Mount Sinai Queens executive talks COVID-19 challenges
by Benjamin Fang
May 22, 2020 | 1792 views | 0 0 comments | 170 170 recommendations | email to a friend | print
Even with all of the planning and their collective life experiences, nothing could have prepared hospitals and health care workers across New York City for the onslaught of the COVID-19 pandemic.

For Caryn Schwab, executive director of Mount Sinai Queens, a particular challenge is making sure the Astoria hospital has enough supplies.

Although the hospital is part of the Mount Sinai health system, which provides personal protective equipment (PPE), ventilators and medication, Schwab said they felt enormous pressure everyday.

“We did the best we could under what were extraordinary circumstances,” she said. “I’m incredibly proud of our entire team, especially those who work on the frontlines.”

Schwab noted that as information and research about the virus came out of China, Italy and other hard-hit areas, the regulations and practices kept changing.

Mount Sinai Queens had to expand the number of beds, especially critical care beds. The team had to evaluate staffing levels, which Schwab said was never enough early on.

Hospital executives were also working with staff to support them through the “enormous emotional toll” of the pandemic and the anxiety of keeping them and their families safe. At the same time, Schwab said, they had to ensure the staff was working at their best in the hospital.

“It felt like we were at war,” she said. “It felt like you were battling everyday against this enemy you couldn’t always see, except by the enormity of the onslaught of patients filling up the beds in the emergency room.”

With Queens as the “epicenter of the epicenter” of the pandemic, the number of coronavirus cases surged in the borough. Inside the hospital, Schwab said health care workers never felt like they could do enough.

With no vaccine and no treatment in place, there was a “huge learning curve” to understand what the virus meant in terms of taking care of patients.

“The staff has to not only take care of patients,” said Schwab, noting that visitors were not allowed, “they became mothers, brothers, daughters that couldn’t be there.”

Everybody was fully covered in PPE. Schwab said she couldn’t even see the facial expressions on people, diminishing the ability to connect with them.

“It was terrifying in a lot of ways,” she said.

Though it took awhile, Schwab said she saw the transformation of the staff’s familiarity with the virus over time. At one point, she heard a member of staff say they “got this now.”

“You could see moving from anxiety and being scared to a growing confidence level,” Schwab said. “We knew how to protect ourselves and patients.”

Although the curve flattened in New York, experts are expecting a second wave of coronavirus hospitalizations. Schwab said with so many lessons learned from this experience, what Mount Sinai Queens is doing now is inventorying those lessons.

They’re currently soliciting the staff for what went well and what they could do better.

“We are starting to focus on recovery now,” Schwab said. “We’re taking care of both COVID and non-COVID patients as the number declines.”

The hospital is offering a wide range of services that were suspended during the height of the pandemic. It opened its infusion center and pre-surgical testing center. All urgent surgeries restarted this week.

The pandemic also pushed the hospital into an accelerated rate of telehealth. They also reduced the number of staff contact with patients to a minimum.

“That was one of the silver linings that came out of the pandemic,” she said.

Mount Sinai Queens is also doing symptom and temperature checks for patients. The site reduced the number of seats in the waiting area, and limited the number of outpatient visits to respect social distancing. The facility is following strict cleaning protocols.

Despite the decline in COVID-19 patients, Schwab said they will remain vigilant and monitor activity daily. She said she believes the virus will remain until a vaccine is approved.

“That’s the ultimate measure of when we’ll be fully passed the pandemic,” Schwab said.

The hospital executive said she’s still concerned about the state reopening, particularly as the weather gets warmer, and whether people can police themselves with masks, hand washing and social distancing.

“It’s a sign of disrespect to health care workers to not follow them,” she said.

Schwab said the hospital is stockpiling PPE, and believes they have the necessary equipment for another wave. They have also identified surge areas, and have the ability to reactive protocols as needed.

“There’s a lot of foundation in place to help us if we do see a surge,” she said.

While Mount Sinai Queens has received some federal funding to tackle the pandemic, Schwab said she hopes more is on the way.

She noted that the cost of handling coronavirus is enormous, including paying for supplies, drugs and renovations to accommodate critical care patients, not to mention the numerous staff members they had to import.

There were huge losses in revenue from suspending outpatient care and surgery.

“We have received some relief,” she said, “but we have a long way to go before we recover.”

While funding is “absolutely crucial” for hospitals to get back on their feet, Schwab said she hopes the federal government also has equipment needed for another crisis.

She said it was a “big surprise” when the federal government didn’t have a stockpile of supplies that states needed.

“There will be another pandemic, we don’t know what that will be,” Schwab said. “I’d be surprised if COVID was the last.”

Despite the health and economic crises the pandemic has caused, one positive outcome has been the support from the community for frontline workers. Schwab said the clapping at 7 p.m. “continues to this day,” often with a parade of NYPD and FDNY personnel stopping by the hospital.

Schwab said although she often hears her staff members say they don’t see themselves as heroes for simply doing their jobs, it’s “wonderful to know that people are recognizing the work and celebrating it.”

“It’s just this moment of joy that people are taking the time to recognize their truly heroic efforts,” she said.

Donations have come from 250 restaurants and community organizations, and colleagues have given to other employees in their time of need.

Schwab said so many flowers were donated that it looked like a florist shop in the hospital’s lobby. Staff members could even go downstairs and make themselves a bouquet to take home.

All kinds of meals, snacks and drinks were also sent to the health care workers.

“We were able to provide lunch and dinner throughout the pandemic to our staff everyday,” Schwab said. “That made such a difference.”
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