Covid: Five Years On

It began with concern about the supply chain. In January and February 2020, several notices went out to Albany Medical Center staff about the impact the virus in China was having on medical supplies.

The “novel coronavirus” would in fact be here in just a few short weeks, becoming the deadliest pandemic in 100 years. In New York State, more than 80,000 people died from Covid.

“We did what our community expected of us. We went into action,” said Dennis P. McKenna, MD, president and CEO of the Albany Med Health System.

Area hospitals, including those in Albany Med Health System, spent mid-March 2020 working on the monumental task of healing the sick and protecting health care workers—and the community at large. In December 2020, Albany Medical Center was selected by New York State to be a hub of the Capital Region Vaccine Network, partnering with the Department of Health, local health departments, and community organizations to distribute a vaccine across eight counties. About one-million residents were vaccinated.

Infectious Disease

Covid is now endemic, said Alan Sanders, MD, chief of the Division of Infectious Diseases at Albany Medical Center.

“It’s here to stay but fortunately we don’t see those numbers of people dying and on ventilators the way we did in the early days,” he said.

Dr. Sanders explained that coronaviruses had been in our “portfolio of viruses,” usually causing something like a common cold. But when Covid appeared, no one had antibodies.

“The world was not immunologically prepared for it, so it destroyed us,” he said. “That it continued to go on such a ‘mutational rampage’ with Delta and Omicron and so on was surprising. We didn’t know an RNA virus would morph that quickly.”

He said vaccines and the natural progress of the virus have made it less virulent by and large for the general population. “It’s lost much of that power,” he said.

From a scientific standpoint, Dr. Sanders said much was learned. From the speed in which a vaccine was developed—which he called a miracle of medicine—to an increased understanding of virus behavior, to newer diagnostic tools, he said we are more prepared for another disease outbreak. “Who knew that people would be able to just go to the local pharmacy and buy a test in a box that could tell them if they had a virus in a matter of minutes.”

He cautioned that vaccine hesitancy and a dismissive attitude toward public health efforts after the pandemic is a concern, especially if and when the next health crisis happens. “It’s sad, but we need to remember the pandemic. We need to remember what we all went through.

Research

Dozens of biomedical and clinical research studies at Albany Medical College have gleaned valuable information that have meaning for future disease outbreaks, as well as treatment of severe respiratory disease.

For example, one study being conducted in conjunction with the University of Wisconsin Madison and Temple University has shown that the blood DNA methylation levels of long Covid patients differ from those of healthy patients, and that long Covid patients share the same blood biomarkers even when they have different symptoms.

“This suggests that long Covid is a single disease and not an aggregation of multiple conditions,” said pulmonologist Ariel Jaitovich, MD, professor in the Departments of Medicine and Molecular and Cellular Physiology at Albany Medical College.

Infrastructure

This critical work entailed developing Covid ICUs, safely maintaining emergency access, setting up virtual workplaces and college classes, and fast-tracking the use of telehealth. Safety measures such as crowd control, masking, and shoring up negative pressure rooms made it safe for patients to access the health care they needed.

"Covid allowed us to implement new technologies to support patient telehealth visits with our practice physicians. Starting in 2020, we started with approximately 14,000 telehealth visits. That increased each year increasing to 25,000 in 2024 with Epic implemented at Albany Medical Center. With Epic fully implemented across the System we are on target to do approximately 36,000 in 2025," said Kristopher Kusche, senior vice president and System Chief Information Officer of the Albany Med Health System.

Samantha DiCiccio, CEO of the Albany Med Health System Visiting Nurses, said regional cooperation was vital to allowing agency nurses to continue to see patients at home.

“We did not have enough gloves, masks, or goggles so we worked with community partners such as University at Albany and Albany Medical Center,” she said. “We received phenomenal support not only in assisting us with getting N95 masks but also by being available to answer any questions.”

Seeing patients safely was vital for urgent care centers, where many patients were turning for health care. In addition to establishing urgent care telehealth, at Saratoga Hospital’s Wilton Urgent Care, through the coordination of supporting services—laboratory, imaging, environmental services, and patient access—most urgent care patients were seen outside, with only the more acute brought into the clinic.

“Snow, ice, heat – the team was out there,” said Julie Sipperly, Wilton Medical Arts site director, adding appreciation for the community who shared food and notes of encouragement. “When you’re going through hard days, those words of support truly made a difference.”

Hillary Alycon, MD, associate vice president of quality management and infection prevention at Glens Falls Hospital, remains inspired by all her team accomplished: facilities built a UV disinfection room to reprocess masks and erected temporary walls when flex space was needed; frontline workers found creative solutions; pharmacy made sure the hospital had vaccines and supportive medications.

“We are unstoppable in the face of need,” she said.

Emergency Response and Preparedness

While disaster preparedness has always been a priority, Scott Heller, vice president of Emergency Management for the System, said it accelerated and expanded during the pandemic.

“We realized how the frequently changing guidance and situations affected our decision-making process and understood exactly how quickly decisions needed to be made. We also recognized the need to pivot if something wasn’t working,” said Heller, who also sits on various preparedness coalitions whose members include the State Department of Health, all System hospitals, and other regional health care facilities. “Officials from our region in New York, and beyond, meet regularly. We conduct more emergency response drills. There is more of a sense that this could happen again and would apply the many lessons we learned during the pandemic.”

Heller recalled the day in April 2020 when area hospitals were asked to take critical patients from overwhelmed hospitals in New York City. “We got on the phone with our counterparts locally. We assessed who had what capacity to take patients and we were successful in accommodating them.

Rakel Astorga, MD, surgeon and chief medical officer at Columbia Memorial Health, said quick action during Covid has shown health care providers what they are capable of.

“Patients came from our community, but many also drove from New York City and southern counties to avoid their overcrowded hospitals. Soon the ICU was full. We added beds as we had to,” she said.

DiCicco said, “For the Visiting Nurses it strengthened our team and provided guidelines, resources and partnerships that have continued beyond the official pandemic.

Heller pointed out that action plans put in place during the pandemic were recently utilized during a recent shortage of IV fluids after a major supply plant was damaged by a hurricane. “Our ability to collaborate for solutions across our communities and especially across our System hospitals is at another level,” he said.