It may seem hard to believe, but March 5 marked the 5th anniversary since Covid-19 first hit Montgomery County.
For some people, the start of the pandemic may seem far removed from their daily lives now. However, for others, the memories of what happened are still very much seared in their minds.
Covid-19 caused unspeakable death and disease in the community. The virus also caused panic and fear among many residents, in part, because it was a new virus. There was no vaccine in March 2020, and no known cure. Covid-19 was highly transmissible. The virus spread like wildfire, and many people ended up in hospitals, and some residents died.
Latest Data
Like many countries around the world, the United States has stopped keeping track of overall cases and deaths. The last known statistics are from April 2024. Worldometer Tracking reported 111,820,082 cases in the United States since the start of the pandemic until that time. Covid-19 had killed 1,219,487 Americans. Those numbers are higher today because Covid-19, on average, infects and kills tens of thousands of people each year.
The Maryland Department of Health still keeps track of Covid-19. As of Feb. 25, the state has had more than 1.5 million cases and 18,336 deaths. The death toll in the County stands at 2,684 people since Covid-19 began.
Covid-19 Impact
MCM spoke with a doctor, a nurse, and two County public health officials about their memories when Covid-19 first started. Here are their stories:
First Memories
Dr. Andy Catanzaro is Chief of Infectious Diseases at Adventist Healthcare White Oak Medical Center. In 2020, he was an infectious disease doctor. One of his first memories was hearing about an outbreak of Covid-19 aboard the Diamond Princess Cruise ship which was docked in Japan. The ship had 2,666 passengers on board. On Feb. 5, 2020, doctors reported Covid-19 had infected 10 people. Within two weeks, 691 passengers had the virus, and there were several deaths.
“That’s when I got the scope of, you take a bunch of people, you release Covid-19 into their environment, and how many of them get sick and some of them get really sick to where they have to go to the hospital. My epidemiology brain said, this is what is coming and my psychological brain said, it can’t be that bad. How bad could it be?” Catanzaro said.
He said he never imagined the sheer power of Covid-19’s transmission capability.
Figuring Out A Plan
“We had to develop a plan about what we were going to do. Then all of a sudden we got punched in the face. We started seeing cases in Seattle, and then eventually it came here. I spoke with my mentor at Medstar Georgetown University Hospital. She told me it was going to be really bad for a really long time, and that’s when I got scared,” Catanzaro said.
“I asked her, so what are you guys doing? She told me, we’re acquiring every scrap of personal protective equipment (PPE) we can get, and we’re getting technology called Bio Fire which is used for testing,” Catanzaro added.
This form of testing for the virus was rudimentary at first. The only treatment, at the time, was providing patients with oxygen.
“I’m a physician and I’m used to treating a disease with medications. I’m used to helping patients and their families understand what is happening and help them. We couldn’t do that. Family members couldn’t show up. The hospitals were locked down. Basically it came down to, you know, this is bigger than all of us, and we just have to figure out a way to survive. So I would go to the front lines. I would talk to people, and I would encourage them. I would try to see patients. Then ultimately I decided let’s do some research because that was my bedrock,” Catanzaro said.
Feeling Helpless
He had worked at the National Institutes of Health (NIH) in Bethesda for 10 years before he joined Adventist Healthcare. His previous experience dealing with the AIDS crisis helped give him some perspective.
“I knew we were powerless when AIDS first came. But suddenly there was triple therapy, and people were emptying out of hospitals. The miracle drugs came. With Covid-19 it was really tough being powerless. Nothing we knew worked and it was really hard,” Catanzaro explained.
Community Support
Despite the many challenges he and his fellow health care workers faced, Catanzaro was overwhelmed by the support in the community.
“The Emergency Room director said we need to set up a tent outside the hospital. The National Guard came and set us up a tent. A 19-year old service member said to me, ‘Don’t worry doc, we got you‘. The nurses showed up, the doctors showed up, people donated. Some went to Home Depot and bought those welding masks to help protect us. Philanthropist and renowned chef Jose Andres gave food to the Emergency Room groups. People did what they could. They came together and helped each other,” Catanzaro said.
Previous Pandemics
He believes the pandemic provided many lessons to health care workers. However, Catanzaro said many of the lessons learned actually already existed.
“We had a disaster management structure but we just hadn’t practiced that muscle. We had predecessors who had been through a pandemic. I went back to some of the 1918 literature to realize that pandemics were always controversial. There was always consternation. Yet people got through it. All of these lessons were there in history. We just had to figure out how to use them as fast as possible,” Catanzaro said.
