A Look at how N.J.’s only Public Health Hospital is Handling This Once-In-A-Lifetime Crisis

BY Shereef Elnahal

Public hospitals are poised to be key assets in all states of emergency – especially global pandemics. Yours is no exception.

New Jersey has only one public health hospital: Newark-based University Hospital.

Our EMS team assisted New York City in responding to the September 11th tragedy. Our hospital and trauma center were at the ready for folks impacted by Hurricane Sandy. We became northern New Jersey’s Ebola evaluation center, servicing Newark airport. And yet, University Hospital has stepped up to meet this global pandemic’s impact on our state perhaps like no other crisis.

The hospital’s chronic financial strains, caused by years of underfunding and infrastructure needs, cannot be addressed as quickly as we would like, and have also contributed to our historical lag in quality scores against hospitals with easier access to capital and staff.

All that aside, with this unprecedented-in-our-lifetime pandemic, the value, necessity, and crisis leadership that we have offered from the beginning of this pandemic has made a compelling case for continued, public support for University Hospital. We are also poised to play an invigorating role in the conversation around greater public health protections that is sure to come out of this period.

Our hospital averaged more than 200 coronavirus patients daily during the peak in April. And during the height of this crisis, we were within the top 10 New Jersey hospitals for admitted coronavirus patients.

The pandemic has hit Newark particularly hard. Population density is high. Economically vulnerable households make staying home from work less practical. More of our service area is essential, frontline workers, making work from home an option for fewer people. Barriers to physical distancing occur on multiple levels due to complex, socio-cultural factors.

In addition, the city’s population already has a high prevalence of underlying medical conditions that stem from health inequities born out of a legacy of
structural racism. This makes outcomes worse for those who contract coronavirus in Newark, and across communities of color. Despite these challenges, University Hospital has risen to serve our public obligation to meet the needs of as many residents in New Jersey as possible.

First, we collaborated with the Department of Health, National Guard and the Army Corps of Engineers to set up the Meadowlands Field Medical Station (FMS) in Secaucus, in order to “decompress” northern New Jersey’s hospitals to make room for patients who need intensive critical care. In cooperation with Epic, our electronic medical record provider, our patient registration system has been extended to New Jersey’s three FMSs.

Second, University Hospital is using its 24/7 Medical Coordination Center (MCC) to coordinate transfers of patients to the Meadowlands FMS from northern New Jersey hospitals. We are also offering crucial intelligence to the state Regional Operations and Intelligence Center (ROIC), the Department of Health (DOH), and Gov. Phil Murphy’s office, and assisting with the allocation of critical supplies and resources.

Third, we are leveraging our status as an academic medical center to research promising therapies and testing platforms. Physician-scientists at Rutgers New Jersey Medical School are the principal investigators in more than five clinical trials testing different therapeutic regimens for coronavirus, including trials involving remdesivir, hydroxychloroquine, azithromycin and other novel antiviral therapy trials set to begin in the coming weeks.

We are also one of only a few hospitals in New Jersey providing a novel therapy
that may be the most promising of all options – convalescent plasma. Matt Platkin, the chief counsel to Governor Murphy, has been one of the most prominent donors in this program.

University Hospital is also undertaking epidemiological investigations that will better equip public health officials, the scientific community, and policymakers to make informed decisions around this virus. This includes studies of asymptomatic health care workers to probe if and how they contracted the virus, with the hope of offering intelligence and statistics to better understand the virus and how it spreads.

Fourth, we are assuring access to routine outpatient care during this pandemic through a partnership with Rutgers New
Jersey Medical School to offer healthcare visits using telehealth. In addition, we are launching a community engagement strategy to keep residents informed of critical information related to these services and other pertinent resources on general health and wellbeing.

Part of University Hospital’s role has always been to serve its community — and the community we serve is among the most vulnerable in our state. Our patients rely heavily on Charity Care and Medicaid, and this funding may be increasingly threatened during the upcoming economic recovery. We think that would be short sighted policy, as New Jersey could stand to lose an asset on which it has always depended to shoulder crises — and never more so than now.

University Hospital has always been there for our state. We are honored to do so, and always will be.

Shereef Elnahal, MD, MBA is the president and chief executive officer of University Hospital in Newark.