There are lessons learned, moments of sadness and of hope – as we look back on the life we once knew and the “new normal” we are still trying to define.
Staff writers Cassie Drumm, Barry Gutman, Karuna Meda, Patrick Monaghan and Shellie Wass contributed to this article. Multimedia editor: Carly Williams.
For most of us, COVID-19 seemed like a problem in faraway places. That is, until the red dots on the Johns Hopkins COVID-19 world map, signifying outbreak, began to crawl across the globe from China until in March 2020, the Philadelphia region entered lockdown. We all have stories of those weeks before lockdown and the freedoms we took for granted: concerts, happy hours, vacations, freely wandering the produce aisles of supermarkets.
Face masks and six-feet distancing weren’t daily habits. Jefferson Health’s Center for Bioterrorism and Disaster Preparedness, however, had been tracking this virus starting in December 2019. Our experts had spearheaded similar tracking and planning for H1N1 in 2009 and Ebola in 2019. They began planning for a pandemic – sourcing and storing personal protective equipment for frontline staff. On January 8, 2020, the Centers for Disease Control and Prevention alerted the U.S. of the virus outbreak in Wuhan, China. On January 11, 2020, China reported its first death. Jefferson Health issued its first enterprise alert on January 25, 2020 and, three days later, a COVID-19 task force first met.
Here’s a look back at what happened next.
The Beginning – March 2020
March 6: Jefferson confirms its first COVID-19 case in New Jersey.
“We knew at the beginning of March that a storm was going to hit us. And it was kind of like the quiet and peacefulness before the storm. We heard about what was happening in New York, but it didn’t hit Philadelphia. We knew that it would hit the fan in a few days, and we were working on it, but preparing for it, in terms of knowing what to do with the inpatient volume increase, or if the outpatient offices would be closed, who would be the doctor of the day.” – Dr. Yair Lev, Cardiologist
March 10: A “Parents’ Guide to Coronavirus” publishes to help inform worried parents on ways to keep themselves and their families safe.
“From my perspective, having been in the context of working on outbreaks before, it was really a race in getting prepared for what we could be hit with in terms of patient volume and then how to protect our staff. We quickly went into the mode of training…getting people trained and comfortable with using powered air-purifying respirators (PAPRs) and the necessary PPE. We were a little bit ahead of the curve in terms of anticipating that this was coming our way. COVID-19 was already spreading so much more than people recognize at that point in time. Then it was sort of just anticipating and watching what was happening on the West coast in terms of initial cases, and then, cases starting in our region in the beginning of March.” – Dr. Patricia Henwood, Emergency Medicine Physician, Lead Emergency Medicine COVID-19 Task Force [Editor’s Note: Read about Dr. Henwood’s global health missions here.]
“One day I came to work and it was mandatory that everyone wore a mask. And I’m like, this is serious. And then the more it started coming, you’d see a room here, a room there. Then the hospital started getting filled up. Then there were no visitors. I was asking myself, ‘Is this something out of a movie?’ Then there was no way of getting around COVID. It was just everywhere you turned. It was just there.” – Rhonda-Brown Parker, 16-year member of Jefferson’s Environmental Services Department, reflecting on her experience working on an all-COVID unit
March 13: Jefferson Health begins curtailing elective surgical procedures, moving forward only with urgent and essential procedures.
“Dr. Anita Jensen [SVP of Learning & Organizational Development], Dr. John Lauriello [SVP of Enterprise Behavioral Health and Chair of the Department of Psychiatry & Human Behavior], Dr. Michael Vergare [Department of Psychiatry Professor & Chair Emeritus] and Dr. Deanna Nobleza [Director of the Student Counselling Center – Center City], came together early on to provide thought leadership around the mental health impact that the pandemic could have on staff. Additional members of the HR team and Department of Psychiatry faculty joined a weekly “think tank” to discuss the real-time psychological strain we were seeing across the organization, and we quickly collaborated to produce and launch a series of mental health and wellbeing resources to help staff cope.” – Samantha Inch, Manager of Employee Emotional Health Resources, Human Resources Department, on the multidisciplinary effort it took to begin a collection of mental health resources for Jefferson Health employees
March 18: Dr. David Nash, founding dean emeritus of the Jefferson College of Population Health, pens a plea to “flatten the curve.” He projects the strain health systems will face, shares worries about how healthcare providers will cope, and stresses the importance of staying apart. “Just look at Italy beyond what you see on TV. Doctors making decisions on who will get a ventilator and who won’t. We don’t want it to ever come to that in Philadelphia.”
