The following is an edited transcript of an MDAdvantage podcast with Steve Adubato and Michael Maron that was recorded on April 9, 2020. Mr. Maron is the President and CEO of Holy Name Medical Center Hospital in Teaneck, a community that has been hit hard in the state of New Jersey, one of the most challenging areas in the nation when it comes to COVID-19.
ADUBATO: As many people who have been monitoring the media know, you have had a very personal experience with COVID-19. How are you feeling now?
MARON: Actually, I’m feeling very well right now. My strength has returned, and I am totally asymptomatic. I lost about 20 pounds, not the way I would suggest doing it, but having the virus actually has had some tangential benefit for me.
ADUBATO: When did you start feeling ill?
MARON: The week before St. Patrick’s Day in March. Cases started presenting here at Holy Name during the first week in March. We ramped up pretty quickly, so it was kind of hectic. We were working long days, seven days a week, and originally, I just dismissed my symptoms as fatigue and not eating properly. I never really spiked a temperature or had severe respiratory distress, although there were times after I quarantined myself at home when simple tasks like making my bed would drain me. I’d have to go slow, and I’d find myself a little short of breath, but I had pulse oximetry. My staff here were fabulous.
Unfortunately, I infected my wife and two sons, so that’s a burden and a guilt I’ll have to bear for the rest of my life. But we managed to use very aggressive telemonitoring to keep ourselves at home, and we had twice-a-day check-ins from nurse practitioners here at Holy Name to make sure that our blood oxygen levels were in a safe zone. Several times, my wife and I got a little low, but we went through some breathing exercises and were able to get the levels back up. By doing so, we were able to stay out of the hospital.
We also participated in the hydroxychloroquine regimen with zinc. I am convinced that that absolutely accelerated our recovery, and so here I am today.
ADUBATO: North Jersey is at the forefront of the COVID-19 epidemic. Our frontline professionals—the nurses, the technicians, all of them—have been doing extraordinary work. They are, as you have said to me in previous interviews, the real heroes. How are the providers at Holy Name Medical Center holding up?
MARON: The physicians are dealing with this crisis the same as everybody else, and they have the same feelings and emotions. What’s most powerful through this whole thing is fear of the unknown. The doctors have never seen a virus like this before. They’ve never seen one as contagious as this is, and they’ve never seen such a wide spectrum of impact.
Some people, like myself, are being infected with the virus. You get sick; you have to stay home. You’re able to recover. Other people end up coming into the emergency room and within hours are on a ventilator and sadly, die at some point—not always right away but after 20, 30 days on a ventilator. The mortality rates are growing, and physicians do not know why.
Every day is a high-volume learning exercise to try to figure out what are the trigger points and why this virus impacts certain people one way and other people in such a deadly, deadly way. We had a very beloved employee who came into the emergency room with early symptoms. They were monitoring him. He seemed to be getting better. We were actually talking about sending him home under this very aggressive telemonitoring program. But one of the physicians said, “You know, let’s just hold him a few hours more; something just doesn’t seem right.” And within that span of time, just a couple of hours, he crashed and was put on a ventilator. He was on the ventilator for almost two weeks and sadly, passed away. So, now they look back and are doing incredible chart reviews—they don’t know why this happened.
ADUBATO: When a story like that one is replicated too many times, the question has to be asked: In such a difficult, horrific situation, what can you, as a leader, do to inspire the physicians on your team to keep battling COVID-19?
MARON: We’ve totally reengineered how clinicians, nurse practitioners, nurses and doctors with different disciplines help out with a much more aggressive team approach to spread the volume out, and that’s worked very, very well. All the physicians of different disciplines have stood up to help the emergency room doctors, the critical care doctors, the pulmonologists and the infectious disease doctors who are at the forefront of this.
We also have totally reengineered this hospital in a big, big way to keep our providers safe. We’ve built close to a hundred new critical care beds and rooms. They’re not really rooms—they’re open wards, designed specifically to improve the efficiency of how clinicians can care for patients and at the same time, keep themselves safe.
At the start of this, Holy Name had 19 intensive care unit (ICU) beds, and we had 10 negative pressure rooms. We now have more than 100 ICU beds and more than 250 negative pressure rooms.
ADUBATO: You talk about reengineering your hospital system, but what about the overall highly competitive hospital system in New Jersey. Is that changed forever?
MARON: I hope it is changed forever. In this crisis, we’ve seen organizations that used to viciously compete with each other start to support and collaborate, and work together. That is an incredibly inspiring move. It also has proven that when we do that we are a thousand times more efficient and effective in caring for the communities. That is our number one priority, so the collaboration here has been incredible.
“We’ve seen organizations that used to viciously compete with each other, start to support and collaborate and work together.”
