COVID-19 Response at HSS
The covid-19 Pandemic has been a defining moment for HSS. Hourly change has become the new normal. But through it all, HSS continues to plan for the future. This experience is bolstering what was already a solid foundation of teamwork, culture, decision-making and leadership for today and tomorrow.
We remain committed to upholding our mission: delivering the highest caliber of care, conducting leading-edge research and educating the next generation of musculoskeletal leaders. The investments we’ve made in our care management enterprise during this crisis will allow us to continue to do what we do—and to do it even better.
What follows is a timeline of events at HSS starting in March 2020, as cases of COVID-19 in New York City began to grow exponentially:
HSS makes the decision to proactively suspend nonemergent care to safeguard patients and staff, effective March 17. Only emergent surgeries or procedures continue to be performed, recognizing the benefit of such interventions outweighing the risks posed by COVID-19.
To ensure that HSS clinicians can continue to deliver urgent and routine musculoskeletal care to patients during the pandemic, HSS rapidly expands HSS Virtual Care, launching new telehealth technology and getting hundreds of doctors on the platform. Between March 16 and April 3, 186 physicians and 117 rehabilitation therapists begin offering virtual visits; in the three months following, more than 40,000 such visits are completed. Currently, more than 500 clinicians have active telehealth accounts, including residents, fellows, nurse practitioners, physician assistants, other nursing staff, physicians, and rehabilitation specialists. Looking forward, HSS clinicians are anticipating that telehealth will continue to play a large role in follow-up care with established patients as well as a smaller role in expanding access for new patients.
In response to the surge in patients at hospitals in the New York City area, HSS offers extensive resources to neighboring Weill Cornell Medicine, including staff, supplies, and capacity at our own facilities. HSS transformed into a multispecialty hospital, treating both COVID-positive and negative critical care and medical/surgical patients from Weill Cornell, while continuing to take care of those in need of essential orthopaedic surgery.
In response to the inordinate stresses inherent in caring for patients during the pandemic, HSS expands health and wellness offerings to all staff, including mental health counseling, peer-to-peer support, employee assistance funds and more. HSS also implements a dedicated multidisciplinary council to offer continued support for staff, to be facilitated by Chief Wellness and Resiliency Officer Steve Forti, appointed in June.
As schools everywhere shift to virtual learning, the HSS Sports Safety Program turns its Learning Center into a virtual physical education platform to deliver movement literacy classes to school-aged children throughout the nation and around the world.
To help those with urgent musculoskeletal issues avoid a trip to a potentially overwhelmed emergency department, HSS expands access to urgent ortho care at several sites in the tristate area. Patients were able to receive immediate care for sprains, strains and severe pain on site from HSS providers.
As part of our return to new normal, HSS medical leaders filled a void in the field by developing actionable criteria for non-essential surgeries, sharing it with other providers nationwide.
Frontline workers at HSS take part in a nationwide clinical trial investigating whether hydroxychloroquine can effectively prevent COVID-19 in healthy healthcare workers. Known as the Healthcare Worker Exposure Response and Outcomes of Hydroxychloroquine (HERO-HCQ) trial, the study is launched by the National Patient-Centered Clinical Research Network (PCORnet) and will track responses in an estimated 15,000 participants across the country to see if they test positive for COVID-19 and whether they develop antibodies to SARS-CoV-2, the virus that causes the disease.
As the peak of the crisis abates and the need for HSS resources diminishes, HSS plans a responsible, meticulous return to non-emergent patient care. This includes a phased return to surgical care, building on the emergent cases that continued to be treated during the pandemic, to include urgent, priority and eventually elective surgeries.
Terminal cleaning of all patient care areas, including intensive disinfection of all patient-care spaces, operating rooms, waiting rooms and other common spaces, prepares the facility for a safe return to care.
Recognizing the adverse impact of racism and social injustice, a leadership council is formed to greater integrate and advance diversity and inclusion efforts across the organization, with a commitment to addressing health inequities and supporting the diverse tapestry of our employees and the communities we serve. In 2020, HSS was named a Leader in LGBTQ Healthcare Equality for the sixth consecutive year by the Human Rights Campaign (HRC) Foundation, the largest national lesbian, gay, bisexual, transgender and queer (LGBTQ) civil rights organization in the US. Prioritizing equitable, supportive care for all patients and ensuring a respectful and welcoming atmosphere for all remains a top priority.
Researchers at HSS find evidence that an immunosuppressive drug approved to treat rheumatoid arthritis and neonatal-onset multisystem inflammatory disease may allow certain people with COVID-19 to avoid having to go on a ventilator. The drug, anakinra, appears to reduce the effects of systemic inflammation in people with COVID-19 who are in severe respiratory distress. The study is published online first in Arthritis & Rheumatology, and was led by HSS rheumatologist Iris Navarro-Millán, MD.
Researchers at HSS find evidence that an immunosuppressive drug…may allow certain people with COVID-19 to avoid having to go on a ventilator
Throughout their training, HSS orthopaedic surgery residents provide care at several New York City hospitals, in addition to HSS. During the pandemic, residents and fellows shifted to provide care in emergency, orthopaedic trauma and intensive care settings across the city, while continuing their training through virtual lectures and simulation-based learning. The residency program published an article in the HSS Journal detailing the guiding principles used in our institutional reorganization, in the hope that it may help other orthopaedic programs responding to similar situations in the future. These included safety of all patients and staff, transparent communication, organized leadership and teamwork.
Sports medicine physicians at the HSS Sports Medicine Institute develop the first set of guidelines for helping patients return to recreational activity safely after mild to moderate infection with COVID-19. The guidelines provide a framework of considerations and recommendations based on the latest evidence regarding how COVID-19 affects different body systems.
HSS initiated nine COVID-related studies, including research on the use of CDK7 inhibitors to target COVID-19 —associated cytokine storm, the mechanisms of cytokine storm in COVID patients, and the association of immunomodulatory medication use and social determinants of health with COVID-19 infection in systemic rheumatic disease patients in New York City.