“There were supplies that became very difficult to obtain in a very short period of time, like N-95 masks, ear loop masks and then gowns. It came in three waves and was due in large part to an explosion in demand that the distribution infrastructure in the United States (which relies on past usage patterns to allocate how much you can buy at any given time) couldn’t handle. So if you looked at 2019 as a basis for what we were buying, nobody was prepared to supply or sell us the new volume of products that we needed. The only way forward was to look to the secondary market, gray markets. Navigating those to ensure that we were getting effective and quality products was just really an adventure all to itself.” –Christopher Fontana, Vice President of Procurement, Supply Chain Management, on PPE shortages
March 18: Mobile testing site construction begins in the parking lot across from Thomas Jefferson University Hospital.
Coronavirus Drive-Thru Testing Site is officially underway at @TJUHospital ..⛑🛠#covid_19 #fightcoronavirus💪 #EmergencyMedicine #tents #structure #eventprofs #tentrental #fema #pandemic #healthcare #temporarystructures #TestingForCovid19 pic.twitter.com/D6nF4K4kEE
— EventQuip (@EventQuip) March 19, 2020
“Dr. Edward Jasper had the forethought many years ago to start stocking supplies of personal protective equipment…like gowns, gloves and masks. We started to put in place protocols and train people on how to use PAPRs, how to make sure that people were fit-tested for N95s. We started doing videos on properly putting on and taking off PPE so that we made sure people were protected.” – Kelly Zabriskie, Enterprise Vice president of Infection Control at Jefferson Health
March 19: Jefferson launches the COVID-19 Better Together Fund to support employees and students in need. In three months, more than $7.5 million is raised to help 3,665 people.
“When those first cases hit, we just didn’t know what was a cold and what was COVID, but to keep everyone safe, we had to tell our patients who I would normally treat in the clinic for a cold or cough to stay home. And I remember wishing I could just see them really quickly and reassure them, placing the stethoscope on someone’s chest can really make a profound difference. I started to hear the fear and worry in my patients. I remember even having a phone call with a woman who unfortunately was hospitalized with COVID and went home and although she was improving, we couldn’t let her back into the office because she was just discharged. And she was probably still contagious to our knowledge, we just weren’t sure. And she said, ‘Well, how are you going to tell me that I’m improving? If you can’t listen to my lungs?’ And I said, I don’t know that I can allow you into the office, you know, so that I can reassure you, but I’ll do everything else that I can to reassure you.” – Dr. Krys Foster, Family Medicine Physician
March 19: Mobile testing site opens.
#COVID19 testing site at Jefferson Hospital now includes a drive-thru for patients with a doctor’s referral. It’s busy.
— Corey Davis (@CoreyDavis6abc) March 19, 2020
“We had a really cold March when we opened up the testing site. So, in the morning setting up, we would just put music on and start dancing around and we found that this also lifted our spirits. It was a bonding experience for us. Then, it just became a habit every morning. We would start warming up and we would have music playing and do a mix between exercises and dancing. We noticed the trend of healthcare workers posting things on social media, so we decided to hop onto that trend and it just took off more than we could have imagined. It helped us put our best-masked faces forward to the patients.” — Jeffrey Salvatore, Jefferson nurse, on the moments that inspired the union of the #SwabSquad and their now-viral videos on the @tjuh_pool Instagram page
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March 22: “A nurse greeted me at the far corner of the Center City testing site and every inch of her body was covered in PPE. The gravity of the illness hit me like a truck and I started crying. ‘Oh sweetie, I’m so sorry,’ she said to me. ‘I wish I could hug you, but I can’t.’” – Alexandra Hackett, COVID-19 survivor and long hauler health advocate. [Editor’s Note: Read about Alexandra’s emotional journey here.]
