For the past year, School of Medicine alumni have stepped forward in innumerable ways to help their patients, families, friends, and communities weather the pandemic. Here, we profile three alumni who showed extraordinary leadership amid a year of great unrest and uncertainty.
Helming a Crisis Response
For Scott Harris, M.D., MPH, state health officer and the director of the Alabama Department of Public Health (ADPH), the COVID-19 pandemic truly began on March 13, 2020—Friday the 13th.
That was the day when the first case of coronavirus was diagnosed in the state. Suddenly, a potential problem the ADPH had been monitoring for two months literally went viral. “We dialed up from business-as-usual to having hundreds of phone calls and thousands of emails every day. It happened almost overnight after we got that first case,” says Harris, a 1991 School of Medicine graduate who also received a master’s from the UAB School of Public Health. “Suddenly we were in full crisis response. Even though we had anticipated that something was going to happen, we couldn’t have imagined what it was going to be like. It was overwhelming.”
Harris says the next few months were like being “in the fog of war.” Businesses and the general public turned to the ADPH for information, but Harris says, at first, the department simply didn’t have much to provide.
“There wasn’t enough data yet on the scope of the problem,” Harris says. “We were trying to think through every way that we could get our hands around this problem, but there just wasn’t enough information.”
So Harris says the ADPH initially spent much of its time reacting to mini-outbreaks throughout the state. Birmingham one week, Auburn-Opelika the next, then Huntsville and Mobile. Hotspots would flare up in a nursing home or poultry plant.
“We were putting out fires and lurching from one crisis to another, trying to address what we could in real time,” Harris says.
Gradually, by working with the Alabama Emergency Management Agency, the Alabama National Guard, and UAB (“We’ve had contact with UAB almost every day,” Harris says), a more strategic game plan emerged. The emphasis was on improving COVID-19 testing, increasing access to PPE (personal protective equipment), and providing better information to the public.
“There were so many processes that had to be built from scratch,” Harris says. “There were all these things that we now take for granted as part of the response, but they had to be turned on almost overnight.”
Along the way, Harris found himself increasingly acting as the public face of public health. He says it is a role he understands and accepts, but doesn’t exactly relish.
“That’s part of my job, but I never thought it would be such a significant part,” Harris says. “I spent a lot of time talking to legislators and the press and the public. But one of our goals through all this has been to communicate effectively.”
As the state endured surges in the disease last summer and again this past winter, Harris says members of the ADPH continued to work long hours to be proactive in anticipating and responding to the various crisis created by the pandemic. For Harris, that unrelenting effort is one of the bright spots from an otherwise demanding year.
“I’ve been in public health for less than six years, and I’m working with people who have several decades of public-health experience,” says Harris, who spent nearly 20 years as a private-practice physician. “I’ve grown to appreciate this job so much because of them, and how much they care about their state. I’ve seen that every single day during all this. I’m proud to be part of an organization that has people like that.”
Confronting the First Wave
The opening weeks of the COVID-19 pandemic hit close to home for Harry Saag, M.D., in more ways than one.
Saag, a 2012 UAB School of Medicine graduate and hospitalist at NYU Langone Health, drove from New York City to Birmingham last March with his father, renowned UAB Infectious Disease specialist Michael Saag M.D., who had been in Boston for a medical conference. They made the long drive specifically to avoid flying as cases of COVID-19 began to escalate.
But by the time they arrived in Birmingham, Harry Saag was experiencing chills and feeling feverish. Two days later, Michael Saag began having similar symptoms. It turns out they were among the first wave of people in the United States to contract the disease.
While the effects of the virus dissipated within a few days for Harry Saag, it took two weeks for Michael Saag to recover. Harry remained in Birmingham during that time and personally treated his father. Finally, in late March, he returned to New York and found that his adopted home had been overrun with the virus.
“The first day I went back to the hospital, I asked if this was a COVID floor,” Saag recalls. “The residents gave me this weird look and said, ‘Every floor is a COVID floor. The whole hospital is a COVID hospital.’ It’s a 450-bed hospital, and every single bed had a COVID patient. That’s when it really hit me what we were facing.”
