By Brad Balfour
A son of Ireland’s County Limerick, Northwell CEO Michael Dowling has been at the forefront of the Corona-verse, fighting for his hospital system, the state of New York and everyone dealing with this deadly viral outbreak. As head of the largest health system in New York State, he is committed to finding sufficient solutions to this catastrophic health crisis as Dowling. A successful businessman, thought leader, political figure and cultural force, Dowling has not only been a crucial part of the community at large, he has been a major figure in the Irish Diaspora, having served as 2017’s Grand Marshal of New York’s St. Patrick’s Day Parade. Previously, IrishExaminerUSA had conducted an exclusive interview with this gracious gentleman, so we sought him out as the ideal authority to comment on the current global crisis. He confirmed that both his family here and in Ireland are safe, but the risks are there.
Long before this emergency began, Dowling had vociferously supported public health care initiatives, stressing the importance of preparedness. As the outbreak first emerged in China, he became a point man on the unfolding health crisis, advising Governor Cuomo and others. Now he and the company are at the forefront of all this — coming up with solutions to the many problems associated with COVID-19 such as waste management, new-style ventilators, and better swabs. The biggest problem has been getting government approval to move forward with many of the ideas developed.
As president/CEO, Dowling heads a nonprofit clinical, academic and research juggernaut with 72,000+ workforce and annual revenues of $13.5 billion. In caring for more than two million people annually through Northwell Health’s vast network of nearly 800 outpatient facilities — including 220 primary care practices, 52 urgent care centers, home care, rehabilitation and end-of-life programs and 23 hospitals — Dowling is impelled to get in front of such a crisis and provide real solutions step by step.
Previously, he had served in New York State for 12 years — seven as state director of Health, Education and Human Services and deputy secretary to the governor as well as commissioner of the New York State Department of Social Services. As a powerful voice in the health care community, Dowling is unabashedly outspoken on such issues as gun violence and immigration, and now this pandemic.
Q: With this Corona virus crisis, why do you think we all got caught like this? Is it endemic to the system — unprepared, reacting too late with too little a sense of urgency?
MD: I think on the national level, the White House poo-pooed this for a long time. You have the President talking about it for a long time saying it’s a hoax or a Democratic plan, a way to disrupt his election, and he didn’t listen to people in the public health sector.
There [are] people in the CDC and Dr. [Anthony] Fauci who have said for a long time this is going to be a problem, it’s going to come here. But the White House ignored everything and pretended like this couldn’t happen, like we couldn’t get hit with something like this. A virus doesn’t need a passport, it can travel with people back and forth.
Then you have states like California, and New York’s Governor Cuomo. They took the reins basically and said we’ve got to start planning. It should have been a national response because this is a national problem. But when the national government was slow to move, the states began to pick it up.
New York has been ahead in the planning here. New York obviously has a higher [concentration] because of the nature of the city, it’s a very global city and people come from all over. It’s very concentrated in population density. So New York would get hit harder than some other areas. To me, this is very political. This is not listening to the right people, not listening to the experts in the field, and making political judgements that were a bad, bad call.
Q: How have things been at your hospitals?
MD: We’ve been very very busy. We’ve had a 12-fold increase in Covid patients in the last week. Our hospital is packed, but we’re managing well. We got a great staff, a good system in place. It’s stressful. We’ve had to cancel lots and lots of services. Cancel all surgeries for the most part, to make beds available. But right now, we’re doing quite well. It’s tough, but we’re not in a crisis situation because we can handle it pretty well.
Q: What lessons can we learn from this? How can we know when a pandemic occurs as opposed to a regular viral outbreak?
MD: The lesson here is you’ve got to monitor what goes on across the world. There was an entity created on the federal level to do just that, but the administration eliminated that [task force] some time last year. So you do [this early warning] system. You monitor what goes on across the world, you get your professionals in place to make sure they understand what the spread might look like. That’s one thing we’ve got to be doing. And we have to be looking at public health as a national security issue. It’s not just all about the military, it’s about what can happen with viruses like this.