“We had to be aware of the latest science. We had to be responsive and reactive to recommendations that were coming to us through a number of different channels—through the CDC, or through professional organizations, the Infectious Disease Association of America. All those scientific developments were driving recommendations that we had to incorporate into our procedures and practices quickly as patients arrived at our door.” – Brian Swift, Chief Pharmacy Officer Jefferson Health, on the influx of CDC recommendations during the early days of COVID-19 treatment
March 23: Jefferson Health institutes a Universal Mask Plan. Face masks are distributed to all members of the workforce (surgical or procedural) to wear continuously throughout their entire shift. New masks are distributed every day. Donations are accepted at this time from the community—including N-95 respirator masks, hand sanitizer and goggles.
“We heard all kinds of stories of cargo planes being hijacked; mobs of people standing outside factories with bundles of cash, trying to outbid each other. So we had entered into agreements where we were assured that our supplies were going to make their way onto a plane one day. And then we got a call the next day by a very shaken supplier to say the supplies were lost. It was just crazy. Like something out of a nightmarish fiction novel.” – Christopher Fontana, Vice President of Procurement, Supply Chain Management, on navigating PPE procurement during the surge
March 24: Dr. Deanna Nobleza, a psychiatrist and Director of the Student Personal Counseling Center, discusses the toll of pandemic stress on our mental and emotional wellbeing and offers ways to cope.
“In September of 2019, we had a celebration of four years of JeffConnect because we had done our 100,000th JeffConnect visit over those four years. We saw that [same amount] [of patients on JeffConnect over [just] four weeks from March into April .” – Dr. Judd Hollander, Senior Vice President of Healthcare Delivery Innovation, on the increase in JeffConnect telehealth appointments during the first surge
“We were seeing more death than we ever had before. There aren’t enough words to describe how difficult it was. Many workers were afraid to go home to their families due to the possibility of getting them sick.” – Lisa Dutterer, Chief Administrative Officer of Jefferson Cherry Hill Hospital
March 25: Emergency medicine physician Dr. Anna Marie Chang shares her COVID-19 diagnosis on Twitter. Read and listen to her survival story here.
It’s taken me a while to write this. Last week I was diagnosed with #COVID2019 . I was tired, febrile, achy. The GI symptoms are no joke. While those symptom improved, I started getting more short of breath. I finally came to the hospital today. pic.twitter.com/6qQDzNZUw6
— annamariechang (@annamariechang) March 25, 2020
“In March, when this all started, I think the immediate issue that we dealt with was regular blood availability because so many places closed mid-March. And so many blood drives that are held in those places were canceled, but at least at Jefferson, for the first few weeks of all of this, we were still mostly business as usual. And that was a very unsettling time because we weren’t sure what was going to happen. If the hospital continued to function at full steam, but the blood supply did not, that mismatch wouldn’t be sustainable for very long. And so for those few weeks, there was a lot of concern on the blood bank side, because we just didn’t know what was going to happen.” – Julie Karp, Director of Transfusion Medicine and Jefferson’s Blood Donor Center at Thomas Jefferson University Hospital
The First Surge – April through May
April 1: Philadelphia Chinese Community Organizations United goes above and beyond and generously donates masks to Thomas Jefferson University Hospital.
— Jefferson Health (@TJUHospital) April 1, 2020
April 7: The patient volume for Jefferson Health is down 50% from baseline. The decrease is attributed to the dramatic and purposeful increase in using telehealth for triage, transitioning care to ambulatory sites that are open and patients coming to the ED for only true emergencies.
“This was teamwork better than anything you could ever imagine. There were technical issues that happened. And there was a team of about 15 people that stayed awake for 11 days, rotating out to get two hours of sleep at a time, to fix the technical issues with our colleagues from Epic and our colleagues from Teladoc health and our colleagues from IS&T and the telehealth team. And so, phenomenal, phenomenal team effort on the tech side.” – Dr. Judd Hollander, on the herculean effort to meet the dramatic demand for telehealth
April 8: Dr. Beth Schwartz discusses the uptick in patients reporting abnormalities with their menstrual cycles during the pandemic—from spotting and bleeding, to early, late and skipped periods.
