Five years ago, much of the city and the world adopted a new vocabulary to describe unprecedented events: Quarantine, social distance, shelter in place, curve, wave, ventilator triage, surge. At the top of the list were two Coronas: the virus and the neighborhood in Queens – the global epicenter of the pandemic.
At the heart of the epicenter was Elmhurst Hospital, a safety-net facility serving Corona, Jackson Heights, Elmhurst, Woodside and other neighborhoods in Northern Queens, hubs of immigration and global travel where cramped quarters and limited health care infrastructure were fertile grounds for the virus to fester.
The largest public hospital in Queens, Elmhurst was flooded with more patients than any other facility in the country during the first Covid wave, forcing the roughly 500-bed institution to rapidly transform in an attempt to absorb the surge. Five years later, many of the systems for managing resources and patient loads that were developed during the pandemic are still in place and have been adapted to the rest of the public hospital system, both during times of peace and in preparation for another disaster. The hospital’s position as a community provider is stronger too, officials say, and the lessons learned from the pandemic – about how to share data, flex clinical space, stockpile supplies and reach the community – have helped the safety-net facility meet increased demand in the present.
“It’s changed Elmhurst almost 360,” said the hospital’s current CEO, Dr. Helen Arteaga-Landaverde, who took the helm during the second wave in February 2021.
Elmhurst is an 11-story Level 1 trauma center serving the bulk of Northern Queens’ un- and underinsured population across seven of the most diverse community districts in the city. Roughly two-thirds of Health + Hospitals patients are uninsured or on Medicaid. In March and April 2020, the hospital was overflowing, playing out the worst-case scenario that then-Gov. Andrew Cuomo described as a wave of infections crashing over the health care system.
The crisis necessitated the hospital to scale up critical services quickly, shutting down elective procedures and physically renovating the space in the process. The experience demonstrated how the hospital could be more flexible in responding to emergencies and showed its leaders how to be better prepared for a pandemic in the future, Arteaga-Landaverde said.
Administration down to rank-and-file received a crash course not only in patient management but in stockpiling personal protective equipment, and scaling up staffing, telehealth and vaccination in the community. Dr. Laura Iavicoli, Elmhurst’s chief medical officer and a 27-year veteran of its emergency department still receives the daily Covid-era dashboards that show the volume of patients in every unit, numbers of flu, RSV and Covid cases and capacity in other facilities. The waiting rooms now have oxygen pumped into them so they can sustain ventilators during the next surge, she said.
“Because there were so many patients and it was so overwhelming, you just had to try to make some order in the chaos,” Iavicoli said.
The experience has helped the hospital adapt to what has become an unprecedented demand for services after the pandemic. Last year, Elmhurst saw 1.2 million patients, equivalent to roughly half the population of the borough. Births in the hospital, which had plummeted during the pandemic, soared to more than 2,600 last year.
To manage the influx, the hospital still relies on the data briefings from other facilities and a handful of protocols remain in place to trigger supply conservation and resource sharing, Iavicoli said. The pandemic also exposed gaps in community care and preventative services, for which the hospital has become a de facto substitute. It has increased its work offsite after becoming a hub for community-based vaccination and public education efforts during the pandemic. It now has partnerships with more than 200 local organizations to connect patients to social services.
In some ways, the lessons from Elmhurst have changed the entire public hospital system. Iavicoli led the Covid response for Health + Hospitals after running it for Elmhurst during the first wave, bringing what she learned in Queens to the systems’ 11 acute care hospitals, 5 post-acute facilities and network of clinics. Hospital leaders also wrote a 21-chapter book, which sells for $131, on Elmhurst’s Covid response that serves as a historical account and a blueprint for the next catastrophe.
“If this happens again, you shouldn’t go back to square one. At least take what we learned and build from it for the next disaster,” said Iavicoli.
After the first wave, hospital leaders looked at the new terrain exposed by the pandemic and hashed out a ten-year plan to prepare the facility for the future. Since Arteaga-Landaverde took the helm in 2021, the hospital has received approximately $140 million in capital from the city, state and federal governments for construction projects to expand its capacity. That includes $20 million to expand the women’s health pavilion, $7.5 million for a new pediatric ICU, the first at a Queens public hospital, $1 million to renovate an infectious disease clinic and funding for a neurological ICU.
“It’s been an investment back to the hospital, brick by brick,” said Arteaga-Landaverde.
