, and find new sources of expertise in order to make sense, make meaning, and make decisions. However, despite their status as a symbol of emergency management and recipients of large amounts of funding, there has been relatively little scientific research into the EOC. With this paper, we synthesize the existing research and propose a variety of research questions to accelerate the process of inquiry into the EOC.Design: Informed by an extensive literature review, this article presents a comprehensive look at the existing state of knowledge surrounding EOCs.Interventions: Research questions to support investigation of the EOC are suggested.Conclusions: The EOC is an underexplored setting ripe for development and discovery by researchers and emergency managers seeking to influence the field of emergency management.

Superstorm Sandy: Emergency management staff perceptions of impact and recommendations for future preparedness, New York State

2017 ◽  
Vol 15 (4) ◽  
pp. 209
Author(s):  
Adam Yanson, MPH ◽  
Asante Shipp Hilts, MPH, DrPH ◽  
Stephanie Mack, BS ◽  
Millicent Eidson, MA, DVM, DACVPM ◽  
Trang Nguyen, MD, DrPH ◽  
...  
Keyword(s):  
New York ◽  
Emergency Management ◽  
Critical Role ◽  
New York State ◽  
Lessons Learned ◽  
Software Systems ◽  
Communication Effectiveness ◽  
Cross Sectional ◽  
Emergency Operations ◽  
York State

Objective: This study collected and summarized feedback from staff at the New York State (NYS) Office of Emergency Management (OEM) and three county OEMs within NYS to understand lessons learned from the 2012 Superstorm Sandy.Design: Cross-sectional qualitative and quantitative analysis.Subjects, Participants: One staff person from each identified critical role from the state and county OEMs who were still employed in the roles identified. Interventions: In-person interviews in 2014 followed by an anonymous survey in 2015 examined the response strengths, challenges, and recommendations using federally and study-defined Public Health Preparedness Capabilities. Quantitative analysis of staff survey ratings was used to summarize perceptions of interagency collaboration, communication effectiveness, and differences by staff position.Results: Response rates were 78 percent for interviews (n = 7) and 45 percent for surveys (n = 36). In interviews, “emergency operations coordination” was cited most frequently (48 percent), specifically for successful interagency coordination. “Emergency operations coordination” was also cited most among challenges (45 percent), with emphasis on problems with uniformity of software systems across agencies. Survey responses indicated that “volunteer management” (50 percent) and the “safety and health of responders” (40 percent) were frequently reported as challenges. Additionally, 38 percent of OEM staff reported that situation reports submitted by health departments need improvement. Recommendations from OEM staff included “emergency operations coordination” (36 percent) such as sharing of resources and “training” (16 percent) including hospital evacuation training.Conclusions: Analysis of OEM staff feedback identified specific challenges, and concrete recommendations were made to improve response going forward.

Hospitals: N.Y. Appellate Court Denies Move to Privatize Public Hospital

1999 ◽  
Vol 27 (2) ◽  
pp. 202-203
Author(s):  
Robert Chatham
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Public Health System ◽  
Municipal Hospital ◽  
The Public ◽  
Public Benefit ◽  
For Profit ◽  
Benefit Corporation ◽  
The City

The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257 (N.Y. Mar. 30, 1999), that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act (HHCA), establishing the New York City Health and Hospitals Corporation (HHC) as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc. (PHS), a private, for-profit entity.

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