“April and May was prime time for convalescent plasma [donation], whether it was recruiting the donors or the processes internal to the blood bank and to the Blood Donor Center…even just making sure the donors have been tested [for COVID-19], which was so early in the process, a lot of people hadn’t been tested officially in some capacity, and then bringing them in. We also had the issues of changing how we deal with blood donors in general, because like any blood center, we’ve always relied on walk-ins and if 40 people walk in, that was a good day. But we had to change our model because we now had to start thinking about social distancing in our own donor center. Around that time we went to appointments only and we were not encouraging walk-ins. In fact, we were, in some cases, turning people away.” – Dr. Julie Karp, Director of Transfusion Medicine and Jefferson’s Blood Donor Center at Thomas Jefferson University Hospital
April 28: Michael Lucidonio, Tony Luke’s son, shares his COVID-19 experience, including being put on a ventilator all the way to recovery.
“During that first surge that we saw in April, May and June, I felt very fortunate that we had amazing collaboration with our supply chain logistics team. They worked diligently to ensure that we had the proper PPE, the type that we’re accustomed to. We never relied on decontaminating or reprocessing our masks.” – Kelly Zabriskie, Enterprise Vice President of Infection Control at Jefferson Health
April 29: The Blue Angels flyover Philadelphia honoring healthcare.
— TJU&H Public Safety (@TJUSecurity) April 28, 2020
“We organized our mental and emotional wellbeing resources for staff into a four-tier pyramid. The tiers of the pyramid matched the resource to the severity of a person’s stress – from low touch, self-facilitated resources at the bottom, to higher-touch professional interventions at the top. These included an ‘Adopt-a-Department’ pilot to match psychiatry liaisons with clinical departments for direct access to mental health support, an expedited referral line to Psychiatry for appointments, live drop-in support groups using Psychological First Aid practices, a variety of coping skills workshops, a hotline to Pastoral Care support, and an online library on the employee portal of asynchronous videos, audio recordings, and tip sheets on managing anxiety, attending to self-care, dealing with difficult emotions, and building resilience.” – Dr. Michael Vergare, Department of Psychiatry Professor & Chair Emeritus and Anita Jensen, Senior Vice President of Learning and Organizational Development, Human Resources Department
May 19: Jefferson launches Nurse2Nurse, a safe space for nurses to talk to their peers about the overwhelming stress and emotions they experienced caring for COVID-19 patients over Zoom with psychiatric mental health nurse practitioners.
The Aftermath – June through August
June 5: Jefferson joins the nationwide HealthCare Action Against Racism event to recognize racism as a public health crisis and a societal travesty.
“There was a quieter period through the summer relative to what we had been seeing. The ongoing concern at this time was when things would get worse again, as they did in the fall and winter. At that point, so many of us were experiencing pandemic fatigue. I think that had set in more with the public. People weren’t practicing social distancing as strictly as before. The politicization of science, with people choosing whether or not to mask, was a huge challenge. For healthcare workers, you recognized the negative impact this was having. It was important for me to get the message out to the public: this is real and ongoing.” – Dr. Patricia Henwood, Emergency Medicine Physician, Lead Emergency Medicine COVID-19 Task Force
July 29: Racist attacks and xenophobia against Asian Americans and Pacific Islanders community increase, fueled by theories about the virus, and flagrantly racist terms like the “Chinese virus” and “kung-flu.” Dr. Deanna Nobleza, who identifies as Filipino-American, shares her family’s experience of grieving the loss of a loved one to COVID-19, while facing racial prejudice and stigma in a poignant interview.
July 30: Psychologist Dr. Shawn Blue discusses the challenges and responsibilities that come with being a part of an underrepresented minority in the mental health space—from macroaggressions to advocacy.
The Second Surge – September through December
September 16: This episode of The Health Nexus Podcast explores what various industries like health care, academics, and the corporate world need to do to promote equality. Hear from Lisette Martinez, Jefferson Chief Diversity Officer, Tiffany Gibson, clinical nurse advocate, and PhD student Lebaron Agostini on their personal experiences and recommendations.