I can give you an idea of the extent of that collaboration. Because I tested positive and now have been cleared for more than two weeks, Hackensack Meridian Health is doing an antibody study. I, personally, am going to let them draw my blood and participate in their study, as will the majority of our employees who also tested positive and who qualify for their antibody study. Additionally, we’re sharing personal protective equipment (PPE). We’re sharing ventilators. We’re sharing resources and supplies.
The Chief Medical Officers have a call every day at 11 o’clock to talk about clinical conditions, to talk about what each sees and has learned in terms of ways to combat this virus more effectively. That spirit is just incredibly inspiring and rewarding. I hope that going forward we can leverage that and not return to our old ways. I hope we can use that as a platform to build a new collaborative, high-quality, much more efficient healthcare system for all the New Jerseyans that we serve.
ADUBATO: This kind of collaboration among New Jersey hospital systems is unprecedented. It’s extraordinary, and as you said, it is critical moving forward. Will the methods of telemedicine that are now being used during the COVID-19 pandemic be the wave of the future when it comes to physicians and other clinicians caring for patients?
MARON: Absolutely, and I certainly hope so. If anything good comes out of this entire crisis, there are a lot of lessons learned as to how we can change, operate, be much more efficient and effective in everything we do, even just using video conferencing for our business meetings, which we all do now. In the past, everybody found telemedicine difficult, cumbersome, not as efficient, but now it’s become sort of the new norm. With telemedicine, the ability for physicians, nurse practitioners and nurses to check in on people at home, to keep them healthy, to monitor them, to put Wi-Fi and Bluetooth devices in a person’s home appropriate for the conditions that they’re dealing with, has proven extremely, extremely beneficial.
If I didn’t have our telemedicine program in place at Holy Name where we have an incredible number of people, I would be overwhelmed. Many of the people at home right now would be admitted to the hospital, even today in the middle of this crisis, if they were being cared for by other health systems that did not build such a robust telemedicine program. And when they’re in the hospital, they’re causing staff to be stretched even more, and they’re causing more PPE to be consumed in caring for them.
When we keep them at home, one nurse practitioner can care for 25 or 30 patients (some nurse practitioners care for as many as 40 people, depending on their acuity) in a day. There’s no way we could replicate that here. The nurse practitioner can do it from her home, she doesn’t have to be gowned with PPE and the patient stays isolated in his or her home. There’s no risk of infecting anybody else. It is the most ideal scenario for caring for patients as long as we can. As best as we can, we keep them at home.
ADUBATO: Will we ever go back to “normal” after recovering from COVID-19? Or do you expect to see significant changes in the way medicine is practiced in the future?
MARON: It’s my hope and my prayer that we will see significant changes in medicine when this is over. To me, it would be tragic if we came out of this and just returned back to business as usual the way it was before. There are just far too many lessons we’ve learned, too many changes that have demonstrated with absolute certainty that we can do this much, much better.
We had a great system before, but we can be even better. I think it is our obligation, our duty and our responsibility to all those who have sacrificed so much and to all those who gave the ultimate sacrifice and lost their lives, to vow not to return to what we would consider the old normal, and use this as a critical pivot point to go to that next level of higher performance.
ADUBATO: Is there a specific message you would like to give to all the physicians?
MARON: Absolutely. I think they are all heroes. Here, we often refer to different inspirational messages over the course of time, and one of my favorites is something Mother Theresa once said: “There is a light in this world, the healing spirit, more powerful than any darkness we may encounter. We sometimes lose sight of this force when there is suffering and too much pain. Then suddenly the spirit will emerge through the lives of ordinary people who hear a call and answer in extraordinary ways.”
That is exactly what I am seeing here. The spirit of the healthcare providers, physicians, nurses, support staff, environmental services, the people who are stepping up in such a big way. They are ordinary people who have heard a call and are responding in extraordinary ways. We should be forever grateful and indebted to them for what they are doing. They are tireless. They are committed. They have demonstrated the resiliency of the human spirit and the human soul. That is where I get my strength.
People ask how I can work seven days a week doing what I’m doing. I tell them that when I walk around and see what these people are doing, I am humbled. I feel like I’m inadequate because they have risen to such another level. I know that is happening in every healthcare institution across the tri-state area, and that is just remarkable and inspiring.
ADUBATO: Mike, I cannot thank you enough. Stay well, and keep doing what you’re doing.
MARON: Thank you, Steve. I also want to thank Patricia Costante and everybody at MDAdvantage. When I was sick, they were reaching out to me. The outpouring of support I received was extremely meaningful, and it absolutely helped me get through the low time. So I am very grateful for the opportunity to tell the story here a little bit. Thank you.