RAISING HEALTH RAISES EVERYONE 2020 Annual Report Sandra Lindsay, RN, first US recipient of a COVID-19 vaccine. Dear friends, This past year has been an inflection point for Northwell Health. 2020 was filled with pain, sacrifice and heroic achievement as our front-line workers, researchers, administrators and support staff joined together in the fight against COVID-19. But 2020 also held the promise of a return toward normalcy—a new kind of normal, marked by an increased awareness of health disparities and sustained work to increase health equity. It was a year of unprecedented challenges, and Northwell met the moment by raising health. Even before the virus made its presence known in New York, our years-long commitment to emergency planning allowed us to respond quickly to the area’s first cases, stepping up at the request of state government to test and treat people in our area and beyond. Northwell managed the field hospital at Javits Convention Center—the largest field hospital mobilization in U.S. history for a non-wartime pandemic—helping to relieve overcrowding in New York City hospitals. In our own facilities, the strategic deployment of physical resources and the selflessness of our doctors, nurses, technicians and environmental workers enabled us to treat more patients than any other health system in the country. As discoveries by researchers at the Feinstein Institutes produced important insights into COVID-19, the ingenuity of team members throughout the health system led to inventions that eased shortages of supplies like nasal swabs and ventilators, and to new, data-smart ways to predict and plan for the impact of the virus. Equally important was Northwell’s commitment to attacking the structural disparities that fueled the pandemic and immeasurably worsened its impact on this country’s racial minorities and disadvantaged populations. Through partnership with faith leaders and community-based organizations, we helped increase access to COVID testing and vaccinated thousands of our most vulnerable neighbors—raising health for all our communities. As we look back at 2020 and forward toward the future, there is reason to hope that science will conquer the pandemic. Northwell will continue its efforts to create a healthier status quo, by helping to find solutions to gun violence, addressing gender-based disparities in care and other efforts. In this report, we are gratified to share stories of how our people fought to defeat COVID-19 at the bedside and in our laboratories, in our command centers and out in the community—and of the many ways we are working to raise health for all. Michael J. Dowling Michael A. Epstein President & CEO Chairman 2 Northwell Health | 2020 Annual Report Northwell Health | 2020 Annual Report 3 Fighting the pandemic The shot that was seen around the world When Northwell nurse Sandra Lindsay, RN, received the nation’s fi rst dose of a vaccine against COVID-19, it lit a beacon of hope for the world. The powerful news made headlines from Brooklyn to Brazil, and beyond. 4 Northwell Health | 2020 Annual Report The shot that was seen around the world Northwell Health | 2020 Annual Report 5 Fighting the pandemic: Learning and leading Caring—and leading—in a crisis The year started with half- the fi ght against COVID-19. COVID-19 testing equipment emergency preparedness heard rumblings about a To set the stage, here is and supplies—the largest helped it prevent chaos as little-understood respiratory a look at some of the key investment in COVID-19 its own caseload grew from illness spreading halfway moments in which the testing by a hospital- about 100 patients in late across the world—and health system stepped up. based lab in the country— March to more than 3,000 allowing it to process in early April. To prevent ended with the striking of As cases mount, Northwell 10,000 tests each day. hospitals from exceeding a defi nitive blow against mobilizes for testing their capacity, the health COVID-19 at Long Island With New York hospitals The fi rst case of COVID-19 system used load-balancing, Jewish Medical Center, struggling, Northwell was confi rmed in New transporting patients from as one Northwell nurse, steps forward Michelle Chester, DNP, York State on March 1st; overstressed facilities to administered the nation’s Northwell saw its fi rst As the surge intensifi ed, others with room. With fi rst dose of vaccine against patient with the disease on hospitals in metropolitan Northwell’s centralized COVID-19 to a second, March 8th. Immediately, New York were at risk of system and command Sandra Lindsay, RN. In Northwell began helping being overwhelmed. At the structure facilitating the the 12 months between, the state Department of request of Governor Andrew process, 810 patients were Northwell Health took Health establish testing Cuomo, Northwell provided transferred