Editor’s note: The following are excerpts from a blog post first published on yourrowan.com. To find out about more local health care heroes, read the full post at yourrowan.com/health-care-heroes.

By Dari Caldwell

According to Webster’s Dictionary, the definition of a hero is “a person who is admired or idealized for courage, outstanding achievements, or noble qualities.” These attributes certainly can be applied to the health care team, but especially to those on the front line during the COVID-19 pandemic.

Since the onset of the pandemic in early 2020, a lot of attention has been given to health care workers, including parades, recognitions and naming them “heroes.” This attention is well-deserved and long overdue! For this blog, I wanted to focus on the front line, and I looked for a variety of health care heroes from different facets of health care. To a person, when I interviewed them, I heard, “But I’m not a hero, I’m just doing my job.” My response was, “but to us, you are a hero. I’m not sure what we would have done without you.”

So the following are a few people I identified through various means and was able to talk with about what their experiences have been:

 

Neil Patel, MD

I was able to grab a few minutes with Dr. Neil Patel who was on duty at Novant Health Rowan Medical Center as the intensivist overseeing the care of patients in the Intensive Care Units. Patel was certainly on the front line during the COVID pandemic, and continues to see patients with COVID. When asked what has been the most challenging part of working through the pandemic, Patel stated, “Seeing people struggle for such a long time with the illness, and watching what their families go through. Many families have had multiple people die of COVID, and it is just horrible to watch.” Patel says he is still seeing COVID patients come into the hospital but it has slowed down considerably. He says that now the patients are much younger, but many are still requiring life saving measures such as breathing tubes. He says his biggest frustration is vaccine hesitancy, and continues to try to educate people about the importance of getting the COVID vaccine.

Patel was born and raised in Charlotte and attended Independence High School. He got an undergraduate degree from UNC Chapel Hill in 1989, and also attended medical school there finishing in 1992. He then completed an internal medicine residency at the University of Iowa, and went on to complete a fellowship in pulmonary and critical care medicine at the University of Iowa. He then came to Rowan County when he finished his fellowship and joined Rowan Diagnostic Clinic where he continues to practice. He has served in many leadership positions at Rowan Medical Center including terms as chief of the medical staff, medical director for respiratory care, medical director of critical care, and is now serving a dual role as a pulmonologist (lungs) and an intensivist (critical care) where he completes 24-hour shifts looking after critically ill patients. Patel is married, and has two grown children, Max and Anna, and lives in Rowan County.

Charles de Comarmond, MD

Catching up with Dr. Charles de Comarmond at the Bill Hefner VA Medical Center was a real learning experience in a “behind the scenes” view of managing a pandemic. As the associate professor of medicine and infectious diseases, not only was de Comarmond instrumental in the Salisbury VA response to COVID-19, but also managed the response for a six-hospital VA district across North Carolina and Virginia, and with some very impressive outcomes. He was born and grew up in the Seychelles (island country off the east coast of Africa), and went to medical school in Europe before coming to the United States for his medical residency. His residency was in internal medicine at Texas Tech University Health Sciences Center, followed by a fellowship in infectious disease at Wake Forest Baptist Medical Center. Upon completing his fellowship, he stayed on with WFBMC as a faculty member and head of a hepatitis C clinic. In 2005, he joined the VA as an infectious disease physician located in Salisbury, and in 2008 he became chief of medicine and infectious disease. His wife is also a pathologist with the Hefner VA, and he has a son, Mathias, who just graduated from Duke. He lives in Salisbury and loves the area.

In recounting the evolution of the COVID pandemic and VA response, I was impressed with the readiness of the VA to address a respiratory pandemic. The VA had modeled potential responses based on the H1N1 flu, SARS, and Ebola — all airborne illnesses. He discussed the initial responses of his team, followed by his six hospitals coordinated response, finally culminating in the VHA nationwide incident command strategy. He said that education of the staff and constant updates and trainings were a key to success for the VA, which approached the pandemic like a national disaster. “Initially, every clinic was shut down, then we went to virtual visits, and initiated a very ‘common sense’ infection control strategy including masking and handwashing. There was a total cultural transformation in just a couple of weeks,” commented de Comarmond. Most remarkable was the effort he led to initiate the “fourth mission” of the VHA. While the VHA (of which the Hefner VA is a part) focuses on veterans healthcare, veterans benefits, and national cemeteries as the first three missions, the fourth mission is “to improve the nation’s preparedness for response to war, terrorism, national emergencies and natural disasters by developing plans and taking actions to ensure continuous service to veterans, as well as support national, state and local emergency management, public health, safety and homeland security efforts.”

This fourth mission came into play early in the pandemic when skilled nursing facilities became hotbeds for the pandemic. On April 4, 2020, positive COVID cases appeared at several skilled nursing facilities in Salisbury, including the State Veterans Home. While not owned or operated by the VA system, the State Veterans Home, operated by Pruitt Health, is a location for veterans. That was enough for de Comarmond to step in and offer help. He gathered an infection prevention team, and assisted the State Veterans Home with guidance, new policies and procedures, setting up of isolation units and negative pressure units, and the provision of personal protective equipment which was, at that point, in shortage. Most impressive, de Comarmond’s team physically rounded at the State Veteran’s Home three days a week, which included Sundays, and continued this for 10 weeks to assure that all possible measures were implemented and spread was under control. As a result the State Veteran’s Home had one of the lowest infection and death rates of skilled nursing facilities. Lives were saved by this action.

Additionally, de Comarmond devised a temporary shield for use with patients undergoing procedures in order to prevent aerosol spread. The engineering department of the VA produced the device based on his drawings, which served well until more refined solutions were available with the arrival of more protective equipment. Drive through testing was implemented early, based on a previous drill including the Rowan County Health Department and American Red Cross. This preparation paid off with the VA being able to quickly set up drive through testing and eventually drive through vaccinations. During the pandemic, de Comamond says he read the book, “The Great Influenza,” by John Barry and was astounded by the similarities in the 1918 pandemic and the COVID-19 pandemic. A pandemic is like the Super Bowl for an infectious disease practitioner, who trains his entire career for such an event.

Dari Caldwell is a Salisbury resident who formerly worked as president of Novant Health Rowan Medical Center and currently serves as chair for the Rowan County Board of Health.