Insufficient Preparedness Crippled NYC Virus Response: Review

Insufficient Preparedness Crippled NYC Virus Response: Review

Photo Courtesy of Comptroller Stringer’s Office

“The pandemic quickly placed extreme stress on New York City’s healthcare systems—including, but not exclusively, H+H,” Comptroller Stringer said.

By Forum Staff

Several deficiencies in preparedness and execution at all levels, from the federal government down to individual hospitals, including inadequate access to needed supplies and equipment, confusing and medically inappropriate guidance, a lack of systems and procedures for managing patient loads across hospitals, and insufficient protocols for deploying staff hindered NYC Health + Hospitals’ response to the COVID-19 pandemic, according to City Comptroller Scott Stringer’s review of the agency’s response to the crisis.

In a letter to Gov. Andrew Cuomo detailing the review’s findings, Stringer noted that the probe also showed that H+H’s challenges arose due in part to insufficient support, assistance, and guidance from the City, State, and federal governments. Stringer stressed that H+H’s ability to deliver proper health care to communities that need it the most requires the assistance of all levels of government, including sufficient funding, established coordination policies and procedures, and the support of its governmental and private partners.

As a result of the review, Stringer outlined recommendations to better prepare for and manage a potential resurgence of COVID-19 patients, as well as future public health emergencies, including establishing formal coordination and guidance mechanisms among all parts of the healthcare system; improved protocols for staff training and deployment of resources; and identifying and remedying supply chain weaknesses.

“COVID-19 has devastated New York City, claiming more than 22,000 lives as of mid-June. The pandemic quickly placed extreme stress on New York City’s healthcare systems—including, but not exclusively, H+H. Years of planning for the next pandemic and early action to obtain necessary resources could not meet the challenge of this health crisis. This review found that H+H, and the larger system within which it has operated during the pandemic, faced an unprecedented situation for which no one was fully prepared. The lack of preparedness forced all players to improvise responses, sometimes successfully, sometimes not – but inevitably at a cost in human lives.  Several deficiencies were noted, including inadequate access to needed supplies and equipment, a lack of systems and procedures for managing patient loads across hospitals, and insufficient protocols for deploying staff,” Stringer wrote. “The COVID-19 pandemic has demonstrated that while planning is important, even the best plans inevitably will not and cannot foresee or anticipate every eventuality, because each emergency and crisis is unique. COVID-19 presented an unprecedented challenge and placed strains on every part of the City’s healthcare system, both private and public. Planning and preparedness must provide for a clear chain of command and responsibility to ensure a coordinated, timely, and effective response and allow for the flexibility that our preliminary inquiry identified. It is clear that H+H—or any individual healthcare system—cannot manage the need created by a health crisis of the magnitude experienced with COVID-19 in isolation and without support and assistance from state and local governments acting in concert with the entire healthcare delivery sector. H+H’s challenges arose at least in part from insufficient and conflicting guidance, originating at the federal level, and an initial lack of coordination among participants in the local healthcare system. Many of these challenges were addressed ‘on the fly’ by both the State and City governments and by the hospital sector, including the Greater New York Hospital Association, H+H, and private independent facilities. The cooperation exhibited by all parties is to be commended.”

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