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No time to waste

Posted by on Wednesday, October 13, 2021 in Fall 2021, Related Content .

In April 2020, weeks after the first reported COVID-19 case in Tennessee, health economists and epidemiologists from the VUMC Departments of Health Policy and Pediatrics and others were working with state health officials on a complex predictive model to chart the trajectory of infections and the resources needed to stop its spread.

“Doing this so fast, and with such a novel and fast-moving disease, has been a new challenge for us,” said team member John Graves, PhD, associate professor of Health Policy.

A month later VUMC pharmacists realized they were among the few in Tennessee who had received a shipment of remdesivir, an antiviral drug newly approved for emergency use in patients severely ill with COVID-19.

There was no time to waste. With the support of VUMC leadership, the Tennessee Department of Health and the Tennessee Hospital Association (THA), a “COVIDRX team” of VUMC pharmacists, physicians and others developed a protocol for distributing remdesivir to patients who met specific clinical criteria.

As more remdesivir arrived at VUMC, the team set up a statewide distribution system. By the end of September 2020, when a federal distribution strategy was implemented, the team had responded to more than 1,400 individual requests from 60-plus hospitals across Tennessee.

In October the THA honored the COVIDRX team with its President’s Award. “Extraordinary times called for extraordinary care, and this group of individuals stepped up to the plate to help hundreds of patients in Tennessee,” said THA president and CEO Wendy Long, MD.

In November the U.S. Food and Drug Administration authorized emergency use of an investigational antibody treatment to prevent recently diagnosed COVID-19 patients from developing severe disease. But how could these patients be treated at VUMC without exposing other patients and staff to the virus?

Within 10 days of FDA approval, VUMC leaders conceived and implemented an answer: a COVID Infusion Clinic with a separate entrance in what previously had been parking garage space. Here COVID-19 outpatients could safely receive intravenous infusions of the virus-fighting monoclonal antibody.

“Vanderbilt was among the first institution in the region to offer (infusion therapy),” said the clinic’s medical director, Karen Bloch, MD, MPH. “This would not have been possible without a truly heroic outlay of time and resources by pharmacy, nursing, HealthIT, and clinicians who advocated for their patients to get treated,” she said.

“The pandemic taught us to think outside the box — a box we didn’t even imagine existed,” added clinic manager Kim Lippard, MBA, MSN.

One of the most remarkable responses to COVID-19 was the unprecedented acceleration of vaccine development and distribution. Months before the first vaccine shipments arrived in Nashville in December 2020, VUMC’s COVID Mass Vaccination Team was ready to go.

By August 2021, nearly 200,000 COVID-19 shots had been given to VUMC employees and members of the community. To do that from scratch “is pretty impressive,” said John Morris Jr., MD, associate chief of staff of the Vanderbilt Health System.

Every team member, from occupational health, nursing, pharmacy, HealthIT and more, “was a link that we could not have gone without,” added Lindsay Miller, MSN, RN, associate nursing officer, Adult Ambulatory Clinics. “We had to have everybody to make this work.”