Page 12 - WCMS4Q21

was manufactured in China. The U. S. strategic stockpile of such equipment had not been restored after the 2009 flu epidemic.
By the first week in March COVID-19 had spread to S. Korea, northern Italy, Iran, and at least 14 U.S. states and across the world, commerce had begun to shut down. No one was quite sure how to contain the epidemic that was about to explode. And explode it did. And shutdowns began. By the second week in March, normal activities across the U.S. had come to a standstill. Schools closed. Travel stopped. Gatherings were discouraged; gathering places closed. The “March Madness” basketball tourna- ment was canceled, as were all professional sporting events. Graduation ceremonies were canceled. Hospitals canceled elective surgery and made plans for expanded care delivery using field hospitals. Morgues and funeral homes were overwhelmed. Because of fear that the virus might be spread not just through respiratory droplets but also through contact with fomites, distilleries turned to producing alcohol-based hand sanitizer instead of whiskey. The stock market fell 30%. “Social distancing” was invented and “shelter in place” became the watch- word. I recorded in my journal in March that it “feels as if the U.S. is teetering on the edge of a pandemic abyss.” Fear was in the air.
The COVID-19 Work Group Reconvenes
Confronted by this impending catastrophe, the Washtenaw County Medical Society Executive Council, led by Jim Szocik, MD, convened a COVID-19 Work Group, once again bringing together all parts of the health care system to share information and see if it could help maintain order in the face of chaotic events. Because of the threat to the University at large, Robert Ernst, MD, chief medical officer for the University, also participated. Sandro Cinti, a member of the Executive Council, once again presided over the meetings. The first meeting took place on Wednesday, April 1 via teleconfer- ence. This was (and remains) the only such coordinating effort that spanned the county.
Unlike the 2009 and 2014 threats, COVID-19 rapidly revealed itself to be both widespread and lethal. Within a week, there were 17,000 COVID cases across Michigan,
and they were expanding exponentially daily at a rate of 101.2; over 1,000 deaths had been recorded. Hundreds of health care workers had tested positive, over 100 at UMH, 700 at Henry Ford, even more than that at Beaumont. The lockdown, which was then 2 weeks old, began to curtail the exponential rate of growth so that by the end of April new cases were accumulating at (only) 1000/day. In May that number gradually came down to 800/day, then 600/day.
At weekly and then biweekly meetings hospital infectious disease specialists shared information on screening of patients and employees, and lessons learned in critical care management. Hospital represen- tatives discussed their occupancy situations, how they were screening patients and employees, what precau- tions they had put into place. Participants discussed how to effectively roll out a coordinated plan for immunizing both health workers and the public. Case and immuniza- tion rates were carefully monitored, including on-cam- pus and off-campus student rates. A topic that was discussed among the participants was intubation and why it should be avoided if at all possible. This was important new information for EMS. Vaccination pro- grams and locations were coordinated between hospi- tals and the Department of Public Health. Information was also shared about St. Joseph Mercy Health System’s innovative collaboration with Huron Valley Ambulance to deliver monoclonal antibody treatments to patients at home.1 Thanks to the work group, everyone knew what everyone else was doing.
The work of the COVID-19 Work Group was greatly enhanced by the addition of epidemiology and math- ematical modeling experts from the School of Public Health, Emily Martin and Marisa Eisenberg, who created a dashboard for the state displaying the trends and epidemiologic characteristics of the pandemic in close to real time, which they shared with the group.
The COVID-19 Work Group represents the finest tradition of the Medical Society working in the public interest. Because the pandemic has not abated, and in fact is well int•o its fourth surge, its work continues 18 months later.
1Malani A, et al: Administration of Monoclonal Antibody for COVID-19 in Patient Homes. JAMA Network Open. 2021;4(10):e2129388. doi:10.1001/jamanetworkopen.2021.29388
12 Washtenaw County Medical Society BULLETIN FALL 2021