Impact On the Health Care System
The stress of the pandemic took its toll on the health care system. Many nurses and other workers became burnt out and left. Catanzaro said he coped with the stress by taking walks in nature, playing board games with his family, talking to other doctors, and therapists for advice.
As he looks back on this time, Catanzaro said his biggest takeaway from the pandemic was “we’re in this together; no one is on an island.” He hopes going forward people will understand that if they stick together, they can get through almost anything.
Nurses On the Frontlines
Nimeet Kapoor is the Program Director, Staffing Management Services at Adventist Healthcare. During the start of the pandemic, Kapoor was the Intensive Care Unit (ICU) Nurse Manager at Adventist Healthcare Shady Grove Medical Center in Rockville.
“We had a lot of patients in the beginning. We went from one ICU unit to three. I went from managing 75 nurses to more than 200 staff members. In the beginning we had 16 to 20 patients but that quickly grew to about 60 to 65 patients at the height of the pandemic,” Kapoor said.
He explained that many nurses at that time felt overwhelmed. They were stressed and fearful. Some nurses who were recent moms or who were pregnant worried about the safety of their loved ones. Many nurses decided it was not safe to see their grandparents and stayed away. Some nurses left the workforce because they were just not comfortable.
People Stepped Up To Help
“As a leader, I didn’t know what to do. So I worked with our Employee Assistant Program group and received help. We had some Meet and Greet sessions with the nurses. We encouraged them to talk about what was happening and create an open space for them, which actually helped a lot,” Kapoor said.
He said nurses from other departments outside of ICU came to help. The hospital asked the nurses to serve in unfamiliar departments, and that created more stress. Despite this, the staff came together and it was a team approach to take care of all of the patients in need.
Overall, Kapoor said the beginnings of Covid-19 were very challenging.
“It really broke my heart, talking to the many nurses, talking to the family members, talking to some of the patients because they were scared. We didn’t know the answers. We had to make difficult decisions about how best to bring family members to their loved ones when they were dying,” Kapoor said.
County Health Response
Dr. James Bridgers is currently the director of the County’s Department of Health and Human Services. When the pandemic hit, he was serving as the deputy health officer under County Health Officer, Dr. Travis Gayles.
He said the County began monitoring and surveilling the disease as early as Jan. 2020.
“We knew that it was highly transmissible in larger congregate settings. Covid-19 had hit Boston and New York, and it was just a matter of time before it would hit Maryland,” Bridgers said.
Tracking Covid-19
“The department was looking at the trend lines and the data for the national statistics, but we also were looking at international data. We knew it was a respiratory virus. It was transmissible either through the air or by touching a surface. We knew that for disease prevention, we needed to contain the disease. That is when we started to have the isolated strategies and policies put in place where people needed to stay home. We needed to see how long the virus would last in the community. We had to move folks out of the general population so that we could mitigate and suppress transmission. Since we were dealing with respiratory like symptoms, individuals needed to don a protective mask to prevent the transmission,” Bridgers said.
“So we looked at all of the models, we looked at all of the theories, we looked at all of the applications that were available at the time, and what we realized that with many new diseases, there is no clear cut strategy. This was a new virus. We had to employ aggressive strategies to keep people safe. Five years ago, we were heavy into testing. We were heavy into surveillance as we tried to figure this virus out,” Bridgers added.
This included monitoring wastewater to determine where Covid-19 was hitting. That strategy was new. However, the County uses it now to figure out the level of any disease in the community.
Strain On The Health Care System
Bridgers said Covid-19 put a great strain on the health care system and the system was not prepared.
“We didn’t anticipate the need for more personal protective equipment, gloves, masks, and infectious disease suits. We didn’t have enough nurses to support the care in our hospital settings. Traveling nurses would come into the County and help in areas where the need was rising. We didn’t have enough hand sanitizers. We needed to wash our hands any time we came into contact with any surface whether it was inside or outside,” Bridgers said.
Vaccinations Provide Hope
It would be 9 months before the first Covid-19 vaccines became available. Bridgers said the vaccines saved countless lives.
“Vaccinations really protect the community as a whole and especially individuals who suffer from chronic illness,” Bridgers said.
“We must stay vigilant with our vaccinations on a regular schedule. Vaccinations are a proven science. They are an effective way to keep people safe. Research and dedicated science produced positive outcomes for residents in our response to Covid-19,” he added.
Lessons Learned
Bridgers said Covid-19 helped shine a light on problems in the health care system 5 years ago and some of those problems still exist today.
