As COVID-19 threat grows, lead healthcare physicians band together

Seven hospitals and healthcare systems now holding regular group calls

As hospitals in Southwestern Pennsylvania prepare for a surge in COVID-19 cases, senior physician leaders from seven hospitals and healthcare systems in the region this past week organized regular phone conferences to share common problems, trade tips they’ve read or learned already, and prepare for the possibility that they’ll have to help each other.

“I said to them, ‘Why not get our own group, discuss our capabilities, now, so we can get ready for the potential for the entire region to be hit by this,’” said Dr. Don Whiting, Allegheny Health Network’s chief medical officer, who organized the group. “We can discuss our supply situation, personal protective equipment, beds, and be ready if, say, we need to share staff, or share supplies.”

The seven physicians — six chief medical officers and one a chief emergency officer — agreed to talk every Monday, Wednesday and Friday to quickly share their thoughts for 30 to 45 minutes.

No specific promises have been made to share resources or staff yet, just a general agreement that the health systems and hospitals may need each other’s help at some point, three of the participants in the calls said.

“And we’ll keep doing this every other day as long as we need to keep going,” Dr. Whiting said.

Together the seven officers from AHN, Butler Health, Excela Health, Heritage Valley, St. Clair Hospital, UPMC and Washington Hospital System, represent all but five of the 29 general acute care hospitals in the eight-county Southwestern Pennsylvania region — hospitals that will have to deal with the most serious cases of COVID-19.

Dr. John Sullivan, St. Clair’s chief medical officer, said when Dr. Whiting asked to join, it was an easy decision “realizing we’re all dealing with the same issue: A global pandemic.”

“We need to be comparing best practices, testing and capacity issues, isolation practices, where we are with supplies,” Dr. Sullivan said. “This is very early in what we anticipate will be a prolonged effort in this outbreak.”

Pulling the group together — even though many of them technically are rivals, and not just between AHN and UPMC — was easier than people may think, in part because most of the doctors involved have either worked together or in the same region for most of their careers, they said.

“The people in this group, some of them I’ve known for two decades,” said Dr. David Rottinghaus, Butler Health’s chief medical officer. “They’re all smart, dedicated professionals.”

Still, he noted: “I can’t remember the last time we all got together to talk before this.”

But, he said, these are “very interesting times. Nobody has ever seen anything like this.”

The first big issue they have all faced: Problems getting enough people tested for COVID-19 so that they know the scope of the problem in the region.

They found they all have the same problem with a shortage of the swabs that are used to take the most accurate patient sample from the back of the nose.

“That [swab shortage] is the test rate limited supply issue right now for all of us,” Dr. Sullivan said.

That shortage, they all have found, is not only because the demand is high, it is also because many of the most popular types of swabs have been made in China. Shipments from China — where COVID-19 was first identified — have largely ended over the last three months. Hospitals all over the country are now scrambling to find domestic suppliers.

Another supply problem is with “reagents,” which are chemicals used in the testing process to help find out if a sample is positive or negative for COVID-19.

Dr. Don Yealy, UPMC’s chief emergency officer, said at UPMC’s press conference on Friday that he was “encouraged by the activities” of collaboration through the phone calls so far.

He said that on the call between the health systems and hospitals Friday morning the problem they discussed was: “What happens when critical care beds become more in demand? How between all of our systems could we manage things better?”

Dr. Whiting said he had the idea to propose the collaborative calls after he and several other health systems, including UPMC, Heritage Valley and St. Clair, were asked to be in on a call with the Allegheny County Health Department Director Dr. Debra Bogen and county Executive Rich Fitzgerald on March 14.

“They just wanted to talk with us about working together, and cutting down on elective surgeries, which is the right thing to do,” Dr. Whiting said. “And they asked us to all work together for the good of the region.”

“So I emailed the other [chief medical officers] and said let’s get together regularly,” he said.

The collaboration could have gone on quietly, without public notice. But Dr. Whiting said that after the second phone call on Wednesday, Dr. Carol Fox, Excela’s chief medical officer, suggested to the group that it should “put out a statement together that unified us in a statement to the community.”

Everyone agreed, he said. The short statement they put out made sure to list the health systems and hospitals alphabetically, not by size.

“Particularly for this area over the last five years” as UPMC and AHN have fought each other so bitterly, Dr. Whiting said, “we thought it was important for the community to know that we’re working together.”

“I can tell you that as clinicians, we hope this is the new normal,” he said. “There’s always good that comes from a crisis, and we hope this is good.”

By  Sean D. Hamill – Reporter, Pittsburgh Post-Gazette