The second thing is that we have to build stockpiles. The fact that we’re trying to scrounge for ventilators, masks and gowns…. We’ve got to build up a national stockpile. And we have to start making these things in the US so we’re not so dependent on China [or other places]. All the masks that we got previously in my system were from China. When China got hit, all those companies closed, the manufacturing stopped and there were no masks being made.
We need to reassess the supply chain. We need to invest much more in the CDC and in research with the National Institute of Health. And, at the state level, we have to build stockpiles and strengthen the public health infrastructure, which has been neglected. The danger will be that when this is all over people will forget and not make plans for the potential of the next one, because there will be another issue like this one. This is the world we live in. We’ve had SARS, we’ve had Ebola, now we have Corona, [and] there will be another one. So we have to make sure that when this is over, we plan and are more prepared supply-wise and mentally for another issue like this that will hit the United States at some point. It might not happen for another 10 years, but it will happen.
Q: This coronavirus shows that the America First mentality, trying to be independent from the rest of the world, just doesn’t work.
MD: The idea of [an] America, that we can be independent from the rest of the world, is one of the stupidest ideas anyone could promote. You can’t do that. The world is completely interconnected, so you can’t disconnect from an interconnected world. We’re more connected than we ever were before. So this idea that you can put a wall around the United States and prevent it from outside [threats] is absolutely stupid and ridiculous. And that’s true for any country. We live in a global world. If I was President of the United States I’d be getting together with China, with Russia, with the EU, and figure out how we collectively work together to handle these issues in the future. [Isolating] the country just doesn’t work.
Q: The idea of cutting off borders is ridiculous if we have international travel.
MD: We have to understand that it’s an interconnected world we live in and we can’t separate ourselves. We have to understand that’s the world we live in. Some politicians think we can’t be interfered with by anyone, but the coronavirus shows that’s not how it works.
Q: Trump has said we’ve got to get back to business in April. Some people have even said that an active economy is more important than lives.
MD: You go back to business when we control this. The worst thing in the world would be to get back to business too soon. I understand the economic impact of this, but to go back to business too soon before we’ve contained this monster will only allow the virus to re-spread and cause unbelievable damage. You take the pain now so you can get back to work later and have less pain later. If it takes two or three weeks more, you can’t put a political time table on this because we just don’t know. So to declare we’re going back to business a couple of weeks from now without any of the evidence to back it up is just more about politics than public health.
Q: What do you think about this business of people promoting conspiracy theories around the cause of the virus?
MD: The world allows you to put anything out there no matter how stupid it is. [With] all these people that promote these conspiracy theories, they say freedom of speech, freedom of expression, which is fine, [but] I’m hoping people are intelligent enough not pay attention to that stupid stuff on the web.
Q: The problem is that people don’t understand viruses are an integral part of the human eco-system and how these outbreaks are normal, and that they evolve.
MD: We’ve gone through this throughout history. They evolve over time. We’ll have a vaccine for this one within a year or so, but who knows what the next one will bring.
Q: It seems that if people don’t understand what’s going on, they impose these conspiracy theories.
MD: There’s always people who think there are conspiracies around everything, that nothing is factual, there’s always somebody concocting a weird story, and unfortunately those ideas always get a following. This is why you have to be discriminatory and be able to make your own intelligent decision after looking at the facts. Don’t automatically follow what shows up on the internet on a day-to-day basis. Some of it is absolutely ridiculous. We saw this with the gun violence issue; some people were claiming the kids in Connecticut who were killed — that it never happened even though you could see people and parents at the funerals. People said it was a hoax. I don’t think you can prevent those kinds of things from being out there. I just hope people wouldn’t fall into the trap of those ideas.
Q: When do you envision life resuming as normal, and whether we can return to normal life?