during the spring the lead in fi ghting the sites—fi rst in New Rochelle, operational oversight of a surge—about the capacity pandemic, treating more where cases were spiking, fi eld hospital set up in the of a tertiary hospital. and then throughout its Javits Convention Center, COVID-19 patients than As vaccines bring hope, footprint. The health system which ultimately treated any other health system Northwell works for equity in the country (by April provided further support to more than 1,000 COVID-19 2021, the number had state eff orts when Northwell patients. The health system’s Soon after the Pfi zer and grown to nearly 192,000). Labs began automating longtime commitment to Moderna vaccines received the processing of test The following pages provide samples, vastly increasing an in-depth look at some of throughput. By September, the most signifi cant ways Northwell Labs had invested Northwell supported New more than $30 million in Yorkers, the nation and the scientifi c community in 6 Northwell Health | 2020 Annual Report Caring—and leading—in a crisis Out in front emergency authorization to the COVID-19 vaccine for Northwell was quick to understand from the FDA, New York communities hardest hit the magnitude of the threat posed State tapped Northwell by the virus. In little more as a regional hub leader than a month, Northwell by COVID-19, and the speed of its for Long Island’s vaccine immunized nearly 8,000, rollout. Quickly the health with vaccine events in response saved lives. system partnered with faith-based settings and county agencies, other elsewhere. As 2021 brought Northwell was: health care providers, and signs that the pandemic community and faith-based was starting to recede, the organizations to coordinate health system continued community vaccination its eff orts to ensure that eff orts. The state turned the most vulnerable to Northwell’s Debbie and disadvantaged First in the New York metropolitan area Salas-Lopez, MD, senior vice were protected. to institute a mask mandate, directing president for community team members to wear a mask in and population health, to chair the New York State’s all hospital and ambulatory settings Long Island Regional Health regardless of potential for patient contact Equity Task Force to ensure safe and equitable access First in the country to design and manufacture 3D-printed nasal swabs, in collaboration with the University of South Florida and Formlabs, to help ease a severe shortage of swabbing kits needed for COVID-19 testing First in the country to publish a large- scale scientifi c report on patients hospitalized with COVID-19 First in the country to administer a vaccine against COVID-19 Northwell Health | 2020 Annual Report 7 Fighting the pandemic: Learning and leading Sharing lessons from the epicenter orthwell started element in being able to preparing for a pandemic respond eff ectively to N more than two decades the unexpected, is told in before the SARS- Leading Through a Pandemic, CoV-2 virus hit New York. by Northwell president and Spurred by a conversation CEO Michael J. Dowling and between executive vice Charles Kenney, the health president Kathleen Gallo system’s chief journalist. and FBI Special Agent John The fi rst book published on O’Neill, now recognized as the crisis by a health care one of the fi rst to raise the leader, it off ers a close-up alarm about a little-known view of an unimaginable fi gure in the Middle East experience, as COVID-19 named Osama Bin Laden, cases went from a trickle to leaders at the health system a stream to a tidal wave— adopted the stance that, and a play-by-play guide unpredictably but inevitably, to the thought processes “bad things will happen,” that kept Northwell from and began to take action. being swamped. All the Following a course highly elements are discussed: unusual for an American developing a daily dashboard health system, Northwell that allowed awareness developed one of the most of key metrics, leveraging advanced non-government integration and a sense emergency response of “systemness” to load- systems in the country. balance when necessary, That story of how Northwell and understanding the leaders eventually became necessary steps to protect “comfortable being staff physically and uncomfortable,” an essential emotionally. Broadening 8 Northwell Health | 2020 Annual Report The inside story On working together to carry the load: When the tsunami struck we were able to cope thanks to the scale and integration of our health system. Dr. Ira Nash, executive director of Northwell Physician Partners, put it this way: Scale is necessary, but it is hardly suffi cient. What I believe distinguished the Northwell eff ort is the utilization of scale, which was possible only because of our true integration… coupled with a sense of obligation to support all parts of the organization.