Q&A with Dr. Naveen Ballem, chief medical officer of Clara Maass Medical Center, Belleville.
The Observer (TO): How are you doing personally? Have you ever dealt with anything even remotely close to this?
Dr. Naveen Ballem (Doc): It has been a trying and difficult time; I have never experienced anything quite like this. There is so much that is still unknown and we continue to learn every day. I am personally helping out on the floors, in the Emergency Room even the ORs. I have been volunteering for some Intensive Care Unit shifts myself, to support my colleagues.
In my personal life, usually when I need to decompress from work, I love playing golf, but with the stay-at-home order, that has not been an option. So, I have brushed off my unused Peloton and ride regularly, which gives me a burst of mental and physical rejuvenation.
My family is healthy and safe, which is what is most important … I have quarantined myself to the guest bedroom, to minimize my exposure to my wife and children. My kids, aged 8 and 12, probably know more about the coronavirus than most kids, or even adults for that matter.
I remember one time when my wife was baking cookies and my 8-year-old said, “Mom, those cookies smell amazing, and if I can smell them, it means I don’t have Coronavirus!” He somehow heard that anosmia, the loss of your sense of smell, is a symptom of the COVID-19. Our children definitely watch and listen; they are a part of this new reality, too.
TO: What is the medicine regimen that is being used, if any, for patients positive for COVID-19? Is the hydroxycholoroquine/Z-Pac combo working? Is it being encouraged?
At Clara Maass, we have treated people with hydroxycholorquine/Z-pac combo and it appeared to show some positive outcomes. We have been fortunate to be able to partner with Gilead and participate in their Remdesivir trial and also with the Mayo Clinic and convalescent plasma treatment trial, all under the leadership of Mona Philips.
Mona and her team were always ahead of the curve and ensured that the patients at Clara would have access to the most current and effective treatments that exist. Although many trials show early promise, this disease and the knowledge we have grows daily. Currently, it appears that the Remdesivir data demonstrated a more rapid recovery from COVID and its postulated that it will also show a statistically significant improvement in survival. Currently, it does not demonstrate the needed statistical data but as more patients are entered into this trial we expect and hope to see a continued improvement in mortality.
How about the staff? Are doctors, nurses, techs, orderlies, etc., beginning to show fatigue? Have any staff quit or retired because of the pandemic?
It has definitely been hard on everyone here, but the most important thing is that no one has forgotten that they are human, or that the people around them need support. In the hospital, every day feels like a year, and every week feels like a second.
Each day, I have seen at least one person break down and cry, but there is always someone else there to comfort them who understands what they are going through. Seeing colleagues struggle is incredibly difficult, but at the end of the day, we are all rowing this ship together. I am so proud of the selfless nature of the people I work with.
We have things that we do to raise people’s spirits.
Whenever something positive happens, we play (The Beatles’) “Here Comes the Sun,” over the loudspeaker, so that everyone, no matter what they and their patients are going through, can share in the positive news coming from somewhere within the hospital. When the shifts change over and a new wave of doctors and nurses clock in, we play “(Simply) The Best” by Tina Turner over the loudspeaker.
Things like that allow us to share in our successes, not just our sadness. The tremendous amount of love and support from our communities, churches, and the Board of Trustees has been overwhelming.
I would never judge anyone if they are scared and do not want to come to work. But what I am witnessing is that almost everyone has stepped up and stepped up with pride. This is our calling. This is why we became healthcare workers.
It wasn’t for the pay, or for the hours … but rather, it was for a greater purpose. I think this underlying bond of purpose and wanting to help people has really come out during this pandemic.
TO: What kind of shifts are doctors, nurses, technicians, working?
Doc: The days are long, and we’ve been in a new normal since the beginning. CMMC is located only 10 miles outside of New York City in Essex County, so we felt the impact of COVID-19 immediately. Our ER, under the leadership of Dr. Fontanetta and Donna Devita, set up a process to separate non-COVID and suspected COVID patients very rapidly.
Our ICU volume surged over 400% in a two-week period, and finding the resources to support that surge really required all hands on deck. With the tireless work of Dr. Frank Califano and his team, the ICU was prepared to tackle this pandemic.
“All hands on deck” has taken on an entirely new meaning in the midst of COVID-19. No matter what their role, every person coming to work every day in this hospital is giving 200%. Staff from every specialty are coming together and sharing best medical practices around this new disease, enabling us to give the most cohesive, collaborative and up to date care possible. From the person who greets you at the front door, to the environmental services staff, who ensure the hospital is safe and sanitized, to the people in dietary services, you realize we are all risking our lives and confronting this disease together.
