Reflecting on the challenges presented by the COVID-19 pandemic and the work that remains to be done.
Think back to one year ago. Lockdown was in full effect. Lines formed outside of grocery stores where shelves displayed scarce supplies of hand sanitizer, toilet paper and other everyday necessities. Neighbors were making and donating masks constructed out of any fabric they had laying around. And all the while, front-line workers were trying to manage the unknown variables of a new pandemic and reconcile the fact that some lives just would not be saved.
Yet, how far we have come as a nation. While controversial in some areas of the country, the adherence to social distancing and masking made a difference. The expedited efforts of pharmaceutical companies to bring more than one viable vaccine to the table have never been seen before. All of this and more have contributed to the economy’s reopening, to grandparents being able to hug their grandchildren again and schools returning to in-person learning.
However, we’re not in the clear just yet. South Jersey continues to meet the challenges of this pandemic, from medical care and vaccine distribution to philanthropic relief for those still struggling. One year later, it’s not about returning to normal, but adjusting to a new normal.
The Health Care Response
As we reported in April 2020, while the public’s knowledge and impact of the coronavirus wasn’t felt in mid-March, the health care industry had already been strategizing for weeks, preparing hospitals for what was to come.
“Wow, what a journey it’s been,” says Dr. Alka Kohli, chief population health and clinical officer at Inspira Health. “A year ago, we knew very little about what was going on and when the virus came upon us, we were still learning what the pandemic was and there was little known about treatment preventions. It was a steep learning curve all over the country and the world.”
Being in the trenches taught medical staff which treatments make the biggest impact and by the end of 2020, Kohli says they felt more comfortable in managing the surge of patients. “I’m heartened that all of our learning has not gone to waste. Our ability to care for this volume of patients has come a long way.”
In those early days, access to personal protective equipment (PPE) and ventilators seemed to dominate headlines as different states saw their hospitalizations surge. Hospitals had to get creative and things have since leveled off and shortages are no longer an issue.
“The pandemic and the initial scarcity of PPE introduced us to a number of new vendors. Having a broader network of suppliers is what allowed us to ensure our staff always had what they needed, and it will serve us well in the future. We’ve also expanded the PPE quantities we keep on hand in the event of another public health emergency,” says Dr. Reginald Blaber, chief clinical officer of Virtua Health.
“Ventilators remain a crucial piece of equipment for our sickest COVID-19 patients. We ordered several additional ventilators in the early days of the pandemic and although they are not all in use, there is a comfort in having them at the ready.”
Time has also shown that not every patient requires a ventilator, says Kohli. “One of the key things we did was pivot to telehealth. This wasn’t necessarily something that was our go-to in health care, but I think it’s something Inspira did well where we could care for those with COVID-19 but were not sick enough to be in the hospital. Remote patient monitoring allowed them to stay home with their loved ones while still being monitored by physicians.”
Inspira has further leveraged technology with a program called Inspira Health+, which has helped many patients hospitalized with COVID-19 safely return home sooner.
Hospitals in South Jersey were able to participate in trials of new therapies to use for treatment of COVID-19, some of which have progressed, showing significant success.
Blaber says Virtua has been providing monoclonal antibody treatment at its infusion center and in the emergency departments. “This treatment is best suited for those who are within two to three days of developing symptoms. Eligible individuals include those with mild to moderate symptoms and one or more risk factors (such as age or a pre-existing condition),” he says. “Virtua has offered this treatment since December 2020 and has provided it to about 600 individuals, many of whom have had strong outcomes and recovered nicely.”
Inspira too has used monoclonal antibodies to treat more than 200 patients on an outpatient basis for patients deemed to be at high risk for severe disease, but not sick enough to be admitted. Additionally, Inspira has been involved in clinical trials related to COVID-19 and recently completed its participation in a phase 2 trial and will soon be enrolling patients into phase 3. The trial is testing the safety and efficacy of a two-pronged treatment that includes an antiviral drug and an anti-inflammatory agent.
Despite these promising treatments, those who contracted COVID-19 may experience long-lasting effects over the course of their lifetime, says Kohli. Known as “long-haulers,” these people may have underlying symptoms that haunt them. Inspira is launching a post-COVID program to help people recover, including pulmonary and rehabilitation services.
“I wish it was the case that people get it and it’s done with—for some people it is—but unfortunately it’s not the case for everyone. We want to make sure we are able to care for people in the long haul,” she says.
Throughout the past year, the heroes have been the health care workers who show up day after day, give their all to patients and even hold their hands in their final moments when family cannot be there. Their sacrifices and the pandemic’s toll cannot be ignored even as some people act as if we’re already on the other side.
“Although our census of COVID-19 patients is comparatively low, data shows that front-line workers are physically and emotionally drained after the events of the past year. We strive to provide resources and assistance, and encourage everyone to extend support to the health care workers in their lives,” Blaber says.
On all fronts, the collaboration between different sectors has been amazing to witness, and has been a key factor in bringing relief to health care workers. “We’ve seen what can happen when we all band together. The fight has been the same for all of us and we’re blessed with the colleagues we have in South Jersey and across the state,” says Kohli. “We’ve been very open with each other, sharing best practices and putting out fires as we need to.”