October 15: Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), joins Thomas Jefferson University’s Department of Medicine Ground Rounds to discuss COVID-19 and the ensuing public health and scientific challenges. [Editor’s Note: You can read our recap of the event here.]
Dr. Anthony Fauci delivering virtual Grand Rounds with us today. pic.twitter.com/Ezstx1tOVX
— Jefferson Health (@TJUHospital) October 15, 2020
“With collective fatigue setting in, and in anticipation of a second surge, some resources were adapted based on feedback, and others were expanded to address mental and emotional wellbeing during the colder, darker months. A Winter Wellness Guide was released with new synchronous workshops, asynchronous videos and live coping skills workshops on topical issues like pandemic fatigue, seasonal affective disorder, reimagining traditions for socially distanced holidays, support for parents and more.” – Anita Jensen, Senior Vice President of Learning and Organizational Development, Human Resources Department
November 6: Jefferson Health launches a no-cost community COVID-19 testing site in Southwest Philadelphia outside of the Richard Allan Preparatory Charter School, the second site to open after the first site at St. Raymond of Penafort Church school parking lot.
“Whenever [my team was] feeling really burned out or anxious or stressed, I tried to remind them, everything we do is for our clinicians and the patients they’re caring for. Everything we’ve done is to keep them safe and able to practice. This is what you’re doing. You’re unsung heroes here. We’ve received a tremendous amount of gratitude from people internally, which really fueled us through the worst times.” – Christopher Fontana, Vice President of Procurement, Supply Chain Management, on burnout, which intensified in the healthcare community during the second surge
November 23: In preparation for the delivery of a COVID vaccine, Jefferson launches an enterprise-wide employee survey to gauge staff willingness to be vaccinated and identify the barriers and information gaps. More than 10,000 respond—setting in motion a comprehensive communication plan to dispel myths, improve confidence in the science and establish a grassroots effort to reach out directly to minority populations at Jefferson.
December 16: The first phase of COVID-19 inoculation with the Pfizer/BioNTech vaccine or the Moderna vaccine distribution begins. Workers with the highest risk for COVID-19 infection are prioritized. Jefferson nurse Jennifer Gil is the first person at Thomas Jefferson University Hospital to receive a vaccine.
“There are so many mixed feelings, a lot of fear, many unknowns. I think the vaccine arriving and getting the vaccine and being grateful that things are happening. What I’m looking forward to is that I’m turning 40 this year. And I love to travel. So that’s the thing that I look forward to the most. Most of my family is based in Taiwan, so I haven’t seen them since 2019. That would be nice for 2021. I think looking forward to actually seeing friends, and I don’t want to say a return to normalcy because I believe this will be a new normal for our lives. Being able to settle into a new normal would be great.” – Dr. Anna Marie Chang, Emergency Medicine Physician, on hopes for the future and vaccination efforts
The Future – The COVID-19 Vaccines and Long-Hauler Effects – January to present
January 8: Over 10,000 Jefferson Health employees are vaccinated, a milestone moment. The next phase of vaccine distribution planning begins as almost all clinical staff have been reached with an invitation to sign up for a vaccine if they choose to do so.
“Moving forward, we have a real sense of purpose and a real sense that we’re making a difference in the world as an organization. Throughout all of this, we’ve done it right, we’ve done it safely, we’ve taken care of a lot of people. We’ve taken care of our own employees throughout all of this, so that, you know, it wasn’t a hotbed of people getting infected by coming to work. People felt safe here.” – Brian Swift, Chief Pharmacy Officer Jefferson Health
January 29: Vaccination of high-risk patients, such as those who are age 65 or older, have health conditions that increase the severity of COVID-19 symptoms, and/or patients who work in essential jobs that increase exposure at work begins.
