Physicians across HCA Healthcare reflect on key moments in the pandemic’s timeline
It’s been more than two years since the World Health Organization (WHO) officially declared COVID-19 a pandemic. Since then, HCA Healthcare clinicians and colleagues have worked together to accelerate COVID-19 research, scale innovations and treat more COVID-19 inpatients than any other health system in the country.
As the world shut down and reopened, hospitals around the globe experienced high COVID-19 patient volumes. Doctors, nurses and other healthcare workers were thrust into the spotlight as they showed up to care for patients with duty, skill and compassion.
When the COVID-19 vaccine was approved, HCA Healthcare quickly vaccinated caregivers and colleagues so that they could keep caring for patients. And, when it was time for the public to take their shot, our caregivers stepped up to lead by example and address common vaccine misconceptions and myths. COVID-19 vaccination signaled a turning point in the pandemic.
As we enter year three of the pandemic, here’s a look back at the last two-plus years with a timeline that charts how COVID-19 progressed and our organization’s response through the eyes of physicians across HCA Healthcare.
In late December 2019, a cluster of patients in Wuhan, China, began to experience shortness of breath and fever.
HCA Healthcare’s supply chain arm, HealthTrust, began sourcing PPE and related items in preparation for the potential spread of the unknown virus to the United States.
In early January 2020, HCA Healthcare activated our Enterprise Emergency Operations Center (EEOC) to assist facility leaders in tackling several different critical scenarios to evaluate the threat of the virus.
On January 21, 2020, the Centers for Disease and Control and Prevention (CDC) confirmed the first U.S. case of the novel coronavirus in samples taken in Washington state.
The CDC confirmed human-to-human spread of the novel coronavirus and the WHO declared the coronavirus outbreak as a public health emergency of international concern on January 30, 2020.
One day later, the White House Coronavirus Task Force declared the SARS-CoV-2 virus a public health emergency and announced new travel policies.
The first COVID-19 positive patient was admitted to an HCA Healthcare facility in San Jose, California in late January 2020.
“The precautions started from that moment,” said Dr. Robert Petree, pulmonary director at Good Samaritan Hospital, whose team manages the respiratory devices and technology crucial to treating COVID-19. “We were diligent in providing equipment to our frontline caregivers and essential workers, their dedication led to methods for improving care.”
The first death attributed to the coronavirus was reported on February 6, 2020, in the United States.
Less than a week later, on February 11, 2020, the World Health Organization announced the official name for the disease causing the 2019 novel coronavirus outbreak: COVID-19.
At the beginning of March 2020, HCA Healthcare announced policies for clinical decisions and staff safety related to COVID-19.
Dr. Jairo Melo, director of pulmonary and critical care at HCA Healthcare affiliate Methodist Hospital, pointed out that the decisions corporate and division leadership made early in the pandemic put his San Antonio, Texas facility in a prime position to fight COVID-19. “We learned how to communicate early on and how to be efficient,” Dr. Melo said. “To be successful, we had to adapt to new policies, different staffing ratios, new procedures and we expanded the standard of ICU care to other units.”
States, organizations and businesses across the country began announcing shutdowns in hopes of slowing the spread of COVID-19.
Having experienced the 2009 influenza pandemic as a physician, Dr. Lamont Tyler, medical director of CareNow Urgent Care in Las Vegas, was concerned about the virus’ rapid progression. “I was concerned not only for the management of patients in an outpatient setting but also about preparedness for patient management and prevention strategies for the broader population against a very contagious respiratory virus. I was also concerned about the timely development of a safe and effective vaccine for the broader population.”
As cases began to rise, a COVID-19 information line staffed by HCA Healthcare nurses was established.
HCA Healthcare began data integration with the CDC and publishing daily census reports in March.
In the middle of March, the federal government and individual states began directing people to practice social distancing. Due to the negative psychological effects of the pandemic, some sparked by isolation, U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. The CDC noted that younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation.
“Since the pandemic started, I have seen a 60-70% increase in patients expressing worsening depression and anxiety,” said Dr. Samuel Neuhut, a psychiatrist at HCA Florida Aventura Hospital. “My practice has been busier than ever, and I feel fortunate that myself and our graduate medical education (GME) residents are able to help as many patients as we do with their mental health treatment.”