This pandemic has clearly played an emotional toll on everyone, including those on the front lines. RWJBarnabas Health with leadership from Dr. Gabe Kaplan have created a confidential hotline for mental health support and well-being.
TO: How does the hospital deal with patients’ families since they cannot visit their loved ones? Is there a patient advocate who works with families? Has this been a challenge?
Doc: I am so inspired by Joe Wotecki, Javier Lavarez and Tania Manago, who make up our Patient Satisfaction team. They work so diligently every day to make sure patients feel supported, such as organizing Facetimes between patients and their families.
Nurses have been positioning patients’ beds near the windows so their families can see them from outside and pray for them. It has definitely presented new challenges, but it is amazing how resourceful health care workers have become to help their patients and families through these very difficult times.
TO: There are talks of reopening our state to get the economy back and flowing. Is the time right to do this now? Is it too soon? Should it already have happened?
Doc: What is most important is that people take the necessary precautions to prevent spreading or catching this virus. From wearing cloth masks, as the CDC recommends, to standing the recommended 6 feet apart, we must all do what we can to take care of ourselves and each other. Hand hygiene is such a simple yet effective way to reduce spread of so many viruses and bacteria, and COVID is another example.
TO: Are you concerned about a second wave of this in the fall/winter? If so what’s the best way to deal with that possibility?
We have learned a lot over the past couple months about the virus, the best ways to treat it, who is most at risk, etc. The best way to deal with that possibility is to be prepared for it, and make sure we are properly equipped to handle it. We have accumulated resources, data, and treatment algorithms … although I am concerned about a second wave, I’m confident that we will utilize our resources effectively against this virus.
I have been a surgeon for over a decade, and in that role, I always focused on one patient at a time. In my current role as Chief Medical Officer, I have the opportunity to help support everyone at Clara Maass Medical Center do their job by ensuring all the resources they need to deliver healthcare are available. Ensuring that we have PPE (personal protective equipment), and ensuring we have enough nurses and physicians to take care of our patients are the new challenges that I have been facing and working through, giving 200% of myself to ensure that we has a hospital have the resources to treat our community with the latest technology, evidence based treatments and most importantly, never forgetting to be human. Having a corporate partner like RWJBarnabas Health, has really kept us ahead of the curve in terms of resources for testing and treating patients and providing us protective equipment for our employees.
TO: In your expert opinion, will there be a vaccine for this hideous virus? If so, when in your best estimation?
DOC: Right now, there are very few things that are certain about the potential for a vaccine, or when it will be available. At CMMC, we are staying on top of and implementing the most up to date and effective treatments that we can, and the same principle will continue to apply in the future.
As knowledge about the virus, its treatment, or a vaccine develops, we will adjust appropriately, and hopefully soon we will be able to effectively prevent this disease, as well as treat it.
Anything else you’d like to share?
I want to thank the local communities around the hospital, who have been providing an endless supply of support, from food, to shoes, hotel rooms, care rentals, masks, gowns, you name it and it has been donated to us to support our health care workers.
The fire department and police have been driving by with sirens on. Our community holds prayer sessions on our parking deck. I want to thank everyone in this community for their endless love and support. We have moved beyond the surge and peak numbers of infection and we have witnessed the “flattening of the curve” and now see a precipitous drop in the number of patients with COVID.
Over the last several weeks, we have been preparing the hospital for a “reopening.”
We have created clean and safe areas throughout our Emergency Room, Operating Rooms, Cardiac Cath Labs, etc. We know that COVID is here in our communities and we are working to create the safest environment possible for people to continue to get their regular healthcare needs met.
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Kevin A. Canessa Jr. is the editor of and broadcaster at The Observer, a place where he has served on and off since 2006. He is responsible for the editorial content of the newspaper and website, the production of the e-Newspaper, writing several stories per week (including the weekly editorial), conducting live broadcasts on Facebook Live, including a weekly recap of the news — and much more behind the scenes. Between 2006 and 2008, he introduced the newspaper to its first-ever blog — which included podcasts, audio and video. Originally from Jersey City, Kevin lived in Kearny until 2004, lived in Port St. Lucie. Florida, for four years until February 2016 and in March of that year, he moved back to West Hudson to return to The Observer full time. Click Here to send Kevin an email.