MONTEREY >> While most people were vaguely aware of something called SARS-CoV-2 or 2019 Novel Coronavirus leading up to the statewide lockdown in March 2020, Monterey County hospitals were gearing up as best they could.

“The height of COVID now feels like a distant memory, but it was an incredibly intense time — especially for those of us in health care,” said Dr. Allen Radner, Salinas Valley Health president and CEO. “There was a lot of fear, anxiety and uncertainty.”

From March 2020 when the World Health Organization first declared the world in the grips of the COVID-19 pandemic until its official end in May 2023, health care systems were challenged and tested by the impact of the crisis. Monterey County’s health care institutions adapted to the new landscape through collaboration, innovation, enhanced infection prevention methods and an agility in dealing with the ebbs and flows of the virus. Therapies, vaccines and natural immunities contributed to its relative taming, but COVID still remains. Though many of the protocols once deemed necessary have faded away or have been transformed, some still are in use today.

“The lessons learned from COVID are long-lasting. Although the emergency response structure was in place before COVID, working together through a sustained emergency activation has allowed us to be more comfortable and nimbler in our response,” said Dr. Martha Blum, Montage Health medical director of infection prevention. “It has left us with ‘muscle memory’ that will allow us to quickly react and respond efficiently should a similar situation arise.”

COVID-19

Area health care facilities — Salinas Valley Health, Natividad and Community Hospital of the Monterey Peninsula — all say they were not blindsided by the onset of the pandemic.

“We may not have known exactly what we were facing, but we were fortunate, in a sense, that the virus spread from Asia to Europe to the United States, and even traveled east to west,” said Radner, who is also a practicing infectious disease specialist. “By the time it reached us, we had already seen the devastation unfolding in Italy, Europe, New York City and major cities like Detroit. In some ways, we knew what was coming. What we didn’t know was how long it would last.”

Blum said that as the situation rapidly escalated, it prompted Montage Health, the Monterey health care organization that is the parent company to Community Hospital of the Monterey Peninsula, to quickly increase its preparedness.

“By the first week of March, we had already started coordinating plans with all Monterey County hospitals and public health authorities for triage, testing, treatment and isolation of suspected patients,” Blum added.

She said that coordination between all area hospitals and with public health was invaluable in maintaining continuous access to high-quality medical care even when system capacities were stretched beyond normal limits.

“At no point did we have to ration treatments,” said Blum.

Natividad Chief Medical Officer Dr. Craig Walls said that before the lockdown, his health care organization took proactive measures to prepare for the anticipated surge in COVID-19 cases.

“Our engineering team played a pivotal role by swiftly converting the hospital rooms into negative-pressure isolation rooms, significantly enhancing safety for both patients and staff,” said Walls. “Simultaneously, our nursing leadership mobilized teams to reconfigure various areas into fully operational patient care rooms.”

He said this effort demonstrated the collaboration and dedication across departments.

When the wave hit

But as health care facilities began to fill up with the sick, there were many challenges to face.

“Initially, while we understood the gravity of the situation, there were still many unanswered questions about how the disease behaved. Diagnostic testing was extremely limited, and there were no specific treatments available,” said Radner.

Salinas Valley Health focused on patient and staff safety, providing basic supportive care, enforcing fundamental isolation precautions and sharing public messaging, said Radner. Its goal was to keep the community as informed as possible to help protect one another.

“Our health care workers were consistently protected with sufficient personal protective equipment,” said Walls. “The dedication and resilience demonstrated by our staff were truly inspiring — they consistently provided compassion, support and comfort to patients and their families during incredibly challenging times.”

Part of that response included the hospitals and their partners in the community using outdoor tents. Salinas Valley Health, Natividad and Montage Health used them to screen and triage patients suspected of having COVID away from the general hospital population, reducing possible exposure. Some tents were also equipped for potential ICU overflow.

They were also part of an effort by the County of Monterey to provide temporary alternative housing and isolation sites at the Monterey County Fairgrounds and Events Center in Monterey, Sherwood Hall in Salinas and San Lorenzo Park and the Salinas Valley Fairgrounds both in King City.

Though Monterey County’s Public Health Officer Dr. Edward Moreno played a pivotal leadership role during the COVID-19 pandemic, he did not respond to inquiries for this story.

Joby Aviation’s “mega-tent” at its facility at the Marina Municipal Airport was also considered for use during the pandemic, but an expected surge of the virus at the time never materialized and it was not utilized.

The county and Coalition of Homeless Services provided stays in area motels in a program that took in people, mostly those without homes, at higher risk of contracting the disease.

Reaching out with information

“As an organization and as a community, we did an outstanding job managing what became a prolonged crisis,” said Radner. “Through our outreach efforts — going into the fields and providing education — we addressed the needs of the entire community.”

Salinas Valley Health formed the Community and Staff Support Project to support the community in areas of need, such as in the agricultural fields, where a predominantly Spanish-speaking workforce was in need of education about the virus and measures to protect themselves and their families. In partnership with the Grower-Shipper Association of Central California, bilingual registered nurses were dispatched to the fields and processing plants to provide personal protective equipment and COVID-19 education to these essential workers. The nurses helped move workers into quarantine housing and access food and necessities. They also made regular visits to answer questions, help manage symptoms and provide any needed medications.

Aside from the area’s health care organizations, the Community Foundation for Monterey County, a nonprofit philanthropic organization, played an important role in providing key resources and services to ensure the health of the community.

