In summer 2020, Edward Michelson, M.D., chair of TTUHSC El Paso's Department of Emergency Medicine, had developed a new daily routine. Each day, he examined a pile of raw data from across the country and around the globe, studiously pouring through them, like a baseball enthusiast reading the latest box scores, looking for trends or insights on the game. However, instead of hits and runs, Dr. Michelson was analyzing the latest new COVID-19 cases and deaths, looking for clues on how the pandemic was progressing through the U.S.
The COVID-19 data of July 23, 2020, revealed movements that were both promising and worrisome to Dr. Michelson. While the number of new cases and deaths in the Northeast were falling, in El Paso, however, they were trending in the opposite direction. The pandemic wave that had paralyzed New York was about to strike our Borderplex.
There was precious little time to lose.
We learned a lot about practicing medicine during the coronavirus pandemic. As the East Coast was grappling with the virus, we in El Paso were bracing ourselves, with our summer serving as a dress rehearsal. It became clear our big wave would arrive in the fall – October, November, and December of 2020. And sure enough, that's when it really hit us."
Edward Michelson, M.D., Chair of TTUHSC El Paso's Department of Emergency Medicine
El Paso's journey began in March 2020 with its first confirmed case of COVID-19. By fall 2020, the city became the nation's hotspot. What averted the calamity experienced on the East Coast were innovative strategies implemented by Dr. Michelson's team, combined with community involvement, adaptive patient care protocols and the invaluable contributions of medical residents. This enabled El Paso to recover faster than the rest of Texas.
Dr. Michelson's "treat and release" strategy focused on efficiently allocating hospital resources, maximizing bed use, and quickly assessing incoming patients. This approach significantly reduced hospitalizations, ICU admissions and deaths. The distribution of monoclonal antibody bamlanivimab (Bam) to eligible patients, and then sending them home for isolation, further contributed to El Paso's remarkable recovery.
While the pandemic's emotional toll on health care professionals was immense, emergency medicine department residents emerged as vital figures in the battle against COVID-19. As medical school graduates completing their final years of training, they stepped up to intubate patients and hone their skills in life-saving procedures. One of the 36 medical residents during this period was Patrick Popieluszko, M.D., who served as senior resident then. Dr. Popieluszko leveraged the residents' skillsets by designating them to handle cardiac or respiratory distress ICU emergencies.
TTUHSC El Paso's emergency medicine program is in the oldest civilian program of its type in Texas. Begun in 1982, it has grown from four residents to 36 today. Dedicated to growing our own physicians, the emergency medicine department currently has seven Foster School of Medicine graduates and eight former medical residents among its 19 faculty members, including Dr. Popieluszko, who serves as an assistant professor of emergency medicine at TTUHSC El Paso.
El Paso's Hispanic community faced heightened challenges during the pandemic, including increased infection and mortality rates and exacerbated preexisting health disparities. TTUHSC El Paso played a crucial role in addressing these disparities through targeted public health interventions, resource allocation, and community engagement. The university's initiatives, including telemedicine and outreach efforts by promotores, contributed to El Paso County's higher-than-average vaccination rate of 79%, compared to 64% statewide in Texas.
Data from the Texas Department of Health Services illustrates El Paso's success in combating the pandemic. From 2020 to 2021, fatalities due to COVID-19 in Texas increased by 40%, while deaths in El Paso decreased by 47%. By the end of 2022, annual deaths across Texas fell 51% compared to 2020, while deaths in El Paso fell 70%.
Dr. Michelson attributes El Paso's achievements to the region's embrace of vaccinations, the collaborative efforts of health care professionals, institutions, community members and the significant contributions of medical residents. He shared these valuable insights at the International Society for Critical Care and Emergency Medicine conference in Belgium in March.
"We had fewer hospitalizations, we had fewer deaths compared to the rest of the state," said Dr. Michelson. "Because we had a substantially better vaccination experience here, El Pasoans adopted it at a higher rate than other counties in Texas."
In the face of adversity, El Paso emerged stronger and more resilient, setting an example for the nation on how to confront and overcome a global health crisis, with medical residents playing a critical role in the city's remarkable recovery.
Rise in severe psychiatric cases among children during the pandemic