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“The vaccine efficacy data is really amazing. It felt like a sort of miracle science…the data is so much better than honestly expected. It was the first thing in the pandemic that was actually a best-case scenario and continues to be. We need to make sure vaccines are reaching all parts of the world, especially those vulnerable countries. Global health security is a real thing and it has a really huge impact. If we don’t invest in the infrastructure of vulnerable health systems, that does have an impact everywhere. I think that there will be this sort of change in the landscape and, and dialogue around recognizing how vulnerable they are to the emergence of these kinds of threats. Unfortunately, I think there is the potential for there to be another pandemic and like we need to be better prepared to respond to that.” – Dr. Patricia Henwood, Emergency Medicine Physician, Lead Emergency Medicine COVID-19 Task Force
“Now that it’s been a year, I can look back on it, and I think it has affected a lot of my work as a researcher in terms of being very invested in COVID-related studies. So, we got our convalescent plasma project up and running. We’ve done multiple studies within emergency medicine networks about the course of COVID. And more recently, we’ve participated in several studies looking at different COVID testing devices and now looking forward to vaccines and how that may play out. So, I think COVID has really impacted me as a researcher in terms of what projects I’m choosing to do. It just has a little bit more of a personal feel to it.” – Dr. Anna Marie Chang, Emergency Medicine Physician [Editor’s Note: You can read more about research efforts investigating the long-term impact of COVID-19 here.]
January 27: Dr. Hollander shares photos of Jefferson offices on Twitter, 10 months after the start of the pandemic.
Return to the inperson office. Notice the status of the plants and the March 2020 calendars and newspaper…. pic.twitter.com/deP7cec962
— Judd Hollander (@JuddHollander) January 27, 2021
“We’re better prepared now because we’ve seen how bad it can get. We’re in a position where, if all supply lines just simply stopped for PPE, we could survive [depending on the category] for several months. Thanks to the support of our executive leaders, we’ve positioned ourselves so that if that ever happens again, for whatever reason, we’re not going to run out of masks, gowns, or other products for quite some time.” – Christopher Fontana, Vice President of Procurement, Supply Chain Management
February 18: Dr. David Rosen weighs in on ways to regain the loss of taste and smell for those still struggling with post-COVID symptoms, including if those videos on social media of eating strange combinations of food are valid.
“Our team really worked hard to make sure that we always had our PPE so we could keep our staff safe – and, technically, our patients. I can’t say enough thanks to them for making sure they did all they could to reach out to vendors. We have a good supply of PPE now, and I am very happy about that because some of these protocols we have in place now for universal masking and source control are probably going to be in place for a while in our ‘new normal’. I think we have to look at that in our office and cubicle workspaces as well, to think about how we’re working with each other to reduce any risks of a future pandemic and making sure that we don’t spread things.” – Kelly Zabriskie, Enterprise Vice President of Infection Control at Jefferson Health
March 5: Messages filled with hope and inspiration filled the hospital hallways as COVID-19 cases continue to drop.
Inspirational messages like this help our staff get through each and every challenge they face. 💪🌟 pic.twitter.com/nJh65iqZ2u
— Jefferson Health (@TJUHospital) March 5, 2021
“I am calmer now than I was last year. I don’t believe there is such a thing as ‘doing everything right.’ I just say do the best that you can. I’m a little more at ease because I do believe masks do work. From the science from [March] to now, I think everyone is a little more educated on the virus and now, I think it’s a part of your everyday routine. I am a whole lot different today than I was this time last year. I just wanted to crawl in a bubble and never come out. I think when we look back 20 years from now we are still just going to say: Wow.” – Rhonda Brown-Parker, Environmental Services Housekeeper
“My daughter has been watching Frozen 2 non-stop and I think about that one song from the movie, ‘The Next Right Thing.’ It’s what I try and we all have done throughout this year and what we continue to do. This pandemic has made it so clear how much science evolves—how much we don’t know. I learned to respect the knowledge we have and the knowledge we don’t. We need to prepare now for the next thing.” – Dr. Patricia Henwood, Emergency Medicine Physician, Lead Emergency Medicine COVID-19 Task Force
March 16: Jefferson Health staff come together to reflect and honor those who have lost their lives to COVID-19, as well as the survivors. 2,200 balloons to represent the 2,200 COVID patients discharged from Thomas Jefferson University Hospital throughout the pandemic were displayed in the hospital’s atrium.