MD: My prediction is as good or bad as everyone else’s. I do think it will run through April and at the end of the month we’ll see it flattening out and by early May we’ll see some of the policies get relaxed. This is my opinion though, just based on what I see. Some time in May we’ll see things coming back gradually, but it will take the economy a long time to come back and it may never come back the same way. In health care it will take us a good year, year and a half, to get back to where we were before this. So we have to be patient. There will be a lot of angst along the way, but that’s what happens in situations like this. We’ve overcome things in the past. We overcame the AIDS epidemic, we overcame Ebola and SARS. It will pass and we’ll look back saying we’ve gone through an experience that was the first of its kind in our lifetime.
Q: Do you think improvements will happen when it gets warmer?
MD: Some people are claiming that, but there’s no evidence that temperature makes a difference. Who was that actor that got the virus while in the hot weather of Australia? There was very hot weather there and yet they got it. There is no scientific evidence I’ve seen for that so we don’t know.
There’s a lot about this virus we don’t know. For example, if you get it and you’re clean, can you get it again? These are questions we don’t have definitive answers to. Most doctors would say once you have had it and overcome it, you should be okay, but I can’t guarantee it. So you’re dealing with an enemy that’s a little bit unknown. We have to be flexible in how we act and think.
Q: The biggest problem is the people who can’t deal with the unknown.
MD: A lot of life is the unknown.
Q: That’s for sure. As a result of all this, what do you folks on the health provider level think you can do? Will you organize people? Make a task force?
MD: We will definitely sit down and talk about the lessons we learned, what should we plan for in a different way, and how we better prepare for the future. Some people are already thinking about that now. In my organization we’re already talking about it now. It will be a collective effort among the various hospitals to sit back and reassess when this is all over.
Q: By abrogating a thorough response on a national level, Trump has put more power into the hands of the states. Will that change going forward?
MD: The states have been at the leading edge here, but I do think it will require [action] on a national level. I don’t think that will happen under this leadership, but at some point the leadership [has to take action] nationally. I hope there will be an organization at the national level that’s interdependent, no states separated from each other completely. We have to take a national approach to this.
I don’t have high expectations for this administration, but I know there are people in the administration who think this way; I just don’t think the leadership does. This is a national event and if you’re going to prevent these things you have to look at it nationally and deal with it globally. We should be working with all these other countries to figure out how we handle these situations in the future.
Q: Do you think if we had a national healthcare system, some of this could have been averted?
MD: If you had a situation like what Bernie Sanders wants, it would be even worse. You don’t want healthcare organizations managed by the government, it just doesn’t work. They’re not fast paced enough, they’re not flexible enough, they don’t allow innovation. It would be a worse situation. If you look around the world, a lot of countries that are having severe problems have nationalized healthcare. Government should be good at setting overall direction, but letting overall operations be run as much as possible privately so you can have a lot more accountability, a lot more flexibility. It would be even worse if we had the kind of programs Bernie Sanders was talking about.
Q: What advice do you have for people at this time?
MD: For now, comply with social isolation and distancing policies to prevent this. I know it’s inconvenient, annoying and difficult for all of us, our lives have been completely changed, but that’s prevention. If we don’t comply and we get together in large groups again, it runs the potential of accelerating the spread. And then we will only have to act with even more drastic action. For now [we have to accept] the inconvenience, because if we do, it will end relatively quickly. I think we have another month for this.
Q: I read that an Irish company is developing a machine using ultraviolet light to clean hospitals, and another company there is printing masks through digital printing technology. Are we going to be looking to Ireland for new insights into solving this pandemic?
MD: We work with a lot of Irish companies now. I work with a whole bunch of Irish companies. Ireland is an epicenter of knowledge and creativity, so we work with Irish companies all the time. I put out a release recently with an Irish company on how to deal with the waste from lab supplies with a company based in Tipperary. Irish companies are here all the time. We see a lot of creativity from Ireland and how they use ultraviolet light and how it can clean rooms and masks. Ireland is in a good position, they’re highly educated and a lot of creativity is coming out of Dublin.