People have been ‘frightened to go back to hospitals and clinics’: UCLA Hospital System CEO

As hospitals became inundated with coronavirus patients, other diseases and health concerns were pushed to the sideline in order to handle the major influx and stress on the system. UCLA Hospital System CEO Johnese Spisso joins The Final Round panel to discuss how the UCLA hospital system has fared amid the coronavirus pandemic and how it’s pushing for new focus to be given to other health conditions.

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MYLES UDLAND: Back to the coronavirus outbreak and what some hospital systems and health systems have done over the last couple of months and what they think the next few months of this, I guess, process, as we'll call it, could look like. We're joined now by Johnese Spisso. She is the CEO of the UCLA hospital system out there in Los Angeles. And Johnese, thanks so much for joining the program. I guess let's just start maybe with what the last three months looked like for you guys trying to get the supplies you need, the capacity in place, and where things stand as the month of May wraps up here.

JOHNESE SPISSO: And Johnese, if you could unmute yourself-- sorry about that.

JOHNESE SPISSO: Well, thank you, and thank you for having me this afternoon. We actually began in February setting up our command center at UCLA Health, as we were watching the worldwide events for the months prior and as we began to see the presence of COVID enter the United States. By the early March, we began seeing our first patients. And we quickly, in addition to making sure we were having adequate staffing and training of our staff, we worked vigilantly to secure enough personal protective equipment to begin doing a surge plan as well to create capacity.

So a little different than the east coast, many of the hospitals here created that surge capacity, but we actually never filled to the volumes that you were seeing, particularly of our colleagues in New York. So by the second week in March, we had begun cancelling and postponing any non-emergent or urgent surgeries and procedures.

So our hospitals that usually are at 100% capacity quickly reduced to about 50% capacity, and our ambulatory clinics also dropped to about 50% capacity. And we picked up a lot of patients transferring to video visits. So we went from doing 150 visit video visits a week to over 10,000 a week very quickly.

What we've been now working on, now that we've had-- we have adequate testing, we have adequate personal protective equipment-- is inviting our patients back who've been postponing their care. In a short period of time, in the first few weeks in March, we had cancelled or postponed over 6,000 surgeries or procedures. We've been working very hard to get those back.

But what we learned is the public was very frightened to come back to hospitals and clinics, and we've really had to do a lot of outreach education. We worked together as a hospital community in Los Angeles to educate the public and to tell them, it's time to come back or the health care that they've put on pause.

We were especially concerned, as a tertiary and quaternary medical center, the reduction that we saw even in our emergency departments in heart attacks and strokes. We know COVID did nothing to cure those, so we were very concerned that people weren't presenting for the care that's needed. And we very quickly began to see that as we opened back up, people who really should have been coming in a lot sooner.

MELODY HAHM: And Johnese, tell us more about that disparity between rhetoric coming from government officials, like Mayor Garcetti, like Governor Newsom, and the actual fear that people were feeling. Because I think the headlines of the numbers ticking up-- even after Memorial Day weekend, we saw that there are a record number of cases-- there clearly is a disconnect, right? With how many hospital beds are needed, the kinds of services that are available, and what the reality looks like.

JOHNESE SPISSO: Yeah, well, I think our governor and mayor did a very good job to keep California and the city of Los Angeles safe so that we didn't have those surges. The things that we're putting in place early on-- the closures of schools, the social distancing requirements, the shelter at home-- we really saw our numbers really being manageable. So for example, in the whole state, we're up to about 94,000 cases. About 46,000 of those are in Los Angeles, but we're a city of 10 million. So that-- the cooperation that we had from people in our state was tremendous. And so we created capacity, but at no time were we really overwhelmed.

Now, we know what can happen when you relax those things. So that's why we've been cautiously reopening. We do have a masking requirement in LA for when people are outside. We're still encouraging everyone to definitely wear their mask, to keep the social distancing and the handwashing. At the same time, we're also starting to reopen things. So it was announced earlier today, retail can reopen with some of the same precautions in place.

Here at the hospitals, we've been doing temperature screening and symptom screening and universal masking for months. That coupled with testing everyone who needs a procedure or admission, we feel that hospitals and clinics are very safe for people to return to.

MELODY HAHM: And of course, you're in a tough position right now because you are the CEO of a nonprofit health system.

JOHNESE SPISSO: Yes.

MELODY HAHM: But that doesn't necessarily mean that you can continue operating on such a shoestring budget, right? So when you think about the impact that it's had on your bottom line over the last couple of months, can you give us some color there?

JOHNESE SPISSO: Yes, it's actually been a devastating impact to our bottom line. In the month of March alone and April, we had a reduction in revenue of about $250 million. That isn't sustainable, which is why, again, we've been anxious to return to our normal business of health care so that we can really meet our mission for the community. So our health system, like so many other health systems in the country, have really had to weather some extreme economic losses, things that we haven't-- that are unprecedented in health care.

DAN ROBERTS: Johnese, Dan Roberts here. Just as quickly, as we wrap up, you know, a lot of you are talking about when and if college sports, and especially college football in the fall, can return. And California's been an interesting example because some of the schools there have already said, you know, we're only going to have digital or virtual classes at first. Some people are wondering whether UCLA and Berkeley can have college football. Where do you stand on this? And especially for your position with the hospitals, are you concerned that having sports return is something that could exacerbate the risk of more cases?

JOHNESE SPISSO: Well, we've been trying to work very closely with our campus and with athletics so that we can have safe and effective policies and procedures in place, whether they choose to continue the distance learning or bring students on site. Again, we feel that we're prepared to work with them. And now with having more testing available and more personal protective equipment, we feel that does open up some opportunities to safely resume things in a very planned and strategic approach. No decisions have been made. It's really something, though, that the university is spending a lot of time on a daily basis and really coordinating closely with us on the health system side.

MYLES UDLAND: All right, Johnese Spisso is the CEO of the UCLA health system. Thank you so much for taking the time to talk to us this afternoon.