Saag says it was “all hands on deck” as he and his colleagues desperately tried to treat the constant influx of patients. During this time, Saag worked alongside residents who were in training for psychiatry and plastic surgery.
“Every doctor was a COVID doctor. There was no such thing as a specialty anymore,” Saag says. “We were flying blind. Every day you came in, the protocols for how to treat it had changed. No one knew for sure what we were doing. Never in my career have I felt so helpless.
“Our smartest doctors were looking at us and saying, ‘Just do your best.’ There was no data yet to suggest whether what we were trying was good or bad. We were all making clinical decisions in the absence of evidence which is a scary feeling.”
Several things stand out for Saag as he looks back on his experience. First was the work of the NYU nursing staff. “My job was a whole lot easier than theirs,” he says. “It was good nursing that kept a lot of folks alive more than good doctoring.”
Second is the fact there already are vaccines in place, and an end to the pandemic is in sight. “That’s a real testament to the scientific community,” Saag says. “The vaccine was built on decades of research that was done to prepare us for this moment, including by folks at UAB. We had the infrastructure and knowledge in place that, in a moment of crisis, enabled us to find an effective vaccine as quickly as we did. That’s remarkable, and it’s a testament to all the great scientists at UAB and elsewhere.”
But overall, Saag has a simple takeaway from this past year. “I’ve never seen anything like it before,” he says, “and I hope to never see it again.”
A Floating, Close Encounter
On the morning of Valentine’s Day 2020, John McMahon Jr., M.D., boarded a plane headed for Yokohama, Japan, and the Diamond Princess cruise ship. But he was not leaving on a romantic vacation. Instead, McMahon was part of the National Disaster Medical System team being sent to retrieve 370 American citizens who were quarantined on the ship at the outset of the COVID-19 pandemic.
A 1979 graduate of the School of Medicine and current emergency medicine physician at the University of South Alabama College of Medicine, McMahon has worked disaster response for the past 24 years. He has been on site following numerous hurricanes, and was among the responders sent to New York City after the 9/11 terrorist attacks.
Despite all those experiences, McMahon says the situation on the Diamond Princess was something he had never encountered. A new pathogen was rapidly circulating through the 3,700 passengers on the ship, leading Japanese officials to quarantine it in the port of Yokohama on February 5. By the time McMahon arrived, approximately 15 percent of the passengers and crew had already been stricken.
“One of the CDC officials with us described the Diamond Princess as a floating petri dish, with COVID-19 just growing on it,” McMahon says. “We were trying to safely get the American citizens who were onboard off the ship before they caught it. Because everybody who stayed on that ship was going to get it.”
Equipped in full PPE with MAXAIR ultrafiltration helmets, McMahon and his colleagues spent approximately eight hours slowly going from cabin to cabin—185 in all—interviewing the American passengers and confirming that they wanted to leave. He says 10 people actually declined because their spouses had been taken to a hospital in Tokyo, and they did not want to leave them behind.
“Some of the cabins were tiny. It wasn’t a comfortable situation for them,” McMahon says. “So they were all very glad to see us, even though we looked like we were suited up in the type of gear you’d see somebody wearing in a movie.”
McMahon says he walked from one end of the massive ship to the other a total of 11 times, covering five decks. The team saw the final passengers at approximately 11:30 p.m. local time, then they were all taken to the airport in Yokohama by a group of 18 buses. At 2:30 a.m., they departed for the United States on a 747 cargo aircraft.
As a precaution, McMahon and the rest of the response team remained quarantined in Yokohama for five days. Ironically, after enduring the experience on the disease-ridden ship, McMahon says the hotel where they stayed “was beautiful, and the weather was gorgeous.”
When he finally returned to Alabama, McMahon spent an additional week in quarantine at his home. As soon as he was able to leave, he immediately went to see Edward Panacek, M.D., MPH, chair of Emergency Medicine at the University of South Alabama College of Medicine, to tell him what he had experienced and warn him about what was on the way.
“I recommended to him that the department and hospital get some MAXAIR helmets and start stockpiling PPE and N95s, because we were going to need them,” McMahon says. “After what I’d seen, I knew this was a true pandemic that was going to be coming to the United States, and we needed to be prepared.” ~ Cary Estes