On March 17, 2020, the first human trial of a vaccine to protect against COVID-19 began.
The U.S. Senate passed the Coronavirus Aid, Relief and Economic Security (CARES) Act providing $2 trillion in aid to hospitals, small businesses and state and local governments on March 26, 2020.
With a focus on protecting our colleagues, care teams and patients, HCA Healthcare implemented a universal masking policy on March 31, 2020
“One word that became popular during the pandemic was ‘frontlinERs’,” recalled Dr. Leeda Roshan, emergency medicine chief resident at Grand Strand Medical Center in Myrtle Beach, South Carolina. “When you are working in an outpatient clinic, an ICU, or on the floors of the hospital, you have the luxury of knowing what precautions need to be taken when seeing and assessing patients. For those of us working in the emergency department, we did not have this safeguard, and with the implementation of a universal masking policy, it helped me feel protected, and gave me the courage to continue facing the pandemic as a ‘frontlinER’ knowing that HCA Healthcare was not only protecting our patients, but also physicians, residents, staff and employees.”
HCA Healthcare implemented a pandemic pay program to help financially support colleagues on March 31, 2020.
The CDC announced new mask-wearing guidelines and recommended all people wear a mask when outside the home on April 3, 2020.
Dr. Neeva Bose, a CareNow area medical director in HCA Healthcare’s Charleston market, credits personal protective equipment and vaccines for her health throughout the pandemic. “I believe universal masking was crucial in protecting many of my colleagues, including myself, from getting COVID-19,” Dr. Bose said. “Having the appropriate PPE has also made it possible to see our patients in the clinic without fear and provides patients the comfort of seeing the provider face to face.”
On April 6, 2020, HCA Healthcare partnered with Google Cloud and SADA on COVID-19 data sharing to help communities respond to COVID-19.
The United States passed a grim milestone on April 10, 2020, surpassing Italy as the global leader for reported deaths due to COVID-19.
Chief Medical Officer of TriStar Summit Medical Center, Dr. Vito Capotorto, notes that the lives lost in this pandemic took a toll on the healthcare community as a whole. “The level of suffering, the number of lives lost, the stress of families being separated, the loneliness of the patients suffering and dying without their loved ones at the bedside: this was all extremely difficult to deal with, day in and day out,” said Dr. Capotorto. As caregivers faced the unimaginable, Dr. Capotorto learned to lean on his colleagues and support provided by our larger organization.
Dr. Leslie Wilke, a pulmonologist at Trident Medical Center, echoed Dr. Vito’s statement’s adding “COVID reminded us of the importance of having a network of friends and family. It was difficult to talk to patients with COVID who had no one in their lives.”
With 93,000 nurses and 47,000 active and affiliated physicians at the height of the pandemic, HCA Healthcare prioritized our commitment to supporting our caregivers’ mental well-being. Resources available to our colleagues and their families, even prior to the pandemic, included NurseCare, a free and confidential program available to our hospital-based nurses, free counseling services through Optum, the HCA Rewards Wellbeing Hub and partnerships with national organizations like National Alliance on Mental Illness, Mental Health America, EVERFI and PsychHub to provide additional support.
To assist colleagues and their families who experienced unexpected financial challenges due to the COVID-19 pandemic, the Frist Foundation announced a $1 million donation to the HCA Healthcare Hope Fund.
HCA Healthcare announced a donation of more than $1 million in grants to help our community partners focus on the COVID-19 emergency response on April 14, 2020.
The same day, HCA Healthcare CEO, Sam Hazen, participated in a White House briefing with the President to announce the launch of the Dynamic Ventilator Reserve, which enabled health systems across the country to contribute ventilators to share with hospitals experiencing shortages.
HCA Healthcare announced the launch of a national campaign on April 21, 2020, with Cracker Barrel, FlyteVu and Sony Music called “There’s Comfort in Giving.” The campaign provided 14,726 meals for our frontline caregivers in six markets: TriStar Health Nashville, Medical City Healthcare Dallas, HCA Houston Healthcare, Tampa, Orlando and Virginia.
