2. Mobilizing Additional Staff
Additional hospital beds were of no use without additional staff—a particular challenge given that thousands of health-care workers were being infected by COVID. In early March, New York State issued a public call for retired health-care professionals from around the state and country to sign up to be relicensed. Further, the state asked medical and nursing school students, and related health professionals such as podiatrists, to also serve. The response was overwhelming—nearly 100,000 health-care professionals agreed to serve, including 30,000 from outside of New York State, willing to travel to what at the time was a global hot spot of COVID cases. To match these additional staff with hospitals in need, New York State built a world-class online portal that allowed hospitals and nursing homes, prioritized by those with the highest need, to connect with these health-care workers and employ them at their facilities. New York State provided additional support, including human resources management, access to temporary housing, and transportation logistics to facilitate health-care facilities employing these volunteers. In addition, the state transferred health-care workers from underutilized hospitals upstate to hospitals in hard-hit communities downstate, and directed federal medical personnel to facilities most in need of additional staff.
3. Balancing Supplies and Equipment
Every state in the nation was faced with the challenge of quickly purchasing and deploying enormous amounts of health-care supplies and equipment, such as PPE, medications, and ventilators. This became particularly challenging given the nation’s dependence on an international supply chain and the lack of federal coordination and leadership. While New York State secured tens of millions of pieces of PPE and thousands of additional ventilators, it was clear that even these efforts would not be sufficient to meet what might be required at the projected peak in late April. The Surge & Flex system took on this challenge. First, the Department of Health expanded the daily reporting requirements for hospitals to include not just bed occupancy and vacancies, but also detailed reports on each facility’s individual stockpile of supplies and equipment. In essence, this data enabled the creation of a real statewide inventory of ventilators, medical drugs, PPE, and other supplies and equipment. An executive order was signed to ensure that New York State had the ability to properly distribute these items to hospitals in need—an exercise that was informed closely by data that demonstrated which hospitals were experiencing the most hardship and shortages of critical supplies and equipment. Further, a transportation logistics system was mobilized to help move this equipment around the state. It would be a tragedy for a patient in need of a ventilator to not receive one, while a hospital nearby had dozens of available ventilators. By the end of May, New York State had successfully allocated in excess of thirteen million pieces of PPE and other critical equipment and supplies.
4. Establishing an Operational Command Center
Standing up the Surge & Flex system in a matter of days was an operational challenge, and to ensure that the system worked seamlessly required a operational command center, staffed twenty-four hours a day, seven days a week, that could make each part work together in a coordinated manner.
The state created a Hospital Capacity Coordination Committee (HCCC) that served as a command center, comprising staff from the New York State Department of Health, senior officials from major hospital systems, and logistical experts from the New York National Guard. The HCCC operated 24/7 and was available to every hospital and health-care facility in New York State, accessible via a hotline that was answered at any time of day. With real-time data being displayed on large television monitors, members of the HCCC could see at a facility-by-facility level which hospitals were seeing influxes of new COVID patients and which facilities needed additional staff, equipment, or other support. Throughout the most challenging days of the COVID crisis, the HCCC was operational and helped facilitate thousands of patient transfers, deliver millions of pieces of PPE, and deploy hundreds of ventilators.
Without Surge & Flex, the impact of COVID on New York State would have been much worse. New York State has now institutionalized each of these four elements so Surge & Flex can be quickly operationalized should a new wave of COVID hit the state or we face another major health emergency.
NEW YORK STATE TESTING PROGRAM
New York State recognized early in the COVID-19 crisis that testing would be the single most important tool to combat and contain COVID-19. New York was the first state in the nation to develop its own diagnostic test and worked quickly to build a network of hundreds of local private labs to test, and set up access to more than 850 collection sites where New Yorkers can go get a test. As a result, as of this writing New York leads the United States and large nations in total tests performed per capita. New York’s testing program is a national model that helped New York not only flatten the curve but actually reduce the infection rate since reopening the economy. The testing program established by New York State was instituted in part by executive order and Department of Health directives that are summarized below.
Creating New York State’s Own Test
Early in the COVID crisis, America’s testing capabilities were severely limited. Specimen samples had to be mailed from all fifty states to the CDC laboratory in Atlanta, where testing was conducted. By the end of January, New York had sent just eleven samples to the CDC. On February 4, the FDA issued an emergency use authorization that allowed a small number of CDC-designated clinical laboratories across the nation to test for coronavirus, using the same test that was being run in the CDC lab in Atlanta. That week, the CDC began to ship approximately two hundred CDC-developed coronavirus laboratory test kits to select U.S. labs, each kit capable of testing approximately seven hundred to eight hundred