“What we found was that the public health structure and infrastructure needed to be strengthened. This pandemic showed us we need more service and access to care in our socially and economically disadvantaged communities. That does not mean just by race. It means across ages and lifespan. We knew that what happened in one community was definitely going to happen in someone else’s community. But access was a challenge. We knew that all individuals were at risk, but we didn’t know initially that people living in communities of color didn’t have access to health care,” Bridgers explained.
The Health Department formed partnerships with nonprofits and many churches in underserved communities. Those partnerships still exist today. Bridgers said they help provide resources and access to care for all people living in the County.
Preparations For The Pandemic
Sean O’Donnell is the Deputy Chief for Public Health Services in the Department of Health and Human Services in the County. Five years ago, he was serving as the manager of the Emergency Preparedness and Response Program for Public Health. He and his team prepared for different types of events that could threaten the health of the community.
“One of the events we prepared for was that a theoretical pandemic could happen at any point. Back in December 2019, one of our epidemiologists stopped me and asked if I had heard about this strange outbreak of illness that had been happening in China. I said I had not. Then after the holidays is when the international community started to talk about this,” O’Donnell said.
“We had just finished some of our preparedness activities and talked about how we would get things out to the community. That’s when we began getting notices from the Centers for Disease Control and Prevention (CDC) about the significance of this. On March 3, 2020 Gayles addressed the County Council. He gave an update on preparations for the virus. Two days later, we got a call from the state about three Covid-19 cases. The County had two of those cases,” O’Donnell explained.
Marshalling The Covid-19 Response
“Our phones were ringing off the hook. One of our first activities was activating our Medical Reserve Corps which are volunteers from the community who work and train with the Health Department. We had dozens of individuals who came in during the day and helped answer those calls. We put together screening questions to try to determine if the person calling had a close contact that could put them at risk. In addition, we started asking is there a way to test for this? There were some tests available but there was a very, very limited supply,” O’Donnell added.
O’Donnell recalls his office went to every lab that it had contact with, and his team got a hold of three to five tests at a time. But the demand already was in the hundreds, if not thousands.
Coping With Challenges
“The need to protect our health care workers was there. The need for PPE was phenomenal. We worked to get out what we had stockpiled, which was a drop in the bucket compared to the need. So there were a lot of challenges with that,” O’Donnell explained.
His office also faced challenges with getting out information to the public.
“You don’t really know how infectious something is going to be, or how it will disproportionally impact people until you have enough data. Those preliminary reports were what we knew at the time and those changed. We had to be careful that what we were putting out to people was accurate, and that we were staying up to date because we could not afford to lose the trust people had in us,” O’Donnell said.
Novel Virus Overwhelms Health Care Facilities
He explained the threat of Covid-19 existed because there was no immunity in the community, since it was a new virus. O’Donnell said that realization spurred the County to take extreme measures to control the virus.
“If it had caused less serious illness, I think, many of the prevention efforts would have been balanced differently against the community cost,” O’Donnell said. “But this was overwhelming our hospitals, this was killing an unprecedented amount of people,” he added.
O’Donnell said the support his agency received was amazing. Many government employees volunteered to help his group even if they worked in other departments.
The virus had an impact on health beyond what the virus was doing in the community. For example, doctors postponed elective surgeries. That is because the hospital needed those hospital beds to take care of Covid-19 patients.
Working Together
The County managed to expand its health care capacity. It reopened Adventist Healthcare’s facility in Silver Spring which had closed because the hospital moved to its new location in White Oak.
“It is astounding what our medical community did to get through this. Their scars look a little different than the scars of the general public because they were on the front lines. They saw those very ill people. They saw the people that did not make it. Our role in public health was to do whatever we could to keep people out of the hospital. We tried to test people, so if they were sick, they would stay home. We tried to get resources out to people to prevent the spread to health care workers, to residents, and ultimately get people vaccinated as quickly as possible,” O’Donnell said.
County’s Struggles
The County had a much higher rate of infection and a much higher rate of hospitalization when the pandemic first started compared with other counties in the state.
“We got hit really, really hard during the first six months of Covid-19, and then after that our numbers got dramatically better. The precautions our residents took such as voluntarily wearing masks, keeping up with social distancing, staying home when sick, and getting vaccinated helped lower the death rate,” O’Donnell said.
“Our elected officials, our Council members, our County Executive gave us so many resources. They provided the direction, they provided the cover. They took all of the criticism in front of the public and let us do the work,” O’Donnell added.
Responding To A Crisis
He said many people stepped up during the pandemic. He always will be grateful for the sacrifices the doctors, nurses, and other health care professionals made during this time. Government workers who were not in health care also came to help. O’Donnell said all of them were heroes.
