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Pandemic Proof

SUNY Upstate Medical University steps up big in the face of deadly COVID-19 threat

By Lou Sorendo

Under new leadership provided by physician Mantosh Dewan, who was recently named president of SUNY Upstate Medical University in Syracuse, the organization has achieved worldwide recognition while in the trenches battling COVID-19.

Dewan said excellent care has been provided during the pandemic because SUNY Upstate has an exceptional depth of expertise in infectious diseases. In addition, he said, significant progress made on the research side has led to groundbreaking innovations to offset the health threat.

The U.S. Food and Drug Administration recently ranked a diagnostic COVID-19 test developed by SUNY Upstate Medical Center and Quadrant Biosciences in Syracuse No. 1 for detecting the virus in its early stages.

The test, called Clarifi COVID-19, also ranked No. 3 worldwide for its sophistication in detecting the virus among all saliva tests available. Helping to spearhead the effort was Frank Middleton, Ph.D., a research scientist at SUNY Upstate.

More than 580,000 Clarifi tests were reportedly administered across SUNY campuses during the fall semester.

While there are other saliva-based tests that are easier than the nasal swab testing procedure, Dewan said Middleton helped create a test that is unique in terms of finding COVID-19 even when 12 separate saliva samples are put together.

“What is not appreciated is his true genius. His test can detect the virus at a very minute level,” Dewan said. “It is much more powerful than many of the ones that are being used commercially.”

On Nov. 19, Upstate University Hospital did nearly 1,000 COVID-19 tests. Meanwhile, Middleton’s lab did 20,000 tests on the same day.

“That’s the genius. There is nobody that can do that scale-wise,” he said.

Dewan said it was a gratifying experience to be able to support health care professionals to develop something new in only three months. The widely employed test was the first to be FDA approved.

“If you think your job is to serve, this is a time we have served better than ever before,” he added.

Meanwhile, SUNY Upstate’s physician Stephen Thomas was the lead principal investigator for the worldwide Pfizer/BioNTech vaccine trial, which has shown a more than 90% efficacy in preventing COVID-19. The SUNY medical school has served as one of the global Phase 3 vaccine trial locations.

As the lead principal investigator, Thomas, Upstate’s chief of infectious disease, supported Pfizer and BioNTech as they prepared vaccine trial data for submission to regulatory agencies, including the U.S. Food and Drug Administration, in November.

Thomas’ team has also been testing treatments with monoclonal antibodies.

“So we will have vaccines to prevent COVID-19, a very good sophisticated test to figure out if you do have it, and then very good treatments if unfortunately you do have it,” Dewan said.

The SUNY Upstate president and his staff recently received a commendation from the SUNY Board of Trustees for exceptional leadership in combating COVID-19.

He said keys to earning the commendation included the outstanding leadership exhibited by those who spearheaded the innovation to develop the highly efficient saliva test for COVID-19.

Dewan said tens of millions of dollars were saved as a result of the new test at the publicly funded facility.

Normally, each test on average costs about $100, but SUNY Upstate — being a public entity — provided it at cost for $15.

Ready for battle

When COVID-19 struck in March and April, SUNY Upstate was ahead of the curve and prepared.

However, while the hospital was properly secured, downstate facilities were being deluged with patients.

At that time, its SUNY sister school, Stony Brook University, had about 400 COVID-19 patients. Upstate University Hospital, meanwhile, had about 20.

In response, Dewan said SUNY Upstate sent several teams of nurses, pharmacy technicians, and respiratory therapists to Stony Brook.

“That was remarkably brave of these people because at that time, we were really not understanding COVID-19 as well,” Dewan said. “It was a huge threat. They went from a very safe place in Syracuse to a hot bed in Stony Brook.”

Meanwhile, when Manhattan was flooded with COVID-19 cases, the U.S. Army set up a 1,000-bed field hospital in Javits Center in New York City.

The state Department of Health took it over, and began to look for the expertise to manage the facility.

That’s when Upstate dispatched one of its emergency room doctors, Chris Tanski, who was designated the chief medical officer at the convention center. Rebecca Milczarski, Upstate’s director of nursing recruitment and retention, became the chief nursing officer while Housam Hegazy, Upstate’s division chief of hospital medicine, was on site as the chief of the hospitalist division.

“I was cited for good leadership, but really it’s the work of these amazing people who work at Upstate” that earned the commendation, Dewan said.

Aggressive response

In the midst of COVID-19, Dewan said the SUNY Upstate leadership staff had to become more nimble being that no one had experienced a pandemic before.

SUNY Upstate used an incident command system, a concept borrowed from the armed forces, and established Stephen Thomas, chief of infectious disease at SUNY Upstate, as its leader.

During the onset of the pandemic, about 100 staff members from every sector of SUNY Upstate met every morning and evening to react to a whirlwind of unexpected virus-related activities.

“The team would huddle and determine what it needed to do and then assign someone to do it,” Dewan said. “We learned how to become more nimble and responsive.”

He said oftentimes within a large organization like SUNY Upstate, time-consuming discussions were held to reach the right answer.

Now, whether it involves how to keep staff, patients and visitors safe, decisions need to be made and implemented much more quickly.

“We’ve actually become a much more efficient and collegial organization. We had 100 people from every part of the organization, many of whom worked in silos previously, become even more valuable,” he said. “They stepped up in a way I have never seen before.”

Everyone on the team is cell phone accessible and available around the clock, he noted, and sleep is certainly at a premium.

The second wave of COVID-19 has resulted in more patients in the hospital than during the first wave.

“Fortunately, we are better prepared. We have learned lessons and are doing very well with this,” he said.

Dewan said efforts are being made to reach out to communities across the region and encourage them to adhere to the same safety protocol that led to success during the first wave of the virus. That includes social distancing, wearing masks and washing hands.

“If we do all of the right things, there won’t be a need for another lockdown,” he said. “We have to do a little bit more to avoid a lot of pain.”

Photo: SUNY Upstate Medical University President Mantosh Dewan, MD, speaks with SUNY Chancellor Jim Malatras, right, during one of the chancellor’s visits to the Upstate campus last fall. Photo provided