195: Hospitals Prepping for COVID-19 Surge

Akin Demehin, Senior Director of Quality and Patient Safety Policy with the American Hospital Association, explains how hospitals are preparing for the possibility of another COVID-19 wave later this year; Dr. Mark Levine, Vermont Health Commissioner,...

Akin Demehin, Senior Director of Quality and Patient Safety Policy with the American Hospital Association, explains how hospitals are preparing for the possibility of another COVID-19 wave later this year; Dr. Mark Levine, Vermont Health Commissioner, discusses how he’s feeling about the recent rash of mass shootings across the country; ASTHO publishes a brief summarizing resources to guide agency healthy aging work; and Missouri shares on a webinar how it used population segmentation to improve COVID-19 vaccination outreach.

American Hospital Association Letter: AHA, Others Urge HHS To Continue Public Health Emergency

Journal of Public Health Management & Practice Research Paper: The National Epidemic of Gun Violence: The Vermont Department of Health Response

ASTHO Brief: Public Health Frameworks to Advance Healthy Aging

ASTHO Webinar Registration: Cluster Analysis for Pop. Segmentation and Outreach: A Case Study in Missouri

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This is Public Health Review Morning Edition for Wednesday, June 8th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


Concerns that the fall could bring another surge in COVID-19 infections have people in healthcare working hard to get ready. Hospitals have been taxed several times since the pandemic began, faced with too many patients, not enough PPE, and an overworked staff.

Akin Demehin is a senior director with the American Hospital Association. In today's morning conversation, he talks about the possibility of another COVID wave later this year.

Given the prediction that we could have another COVID surge this fall, what are your members doing to get ready for that?


You know, unfortunately hospitals have been through this process before over the course of this pandemic and have dealt with wave after successive wave of COVID cases and, ultimately, COVID hospitalizations as well. And so, they really turn to a few different strategies to help prepare for the possibility of patient surges.

The first is ongoing vigilance. Hospitals, like so many others across the country and certainly public health officials, look very closely at the data that are being shared at the local, state, and national levels to get a sense of what may be coming down the pipeline in terms of potential case volumes.

They're implementing their response plans as well, and those have multiple components. Hospitals are looking carefully at their supplies of things like personal protective equipment and other medical supplies that are essential to have in the face of significant upticks in the number of COVID hospitalizations.

One of the things that hospitals have also grappled with, especially during the Delta and the Omicron surges, is the fact that parts of their workforce may be unable to work at a given time because they may become infected with COVID themselves. And so, having a backup plan for staffing to make sure that they can maintain the level of staffing that they need to and call in those additional resources and backup resources is always something that hospitals are thinking of and planning for with the potential surge coming.


As you've said, hospitals have been through this too many times already, and so I suspect much of the response is quite familiar to them. But is there anything we're expecting to be different this time, from a hospital point of view?


Well, the one thing I'll say about this pandemic is that I think it's taught us all some humility about what we know and what we don't know. And obviously at this juncture, we don't know exactly what the particular variant of COVID may look like by the time the fall comes around. I think that's where the vigilance in monitoring—not just the data but also the ongoing scientific evidence around the pandemic—becomes so critical.

I will say that hospitals have really tried to continuously learn from their previous experiences to make their responses even more effective. Just to give you an example of that, very early in the pandemic one of the things that happened—because there was so much concern over hospital capacity and hospital supply levels to respond—is that we saw hospitals deferring a number of nonessential procedures.

And I think as the pandemic has worn on, hospitals have been able to use that approach in a much more measured and strategic way and really trying to minimize the number of elective cases that do have to be deferred, in part because we know hospitals and we know patients are really depending on having those kinds of procedures. We call them non-urgent, but you know, it can involve things like diagnosing cancer. It can involve a knee replacement surgery, which has a major quality of life implication. And so, being more precise around the criteria that we use and the process for that is one example of how hospitals are trying to learn.

I think, too, that as the availability of therapeutics has improved, as we've learned more about how to treat COVID patients over the course of the pandemic, we've seen hospitals rapidly adapt their care protocols and practices to try to reflect that and really trying to learn as much as we can to be as ready as we possibly can for whatever comes our way.


Last question for you—public health professionals listen to this newscast and they may be asking how they can get involved, if they're not already. What's the best way for them to support hospitals in their area?


I would say that hospitals have, especially in the course of this pandemic, built relationships with their state and local health departments that have been just instrumental in mounting an effective response to the pandemic.

Just to give you a couple of concrete examples: when hospitals have experienced severe shortages in either supplies or healthcare workers, they've often turned to their public health leaders in their states and in their localities to raise those concerns. That's given an opportunity to escalate some of those needs to our federal partners and to coordinate a response with them. It's given us the opportunity to coordinate resources across states to make sure that everyone in a particular region is able to access some of the response resources that have been put into place.

I think one of the great learnings from this pandemic and really one of our opportunities moving forward is to continue those incredibly constructive and important relationships with public health officials so that we're not only able to respond to this pandemic, they're ready to respond to ones in the future as well.



Gun violence in the country is out of control. Last weekend, more than a dozen people were killed and more than 70 injured in at least 13 mass shootings in the U.S.—that's on top of events in Buffalo, Texas, Oklahoma, and California.

Vermont health commissioner Dr. Mark Levine wrote about a near miss event in his state in 2018 for the January/February 2020 issue of the Journal of Public Health Management and Practice. Given the tragedy of the last few weeks, we asked him how he's feeling about the article and all that's happened since it was published.


You know, I guess I could begin with frustrated and exasperated. This problem never really went away, and we're now seeing it exacerbated by the pandemic and its impact on mental health, the circumstances that people find themselves living in, their anger about things they cannot control. And I think we've seen an overall lack of civility and respect in the way we treat one another that's now being brought to extremes.


We'll have more from our conversation with Dr. Levine tomorrow.


As part of Alzheimer's and Brain Awareness Month, ASTHO summarizes resources to guide agency healthy aging work in a new brief, now online. Readers will find ASTHO's healthy aging policy statement, a six-step process developed by the Trust for America's Health, and AARP's assessment framework. Read the brief using the link in the show notes.


Finally this morning, you can learn how Missouri used population segmentation to improve its COVID-19 vaccination outreach in a webinar planned later this month. State health officials will outline the approach and tell you how to adopt it in your jurisdiction. The event is set for Thursday, June 30. Sign up using the link in the show notes.


That'll do it for today's newscast. We are back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.

Mark Levine MD

Commissioner of Health, Vermont Department of Health

Akin Demehin MPH

Senior Director Quality and Safety Policy, American Hospital Association