Osler Alum Leads Johns Hopkins COVID-19 Response

Lisa Maragakis (Osler, 2001) has spent most of her career taking a lead role in ensuring the safety of patients, families and employees against high-risk contagions, such as COVID-19. “We were always preparing for something like this,” says Johns Hopkins Health System’s senior director of infection prevention. “We knew that a new strain of influenza could bring trouble. The threat of a pandemic with a novel respiratory virus was well known, so a lot of thought had been put in place in parts of our organization about how we could safely and effectively care for patients under these circumstances.”

Maragakis serves as an incident commander for the COVID-19 response at Johns Hopkins Medicine’s Unified Incident Command Center — alongside emergency management leaders Rob Carter and Gabe Kelen. Together, they are actively engaged in addressing issues regarding the pandemic. Maragakis also serves as an adviser on Gov. Larry Hogan’s Maryland COVID-19 response team, and is called upon often nationally to provide updates and offer her expertise about the pandemic.

She and her colleagues have been vigilant about tracking infections from around the world. “We were watching this virus in December of 2019. In January of 2020, our infection prevention teams worked with colleagues in emergency management and across the organization intensely, trying to put plans in place and to acquire reusable respirators and personal protective equipment.”

Maragakis’ fears about rapid spread proved warranted. By mid-April, according to Gov. Hogan’s office, at least 13,684 patients in Maryland had been afflicted with COVID-19; some 582 Marylanders had died. As cases surged, the enormity of the crisis exceeded any other infection control response Johns Hopkins has encountered in recent history, says Maragakis. “It felt surreal,” she says. “It was a ton of work for everyone, especially because it occurred during the flu season and touched every aspect of Johns Hopkins and the surrounding community.”

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Maragakis also oversees, along with pulmonologist Brian Garibaldi (Osler, 2007), the Johns Hopkins Hospital biocontainment unit (BCU) for patients with Ebola or other high-level pathogens (one of only 10 such units in the U.S.). She and the infection prevention team worked closely with facilities staff and engineers around-the-clock to provide guidance as they converted many hospital units into special respiratory isolation COVID-19 units at The Johns Hopkins Hospital and throughout the health system. The BCU was the first unit to admit patients with COVID-19, and the BCU team, along with the infection prevention team, served as an expert resource for others across the institution as more units were converted to “biomode” to care for patients with COVID-19. At the height of the pandemic, approximately 300 patients with COVID-19 were cared for in the health system’s COVID-19 units, and almost a third were on ventilators. (On November 4, 2020, approximately 8,300 patients with COVID-19 had been admitted to Johns Hopkins Medicine hospitals.)

During that time, says Maragakis, “We seized the opportunity to act as one organization, sharing expertise and providing a unified approach to infection prevention and care. That helped when patients started being admitted to each of the JHM hospitals; we were able to leverage facilities expertise, infection prevention, clinical teams and emergency management structure to handle the crisis across all the entities.” The other Maryland, Washington, D.C., and Florida hospitals — Suburban Hospital, Sibley Memorial Hospital, Howard County General Hospital, Johns Hopkins Bayview Medical Center and Johns Hopkins All Children’s Hospital — added more than 200 COVID-19 rooms among them. Maragakis and her team were consulted often during the process.

Through it all, Maragakis credits her Osler training for much of what she’s been able to accomplish. “I would put aequanimitas at the top of the list of vital skills or qualities. There’s nothing more important than staying calm and composed, so you can take stock of how to alleviate and address a situation.” The Department of Medicine, she adds, has shouldered the vast majority of the burden of caring for patients with COVID-19. “I’m incredibly proud of our department and all of my colleagues in the Department of Medicine, especially the Osler interns and residents. And, being an Osler alum, I recognize and appreciate my colleagues’ dedication, work ethic and outstanding efforts to meet these challenging times.”