Community Foundation for Monterey County formed and led the COVID-19 Collaborative, a county-wide, multi-sector initiative that partnered with local public health, nonprofits, businesses and philanthropic funders to align and amplify mitigation efforts, especially outreach and services for farmworkers and non-English speaking communities. It secured nearly $2 million for services including obtaining free testing kits and vaccinations to vulnerable people through its nonprofit partners.

The Community Foundation for Monterey County would also create the COVID-19 Relief Fund which provided more than $4 million in relief to nonprofits to support the county’s most vulnerable populations facing the pandemic’s economic and social ramifications.

Working with the County of Monterey, Community Foundation for Monterey County secured $5 million to fund and create the VIDA (Virus Integrated Distribution of Aid) program. More than 110 community health workers were trained in culturally- and linguistically-tailored outreach in English, Spanish and indigenous languages such as Triqui, Zapoteco and Mixteco, to provide information about services to historically underserved communities. One of its key services was education and prevention messaging that explained COVID-19 safety, testing, quarantine and vaccine benefits. Zip codes in which community health workers were active achieved some of the highest vaccination rates in the county.

Treatments, vaccines

Local health care systems and their partners in the community continued to work to stem the tide of COVID-19 cases as antiviral medications and vaccines were still on the horizon.

“There were several turning points of the pandemic. First was the availability of the antiviral medication Remdesivir, which offered us a specific therapy to counteract the virus,” said Blum. “Next, and most significantly, was the arrival of the vaccine in December 2020. For me, the start of vaccination for health care workers in December 2020 was very emotional as it was the point when I first felt there was going to be an end in sight.”

Walls said the arrival of the first vaccines was a moment of hope and transformation.

“It felt as if we were finally seeing the light at the end of the tunnel. Our team mobilized swiftly to offer vaccinations to our community,” he said.

When COVID-19 vaccines became available, Radner wanted to send a message to the community and demonstrate his scientific belief in the safety and efficacy of the vaccines. He became the first person in Monterey County to receive a dose of the vaccine on Dec. 17, 2020, followed the same day by staff at Salinas Valley Health.

Community Foundation for Monterey County President and CEO Dan Baldwin said the COVID-19 pandemic reinforced the need for community trust. VIDA’s community health workers literally walked door-to-door — covering nearly 25,000 homes — and discussed the benefits of COVID vaccinations.

“They helped people get vaccinated who have a deep mistrust of the ‘system’ but knew they needed to protect each other,” said Baldwin. “It is the ‘trusted messenger’ approach — neighbor speaking to neighbor.”

Baldwin added that the Community Foundation’s role in disaster response showed it can convene groups and support local government in different ways.

“This work then helps us inform donors, which brings more funds in to address urgent needs,” he said.

Once they became available, Montage, Salinas Valley Health and Natividad quickly offered vaccinations to the community through clinics contributing to protecting tens of thousands.

“The successive waves of COVID variants and development of more widespread immunity resulted in the de-escalation of the state of emergency in May 2023,” said Blum.

Walls said the effort embodied a spirit of collaboration and community service.

“To this day, I continue to hear from residents throughout Monterey County about how much they appreciated our vaccination clinics,” said Walls.

But going through something as earthshaking as a pandemic is certain to leave an indelible mark, hopefully for the better.

Lessons learned

“The COVID-19 pandemic was a defining moment that transformed our health care system in lasting ways,” said Blum. “It challenged us like never before — but it also accelerated innovation, deepened our commitment to safety and strengthened our resilience.”

Blum said Montage has enhanced its infection prevention protocols, expanded its telehealth capabilities, opened three urgent care locations and improved its ability to respond rapidly to emerging health threats.

“We’ve risen to challenges before, and we’ll continue to do so with compassion and dedication. Our experiences throughout the pandemic only solidified our dedication to the health of our community, including the most vulnerable among us,” said Walls. “In addition, I believe that we and the other local hospitals have benefited from a more collaborative approach to addressing community health needs.”

Walls said Natividad is “absolutely better equipped to handle another pandemic,” adding that the lessons learned during the COVID pandemic have been invaluable.

And as some habits and actions have stayed with individuals when it comes to avoiding illness, so too have health care systems brought forward policies and procedures from the experience of the pandemic.

“We continue to test, isolate, and treat individuals for COVID-19,” said Blum. “There’s also a growing recognition of the importance of staying home when sick and wearing masks to reduce the risk of spreading or contracting respiratory viruses.”

The Community Foundation says that while it was not created during the pandemic, COVID-19 did inspire the need for its newly created Community Organizations Active in Disaster manager position which has begun coordinating response and preparedness for future disasters and has already been put to use playing a critical role in disseminating funds in the aftermath of the Vistra fire in Moss Landing. Community Foundation has also been exploring ways to make long-term community health workers efforts sustainable for local nonprofits.

Moving forward

More than 101,000 Californians, and more than 1 million Americans, have died from COVID-19 — exceeding by a wide margin American service member casualties in every war combined, according to Cal Matters.

But there are currently a host of other threats to public health, such as H5N1 (highly pathogenic avian influenza or “bird flu”), fungi such as aspergillus and valley fever, and drug-resistant bacteria, among others, that the World Health Organization and the Coalition for Epidemic Preparedness Innovations are monitoring.

“We believe we made a significant impact,” said Radner. “Our vaccine outreach and clinics saved lives. COVID is still with us, and there will be other pandemics. It’s critical that we don’t forget the lessons we’ve learned.”