“Always focus on the front windshield and not the rearview mirror.” ― Gen. Colin Powell
Almost a year ago to the day, Feb. 3, 2020, Santa Clara County declared a local health emergency due COVID-19, the first county in California to do so.
Three-hundred-and-sixty-six days later, there have been more than 3.3 million COVID-19 cases in California and more than 42,000 deaths. Along the way, there have been major ebbs and flows in caseload and an ever-changing regulatory environment in which to operate.
With those peaks and valleys of patient need for hospital care came a challenge greater than any modern hospitals have faced: The demand, amid a global pandemic, to rapidly adjust the focus and activity of large organizations — despite their constant state of readiness — based on confusing or conflicting guidance from authorities.
Given that direction from federal, state, and local officials shifted multiple times within a single year, it’s not surprising that there’s a sense of whiplash among California’s hospital leaders. That’s because hospitals typically operate more like aircraft carriers than speedboats, so what you’ve accomplished in the past year — the thousands upon thousands of lives saved — is nothing short of incredible.
The past year’s shifting headwinds (and tailwinds) have been perhaps the greatest source of frustration because they mean greater pressure on everyone to adapt —time and again — to new rules and new conditions. On Monday, the need to change course came again, in the form of an All Facilities Letter that rescinds all nurse staffing ratio waivers for hospitals as of Feb. 8.
Time to adjust the sails once more.
And there will be even more changes in the months ahead. While the current focus is on vaccinating as many people as we can, as quickly as we can, with new COVID-19 variants popping up and businesses and activities reopening, there could well be another surge before we’re out of the woods with widespread “community immunity.”
As we enter the next phases of this crisis, for as long as it lasts, it’s helpful to do so with the understanding that different, sometimes competing, pressures will wax and wane in the minds of policymakers. That drives what feels like an erratic response at times but might actually be an attempt to consider the pandemic holistically rather than piecemeal. A common question we hear is: Shouldn’t health be the sole factor in making far-reaching decisions? Perhaps, but policymakers don’t look at any situation with a singular sense of purpose; there’s always a balance they’re trying to strike.
If there’s a clinical analogy, it’s the way physicians might consider the totality of a person’s physical, mental, genetic, life conditions, and more when formulating a care plan, rather than treating just one disease at a time.
Through 2021, new players will enter the mix as well — the state Legislature and Congress, which had largely deferred to the executive branches of government, will play a more prominent role in shaping pandemic policy. Their new ideas will bring even more change, and more public debate about the best course of action.
As these debates unfold, it will be the role of your association, as always, to advocate for the policies you need to do your jobs well — to make sure policymakers hear and understand the COVID-19 hospital story.
A full year into this crisis is a good time for three activities:
- Acknowledge the extraordinary accomplishments of California’s hospitals
- Understand what is different about how hospitals operate, and how they operate together, to enhance disaster response going forward
- Prepare, even after an entire year, for things to change again
In doing these things, we are heeding Gen. Powell’s sound advice by focusing on what’s in our front windshield, as we draw on a better understanding of how we got here.