Burlington County Commissioner Director Felicia Hopson says county-level assistance has been crucial. “Every department of our county government has been impacted and every department has been involved in our response—from Human Services and Public Works to Public Safety and Parks—but especially our Health Department. Since the pandemic’s start, Dr. Herb Conaway and his team have been at the center of virtually all our government’s actions, and I can’t say enough about the job they have done for our residents. Testing. Vaccines. Contact tracing. These have been life-saving services. … One of my biggest takeaways from the last year is that it takes all levels of government working together with businesses, nonprofits and our own residents to respond to a crisis like COVID-19,” she said in a statement.
Hopson says the Burlington County vaccine mega-site is another example. “A few months ago, it was just an empty space. Together, with the state of New Jersey, New Jersey National Guard and Virtua Health, we’ve remade it into a fully operational site where thousands of people come daily to get vaccinated,” she said.
It takes a village, as Kohli puts it. “It’s not just about finding vaccinators, but clerical workers and EMS to be on hand for the 15-minute oversight and security teams. We could not have done this without them,” she says.
Inspira also partnered with counties to help vaccinate teachers, as well as the homeless population in Salem County, along with Acenda Health. “This was particularly challenging because the homeless don’t have an address or one place they are staying. For this, we accepted the Johnson & Johnson vaccine on behalf of Acenda and helped administer it with our own employees because it was the right thing to do.”
Vaccines have brought the most hope to those on the front lines. “Vaccines are our best resource for protecting ourselves against COVID-19,” Blaber continues. “The efficacy of all of the available vaccines is tremendous, and as more data becomes available, I become increasingly hopeful that we can slow and stop the spread of this virus. Of course, that requires all eligible individuals to take advantage of this opportunity to protect themselves and the people they love. In a public health emergency, everyone can contribute toward the solution.”
Virtua has vaccinated more than 200,000 people (as of late March) and that number grows by a few thousand each day, Blaber says. “This campaign has brought tremendous joy to our staff. It is hugely satisfying to be the source of such relief and hope to our community. The people we encounter are grateful and appreciative. Whenever I volunteer as a vaccinator, I feel energized knowing my efforts make a meaningful difference.”
However, the vaccine is not a pass for carelessness. “The new strains of the virus are worrisome. In some ways, it feels like a race against time to see how many people we can protect through vaccination before the variants gain momentum in our region,” Blaber continues. “Because there is such strong reason for hope, it is all the more reason why everyone should be extra diligent. We must continue to protect ourselves and others by wearing masks, washing our hands and avoiding large gatherings.”
Kohli concurs . “Just because you are vaccinated you should not forget all of the precautions. You may still be a carrier. … We don’t understand yet very well how much protection the vaccines give [against the new variants],"and now we have several variants,” she says. “The virus knows no borders and it’s a race between the variants and the vaccine. Vigilance will prevent another surge.”
Despite the suffering the pandemic has caused, Kohli sees an opportunity to be thankful. “I choose to see the glass as half full,” she says. “We’ve been brought closer together as a community. Going back to when this first started, I think about the support people gave us and I choose to see the love in it all. I think it’s something we all hold very dear to our hearts. … This is an event for the history books and we’re living it.”
Hunger: Another Symptom of COVID-19
While doctors, nurses and EMS responded to the critical medical needs of patients suffering from COVID-19, there were others making their own impact on the front lines of the community, namely fighting food insecurity.
The economy’s sudden shutdown immediately put people at risk, says Fred C. Wasiak, president and CEO of the Food Bank of South Jersey. “As we entered March 2020, seemingly overnight, the demand for food support in our region escalated dramatically—hitting a 200% increase within a handful of weeks. It was a remarkable rise in food insecurity in a small window of time, signaling not only a reaction to the impact of COVID-19 in our region, but also the sobering reality that our region’s food-insecurity landscape was changing and, in this change, virtually eroding away years upon years of progressive hunger-relief strides. Within the span of a few weeks, South Jersey devolved from a region in which 1 in 11 people were food insecure, to a region that was plummeting to 1 in 7 residents suffering with the daily disaster of hunger.”
Within those first few months, more than 40 percent of those attending food distributions were first-time food bank assistance recipients. “We are so grateful for the support, care and compassion of the South Jersey community. We could not feed South Jersey alone. While COVID safety restrictions greatly reduced, if not completely eliminated, community donated food drives, the community rallied to support us with donations, including supporting virtual food drives—greatly strengthening our ability to keep our shelves stocked,” Wasiak says.
Unlike the vaccines’ hopeful impact on the health care industry, a year into the pandemic, there is no sign of demand changing for those facing food insecurity. “There is nothing normal about food insecurity. Ever. With that, unfortunately, the need for food in our region remains at higher levels and we anticipate throughout 2021 this same level of accelerated food insecurity will be a part of life in South Jersey,” he says. “We are still operating at peak efficiency and still responding to the urgent need for food in our region. South Jersey is still seeing record levels of food insecurity and this will be the landscape of hunger for the foreseeable future.”
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Published and copyrighted in South Jersey Magazine, Volume 18, Issue 1 (April 2021).