A conference room across from the Emergency Department at Atrium Health’s Carolinas Medical Center is normally used for lectures and classes. But in March, as hospitals across the U.S. scrambled to respond to the coronavirus, four Atrium employees grabbed masks and hand sanitizer and turned the space into what they called a “war room” to fight COVID-19.
“We recognized that this pandemic was moving faster than our traditional processes could handle,” said Dr. David Callaway, the director of the Division of Operational and Disaster Medicine and a professor of Emergency Medicine at Carolinas Medical Center.
Callaway is accustomed to responding to crises. He was a Navy doctor in 2003 during the initial invasion of Iraq and also treated wounded soldiers on the Kuwait-Iraq border.
Callaway and other team members rearranged the room so the tables were in a large square. They sat 8 to 10 feet apart, surrounded by computer screens and dry erase boards.
“We put some paraphernalia in there to motivate us. We had a lot of motivational posters -- American flags and Churchill quotes and Teddy Roosevelt quotes,” Callaway said.
“You must never be fearful of what you are doing when it is right,” read a Rosa Parks poster.
There were also eight “war room rules” handwritten on a large piece of paper. No. 3 was “Be kind.” No. 5 was “Change your socks,” which Callaway said is based on a military expression. He said it means to make sure team members take care of themselves, take breaks and don’t forget to eat.
From the “war room,” the team coordinated with groups across the Atrium Health hospital system. They monitored the number of intensive care beds in case there was a surge in coronavirus patients.
“We were living in the war room for about two and half months. Pretty much every day and many nights,” said Christian Schulz, PA-C, Associate Medical Director for CMC’s Emergency Department.
He estimated the team worked at least 16 hours per day.
Each day, they would write three priorities on a dry erase board. For example, “Find N95 masks for everyone who sees patients face-to-face” or “Keep patients out of the hallways [to keep them from possibly spreading the virus].”
Sometimes, it seemed drastic measures would be necessary. Callaway remembered a group call with two emergency medicine doctors in New York City.
“They basically just said, ‘We’re getting pounded. We’re stacking up the bodies in the emergency department. Our nurses are quitting. We have staff going down like flies,’” he said, adding that he worried Charlotte would soon be in the same situation.
Dr. David Pearson, an Emergency Medicine physician who also worked in the "war room," said he had a similar moment in the early days of the pandemic. Pearson and other doctors were walking around the hospital, looking for extra space that could hold a surge of patients, when they came to the parking garage.
“We started ... just very matter-of-factly going, ‘Yeah, OK. We could fit one bed into each parking spot,’” Pearson said.
“That was the moment where I was like, ‘Wow, this is for real.’”
It never came to that. In April, Atrium and Charlotte’s other major hospital system, Novant, canceled their requestfor a field hospital. The hospital systems said they had enough beds to handle any potential coronavirus surge.
The Atrium team stopped using the "war room" in early July and Callaway said he’s not sure they will have to use it again soon.
“Part of why you need that initial hybrid war room is because you’re trying to get everybody to buy into the same narrative, buy into the same trust and you’re creating new processes. So you have to have some degree of in-person ability to do that,” Callaway said.
Now he said the team could probably set up a similar process virtually. But -- just in case -- the posters and motivational quotes are still there.
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