coronavirus and hosptial response

Interoperable Communications Essential for COVID-19 Response

Confronting Paper Thin Realities:
Toilet Paper & Luca’s Dead Sister

How Interoperable Communications Is Essential but Overlooked in the COVID-19 Pandemic

According to media reports[1] in the early days of the COVID-19 outbreak, Luca Franzese’s sister, Teresa, died from a coronavirus (COVID-19) infection in Naples, Italy.  Under house quarantine, he called the city for help, but nobody knew what to do.  The funeral home wasn’t cooperating and didn’t know what to do either. Her decaying body remained unattended for 36 hours until Luca took to the internet to express his outrage.  In another part of Italy, a similar story played out, with an elderly woman left to attend to her dead husband for 3 days, calling from her balcony for help.  Indignant, her neighbors figuratively stormed city hall.  Back in the US, memes of empty toilet paper store shelves swirl the internet. A good laugh, but now the food shelves are emptying as well.  Meanwhile, business operations shutter, employees are sent home, restaurants are empty, and events are cancelled.  The economic and financial undercurrents of the COVID-19 pandemic threaten to pull us into deeper waters.

Below the surface of the COVID-19 pandemic roils a potentially highly volatile environment.  To effectively manage the increasing unpredictability that will surface in a myriad of unexpected ways, public and private partners must closely coordinate and work together.  In order to be successful, delivering the right information, to the right people at the right time to take informed action is essential.

These vignettes highlight a much bigger problem. Government agencies still struggle to communicate and coordinate with one another and even more so with private sector entities providing critical services during times of emergency.  This problem, coined “a lack of interoperability”, was exposed and brought to national attention after the attacks of September 11th.  The inability for police and fire to communicate with one another contributed to avoidable losses of lives. Nearly twenty years later, the problem continues with real world impacts, including more preventable losses of lives.  At this point, the cases of failed emergency responses arising from an inability to communicate, share information and coordinate could fill a book.  After-incident reports point to this problem as a major cause of delayed or poor emergency response in school, airport, theater and nightclub shootings, plane and train crashes, hurricanes, oil spills and wildfires.  Despite the recurring lesson, it remains unlearned.  Many emergency communications leaders will confidently attest that they have interoperability.  The reality is they don’t in any real-world sense, nor do they realize it until it’s too late.  Some, however, are leading the way and acting.  In New Jersey, nearly every hospital can seamlessly communicate on demand with one another as well as with their state and county public safety counterparts, using Mutualink.  In New Jersey, Mutualink was successfully used in the H1N1 and Ebola outbreaks, and is in service helping hospitals and their partners respond to COVID-19 today.

The need to connect hospitals, public health agencies and emergency management is immediate.  Acute care, urgent care and community health clinics are the frontlines of the COVID-19 epidemic.  The ability for partners to share up-to-the-minute status on resource availability – be it beds, medicines, equipment or healthcare professionals – is essential to the optimal utilization of the healthcare delivery system. Also, connecting the health care system to enable real-time coordination with emergency managers and public safety agencies performing an array of support functions is equally important.  These include identifying suspected sick persons in the field, rendering first aid, assisting with personnel transport, ensuring security at testing and health care delivery sites, and, if needed, enforcing quarantines and ensuring distribution of essential items to those in need.

And here is the essential point:  If your Teresa Franzese dies in the middle of the night, does anybody care?  The answer is undoubtedly, yes.  Even our often-maligned public servants and leaders do.  In fact, they continue to man the stations while most self-quarantine.  The problem is what to do about Teresa and Luca.

It starts with getting the right information to the right people at the right time.  It starts with saving Teresa Franzese in the first instance.  It starts with the right people having the right information to assess a self-quarantined person, formulating a plan and taking action. This could mean sending skilled medical staff to her, directing her to available medical help close-by, or perhaps remotely monitoring and sending medications to her.

In the second instance, it means connecting the morgue, funeral home and local health officials to solve the problem, instead of a round robin of finger-pointing resulting in inaction, only then to be buried beneath the next wave of urgent problems.  In response to media inquiries, the head of the association of funeral home directors reportedly told Al Jazeera “hat “the delay in collecting Teresa’s body was due to administrative hurdles, not any reluctance on their part.”[2]  Apparently unaware of other reported cases, one of Campania’s Regional Health Commissioners reportedly explained that “it was the first case in Italy in which a person with the virus dies at home, so there was some confusion on what to do.”[3] Sadly, this is a case of poor information coupled with a lack of coordination leading to inaction – not callous indifference.

Crises and pandemics happen and will continue to happen.  Inconvenience is tolerable. Perceived indifference marked by confusion, indecision and inaction isn’t.  It’s the first symptom of a different kind of contagion that stirs in the hearts of people and spreads into waves of public discontent and disorder.  Rarely do societies collapse from privation.  Humans are innately resilient and have remarkably high tolerances to discomfort when they believe they are all in it together. It’s the perception of indifference and the many small indignities suffered through inaction that ripple out, join and coalesce into waves of discontent.  It is precisely what led to Luca’s plaintive words, “Italy has abandoned us” being cast across Facebook, being heard 9.5 million times as of last count and splashed across the world’s headlines.  It’s why another retorted to an Italian news outlet, IVG.IT, “We are treated worse than garbage.”[4]

Tomorrow, communities could be better equipped to handle the COVId-19 crisis by deploying a real-time multimedia solution that connects critical community partners.  This will enable a coordinated and informed action environment.  Using a system such as Mutualink creates a dynamic environment where partners can instantly and securely communicate with one another across any network and any device, share critical data and real-time video from the field.  The ability to bridge different communication siloes, including different radio systems that don’t communicate with one another, mobile phones and push-to-talk applications allows for the right parties to come together in an instant, eliminating message relays, delays and inadequate information exchange.  Enabling partners to see what’s happening in the field to form assessments and make decisions is vital.  Maintaining broad situational awareness and updating partners as to needs and availability advances the prompt and efficient delivery of services.

Simply put, the ability to connect the right parties, at the right time with the right information makes all the difference in pandemics like the COVID-19 emergency.  It would have a made a difference in Luca’s case, and there will be many more Lucas ahead. All it takes is a simple decision to do it.

March 17, 2020

By Joe Mazzarella, President, Mutualink, Inc.

[1]Antonia Farzan (March12, 2020) ‘Italy Has Abandoned Us’: People Are Being Trapped at Home with Their Loved Ones’ Bodies amid Coronavirus Lockdown.  Washington Post.   Retrieved from: www.msn.com/en-us/news/us/italy-has-abandoned-us-people-are-being-trapped-at-home-with-their-loved-ones-bodies-amid-coronavirus-lockdown/ar-BB115sYP?ocid=hplocalnews.

[2] Id. (citing Megan Iacobini de Fazio (March 10, 2020) Funeral services ‘refused’ to collect body of coronavirus victim.  Al Jazeera (https://www.aljazeera.com/news/2020/03/funeral-services-refused-collect-body-coronavirus-victim-200310144913034.html).

[3] Id. (citing:  https://www.iene.mediaset.it/2020/news/coronavirus-morta-casa_723875.shtml?fbclid=IwAR1a5Rf0s6_v093dAGRjta2P-kIBUAxXtmxPxDCr-z5UvECyg_8sJ_w5wwI)

[4] Id. (citing: https://www.ivg.it/2020/03/coronavirus-a-borghetto-e-cadavere-in-casa-si-attende-lesito-dei-tamponi-e-anche-i-militi-finiscono-in-quarantena/).