A majority of states began to move forward with reopening strategies in May 2020.
“After the first wave, we were able to apply more evidence-based medicine and develop a more uniform approach to treating patients,” said Dr. Jeffrey Marcus, a pulmonologist at HCA Healthcare’s Good Samaritan Hospital in California. “We created a clinical COVID-19 committee that was multi-disciplinary and addressed all aspects of COVID-19 care from bedside to lab therapeutics.”
As infections continued to rise across the country, the United States passed 2 million COVID-19 cases in June 2020, impacting several HCA Healthcare markets and facilities.
HCA Healthcare created a hotline for patients who lost jobs and/or health insurance to receive free, confidential and personalized guidance.
COVID-19 cases surged over the July Fourth weekend with the United States seeing 250,000 cases in 5 days.
“Initially, the most challenging concern was the turnaround time of COVID-19 PCR test results sent to the reference labs,” said Dr. Lamont Tyler. “What was anticipated to be a 1-2 day turnaround for test results ended up taking 3-7 days to get a final result. This was mostly due to the volume of COVID-19 testing.” Dr. Tyler found the implementation of a rapid COVID-19 testing platform that provided results within 15 minutes to be a key diagnostic tool to help our communities battle the disease outbreak. He adds that the testing platform became an incredible asset to CareNow Urgent Care’s capabilities, especially when the country saw surges of the virus.
As the back-to-school season approached, the CDC released new science-based resources and tolls for school administrators, teachers, parents, guardians and caregivers for safe school reopening on July 23, 2020.
As COVID-19 cases surged in many of our markets, HCA Healthcare colleagues joined together with a powerful message to help slow the spread of COVID-19: “Spread knowledge. Save lives.”
HCA Healthcare announced the return of approximately $6 billion in Cares Act funding on October 8, 2020.
To ensure a safe final 2020 presidential debate for all attendees, HCA Healthcare partnered with Belmont University and the Nashville Metro Public Health Department to help implement the health and safety protocols.
Veterans Day took on additional significance in 2020 as many HCA Healthcare colleagues were deployed domestically to help during the early COVID-19 surges.
For more than three weeks, Dr. Eric Stem, an orthopedic surgeon affiliated with Summerville Medical Center and a Colonel in the U.S. Air Force Reserve, volunteered to treat COVID-19 patients in New York City. Dr. Stem told The Summerville Journal Scene that missions in the Air Force often included flying planes and carrying people around the world. By contrast, he added that “this wasn’t exactly the mission – but that is what was needed at the time.”
Over the 2020 holiday season, healthcare workers grappled with another spike in COVID-19 cases.
During a physically, mentally and emotionally demanding time in healthcare, Dr. Rod D. McKinlay focused on providing support and maintaining open lines of communication in his leadership role at St. Mark’s Hospital in Salt Lake City, Utah. “As a medical staff president, you’re called to work through difficult scenarios because conflicts inevitably arise,” said Dr. McKinlay. “I think if you listen to both sides of the story and give people benefit of the doubt, you can usually come to a mutually agreeable solution. More often than not, the key is stepping back to listen.”
The U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the first COVID-19 vaccine – the Pfizer-BioNTech COVID-19 vaccine – on December 11, 2020.
Four days later, on December 15, 2020, the first HCA Healthcare clinician received the first dose of the COVID-19 vaccine.
Capotorto was not aware he was the first recipient at HCA Healthcare to obtain the vaccine when he rolled up his sleeve at his former HCA Healthcare hospital, Henrico Doctors’ Hospital in Richmond, Virginia. “I knew I was the first person at my hospital, but not more than that,” Dr. Capotorto reflects.
I couldn’t wait to get the vaccine. I was Chief of Staff and was very involved with the hospital staff and setting up the vaccine clinics. For me the vaccine signified hope,” added Dr. Capotorto, who now serves HCA Healthcare patients at sister facility TriStar Summit Medical Center in Nashville, Tennessee.
The FDA issued an EUA for the second COVID-19 vaccine – the Moderna COVID-19 vaccine – on December 18, 2020.
By December 24, 2020, an estimated 1 million people had been vaccinated against COVID-19 in the United States.
