One Year Later: A Look Back at COVID-19 at Cook Children's

Disclaimer: Some visuals in this video and story were filmed prior to the mask-wearing requirement.

Coming off one of the busiest winters in its history, with record high inpatient volumes, Cook Children’s employees, medical staff and leadership looked forward to returning to the business at hand in early 2020.

Much of that business centered on keeping up with the recent population growth in the Dallas-Fort Worth Metroplex. A focus on development in the area meant building new facilities in Prosper and Walsh Ranch in west Fort Worth, as well as expanding Cook Children’s Medical Center campus with a new specialty center and parking garage.

“We were very busy but very positive about the future of Cook Children’s,” said Rick Merrill, president and CEO of Cook Children’s.

Then everything changed. A new version of the coronavirus, SARS-CoV-2 which causes COVID-19 disease, enveloped the nation.

“It certainly changed a lot about what we did and how we thought about moving forward as an organization,” Merrill said.

Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s, remembers first hearing about COVID-19 when it ravaged through China. Then the virus turned up in Italy.

Dr. Whitworth told her parents in late January or early February that a time would soon come when she would tell them they could not leave the house. She also worried about her own daughter’s wedding, scheduled for March 14, 2020.

Three days before the wedding, the best man told everyone of his exposure to COVID-19. Around that time, health departments recommended quarantining exposed individuals. Two days before the wedding, guests were alerted about a scaled-back ceremony.

“We had this small wedding on March 14,” Dr. Whitworth said. “And, so for me, that was the personal event that I went, ‘Oh, here we go.’ I was going to be off for a few days after the wedding. But the day after the wedding, they opened the Command Center, which was March 15th. I think that was the point, I realized, ‘No vacation.’ No, I have to get back to work. I have to get back and see what I can do to help.”

With the increased threat of COVID-19 and the demand on staff and supplies required to battle the virus, leadership declared the event an internal disaster. They also activated the Command Center, which is a central hub that manages any type of disaster experienced by the organization. The Command Center kept current with patient volume, staffing, questions from employees, supplies and logistics. Any decisions made based on COVID-19 at Cook Children’s now went through the Command Center.

“I think that’s really what this organization does so well. We decided early on to set up the Command Center staffed by first-class people. They were able to effectively deal with the day-to-day issues, including so many questions and concerns from our 8,000 employees. They were able to coordinate our efforts in a way that has allowed us to get through the COVID crisis, probably as good, if not better, than most other health care organizations in the country,” Merrill said.

Heading up the Command Center were four incident commanders who rotated each week. They were available 24-7. They led daily meetings to keep up with COVID-19 demands, which included staff from the nursing units where COVID-19 patients stayed, supply chain, Infectious Diseases, Infection Control, Employee Health and more.

The incident commanders were:

• Debbie Boudreaux, Assistant Vice President of Nursing
• Stan Davis, Chief Operating Officer
• Nick Markham, Assistant Vice President of Facilities/Campus Services
• Jack Sosebee, Vice President of the Medical Center

“We define a disaster as something that is outside of your normal operations,” Davis said. “I mean we have ‘disasters’ every day that we can react to within our existing resources. We can handle those normal day-to-day types of disasters. But for anything that stretches the operations of the organization, we activate our Incident Command Center to bring a group of people together to analyze the activities occurring and put a response plan in place. The Command Center handles the communications, resources, staffing and mitigation activities that need to be addressed. We bring all of the experts who can help with the disaster together to discuss the situation. We get references from outside sources like the city of Fort Worth, or maybe the CDC or the health department. They help to inform what we know—and learn what we don’t know—so that we can best handle and manage the situation and bring normalcy back as soon as possible.”

Jack Sosebee, vice president of the Medical Center, said the main challenge throughout the pandemic became the unknown. Things frequently changed with new directions from the Centers for Disease Control or the state. As the pandemic numbers increased, the Command Center made difficult decisions. For instance, they changed the number of visitors allowed in the medical center from two caregivers to one. As the COVID-19 case numbers have decreased, they recently returned to two caregivers again.

“I think we’ve learned from this,” Sosebee said. “I think it’s something we can build on. Hopefully, we won’t ever have to do that again. But I think, looking back at it, the response from Cook Children’s was just outstanding. The response to COVID is our culture. You didn’t find people that refused to do things. Everybody stepped up to the plate and did what was needed. I think that this brought our organization closer together. I think if there’s anything positive out of all this, I think that’s one of the things.”

The response to COVID-19 did not come without a lot of hard work. Kaysey Pollan, director of Environmental Safety and Emergency Management, prepared Cook Children’s for events such as COVID-19 with disaster drills. Davis jokes that he will never complain about one of Pollan’s drills again and credits her preparation years before COVID-19 for laying the groundwork for the success the system has had throughout this crisis.

Pollan makes sure no one is duplicating efforts, and no one is overlooking anything. She gets people in the right place to respond to severe events such as COVID-19. As the events evolve, Pollan plays the role of liaison. She works with neighboring hospitals, critical people in the city, county and state to be informed and offer assistance as needed.

“Early on, it was just how quickly the situation was changing and evolving,” Pollan said. “We saw so much information that changed daily. It was challenging to keep our staff informed promptly. We saw so many changes with PPE and guidance from the CDC and mandates and regulations from a local level that we had to implement. It’s tough, you know? A year-long disaster response focused on the same event, doing the same thing every day. It becomes tedious. It becomes very wearing. I think more so recently; it’s been important for us to keep a pulse on our staff and make sure that they are engaged and as happy as they possibly can be through all of this.”

Of everything that occurred over the past year, perhaps nothing proved more uplifting than the arrival of vaccines to fight the COVID-19 virus. Almost 70% of employees received the vaccine first, followed by a couple more thousand patients 16 years old and older, and then employee family members.

“I don’t even know what day it was now, but we were all waiting outside for the truck to come with the vaccine,” Boudreaux said. “You would think it would come in like a Brink’s armor truck. We were all excited waiting, and the guy in the UPS truck pulled up and backed down the hospital's delivery area. I couldn’t believe it. They opened the back of the truck and pulled out the vaccine, and it was just like, ‘Oh, my gosh, it’s finally here!’ It was such a moment. I can’t describe it. It’s finally here.”

A year later, things are getting better. The COVID-19 patient and employee population have reached record lows. The Command Center no longer meets weekly, and the four incident commanders now share their duties with other leaders within the Cook Children’s system.

While things improve, the diligence to fight COVID-19 remains, and so does a tremendous amount of pride in how Cook Children’s handled this crisis.

“I would have to say I’m most proud of the organization, how we, as a whole, responded,” Markham said. “With each step of the planning that we’ve had, it’s just been amazing. We’re at a year, and it’s been a long year. It’s been trying, and it’s been hard. These people have worked and been away from their families and are putting in all this time and effort. Each time we get past a landmark, a period of accomplishment, something else comes up. It’s that group of people who rose to the occasion every time. It’s been awesome to see. It’s been amazing that we get to surround ourselves with this group of people every day and every day they rise to the occasion.”