HCA Healthcare announced that it formed a consortium of prominent public and private research institutions to use our organization’s vast data on COVID-19 hospital care to improve patient outcomes and public knowledge.
HCA Healthcare shared news of an investment in the domestic production of PPE on January 21, 2021.
The FDA granted an EUA on February 27, 2021, for the Johnson and Johnson one shot COVID-19 vaccine.
The Delta variant became the dominant COVID-19 variant in the United States on June 1, 2021.
At the end of November 2021, The CDC recommended that everyone over the age of 18 who received a Pfizer or Modera vaccine receive a COVID-19 booster shot 6 months after they were fully vaccinated.
The Omicron variant of COVID-19 became the dominant strain in the United States on December 21, 2021, displacing Delta with unprecedented speed.
On December 22, 2021, the FDA granted an EUA to the first oral treatment for COVID-19 in the United States. Pfizer’s COVID-19 antiviral pill was approved to be prescribed for use in those ages 12 and up who are at risk for severe disease or hospitalization.
Shortly after, on December 23, 2021, the FDA granted emergency authorization for the use of Merck’s antiviral COVID-19 pill. The drug was approved to help treat adults 18 and up who have tested positive for the virus and are at a high risk of hospitalization or death.
Mask mandates were eased across the country in February as hospitalization numbers declined.
On March 29, 2022, the CDC estimated the BA.2 subvariant of Omicron is the dominant coronavirus variant in the U.S.
The same day, the FDA authorized a second booster dose of two COVID-19 vaccines for older and immunocompromised individuals.
“We have been through the toughest times that we’ve ever seen in our lifetime,” said hospitalist Dr. Gerald Onuoha, who serves HCA Healthcare patients at TriStar Hendersonville Medical Center in Tennessee. “We have gotten through it because we have done it together. Our strength is in our love and support for each other.”
The COVID-19 pandemic – like all other pandemics before it – will end. But our physicians note that their work is far from over and that they must continue to innovative, research new variants and care models, encourage vaccination uptake and protect our colleagues and communities.
“We need to understand that these conditions aren’t going anywhere. We can’t and won’t drop our defenses, rather we will continue to apply what we learned, which is communication, efficiency, flexibility, and adaptability,” Dr. Melo emphasizes. “When patients come to us, they know they are getting great and structured care. I’m very proud of our teams for everything we’ve persevered on. We grew and succeeded and did better as a group, despite the crisis.”
Dr. Bose wants to see her community thrive, but recognizes that for the foreseeable future, fighting the virus – through vaccines, treatment and research – will be key. “I believe as we enter the next stage of the pandemic, prevention and management will continue to be at the forefront and hopefully this leads to lower case numbers. I am confident our hospitals and clinics will be better able to handle each subsequent wave of the virus as we learn and grow.”
“As we see cases decline, I rejoice but I am also cautious. We have seen it before only to be followed by another surge,” Dr. Capotorto cautions. “We must continue to get vaccinated and get boosters.”
“My hope is for continued dialogue, collaboration and implementation of population-based strategies that facilitate prevention, preparedness and management of current and potential pandemics,” said Dr. Tyler.
“I believe that society and our world at large has learned a tremendous amount during these past two years,” said Dr. Roshan. “I know that I was fortunate enough to work in a hospital that always put their patients first, even when it seemed impossible, and a community that was beyond supportive of everything healthcare workers endured during this pandemic. My hope is that the lessons we have all learned are never forgotten and that we can continue to have the strength to face any challenge that comes our way.”
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About HCA Healthcare
HCA Healthcare, one of the nation's leading providers of healthcare services, is comprised of 182 hospitals and more than 2,300 sites of care, in 20 states and the United Kingdom. Our more than 283,000 colleagues are connected by a single purpose — to give patients healthier tomorrows.
As an enterprise, we recognize the significant responsibility we have as a leading healthcare provider within each of the communities we serve, as well as the opportunity we have to improve the lives of the patients for whom we are entrusted to care. Through the compassion, knowledge and skill of our caregivers, and our ability to leverage our scale and innovative capabilities, HCA Healthcare is in a unique position to play a leading role in the transformation of care.