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Novant Health responds to leaked internal video of ‘frank discussion’ on Covid-19 messaging

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New Hanover Regional Medical Center, now owned by Novant Health.

On Friday, a video clip taken from an internal Novant Health meeting was leaked onto social media. The meeting features the former chief of medical staff suggesting making messaging “a little bit more scary for the public” by including the number of “post-Covid” patients still in the hospital — patients who aren’t currently included as part of Covid’s impact on the hospital. This was described as “manipulating data” as part of a “fear campaign” on Twitter and Facebook — a charge the health system denies.

It’s not clear how the excerpt of the video was initially leaked, or what the rest of the conversation included. The roughly two-minute segment (and some shorter iterations) circulating on social media features Director of Marketing Carolyn Fisher, former chief of medical staff Dr. Mary Rudyk, and Shelbourn Stevens, who was recently named president of New Hanover Regional Medical Center and the coastal market.

Audio version: Novant internal discussion on "post-Covid" patients and messaging.

In the video, Rudyk appears to suggest a way to increase the impact of the public data on Covid patients currently being released by the hospital.

“I guess my feeling at this point in time is maybe we need to be completely — a little bit more scary for the public," Rudyk says. "Then there's another comment [that] I completely agree, there are many people still hospitalized, that we're considering post-Covid. But we're not counting in those numbers. So how do we include those post-Covid people in the numbers of patients we have in the hospital?”

Rudyk adds that these patients are “still in the hospital, that are off the Covid floor, but are still occupying the hospital for a variety of reasons.”

In the video, Stevens notes that these patients who no longer test positive are listed as “recovered” on the hospital’s Covid dashboard — but adds that “we would still consider them a COVID patient because they're still healing.” Stevens suggests continuing the conversation “offline” and taking it to the hospital’s marketing department.

The clip ends with Rudyk saying to Fisher, “I’m just going to say, Carolyn, I think we have to be more poppy, we have to be more forceful, we have to say something coming out, ‘you know you don’t get vaccinated, you know you’re going to die.’ I mean, let’s just be really blunt to these people.”

Several posters on social media presented the clip as evidence of NHRMC using falsified or manipulated data as part of a fear campaign, and directed people to “Join NHCCC” — the New Hanover County Concerned Citizens group.

NHCCC is a self-described “volunteer led organization” that claims is it responding to "the direct influence and attack from Communist, Socialist, and Liberal Progressive agendas that are being implemented by our County Commissioners, Our City Councilors, and our County School Board.” The group, which appears to oppose mask mandates and vaccine requirements, has been promoted at several recent public meetings by Libby Dunn, a prospective Republican candidate in the 2022 county commissioner race.

Public health messaging and transparency

The strain of Covid-19 on hospitals has been central to public health messaging since early in the pandemic; the initial ‘flatten the curve’ campaign was directly tied to slowing the spread of the virus to prevent the kind of hospital overloads seen in Italy. 

Early on, NHRMC actually resisted releasing the number of Covid-19 patients, citing a very broad interpretation of HIPAA, along with other concerns. The policy was criticized both by some conservative leaders — who suspected the hospital might be concealing low numbers while overemphasizing the seriousness of Covid — and more liberal groups — who believed the Covid-19 numbers would bear out the seriousness of the pandemic. Media outlets also expressed frustrations over the lack of transparency, especially since NHRMC was, at the time, a publicly-owned hospital system.

Related: NHRMC hasn’t released Covid-19 hospitalization numbers, here’s why (Port City Daily)

Ultimately, NHRMC — along with health systems around the nation — began releasing general Covid stats; alongside the state, county, school district, and UNCW, NHRMC has maintained a Covid dashboard for much of the pandemic.

It’s worth noting that over the last month the hospital numbers have been as high as at any time during the pandemic, without adding the ‘recovered’ cases as Rubyk suggested. And, while Rubyk does seem to suggest that higher numbers might be ‘more scary’ she does not suggest artificially inflating them — by implication, Rubyk's point seems to be that while these recovered patients are testing negative for Covid, they are still occupying beds and thus still straining the hospital's occupancy capacity, supplies, nursing staff, and so on.

It’s also worth noting that as vaccination rates have slowed and the Delta variant has been surging, public health messaging has struck an increasingly dire note, particularly directed towards the unvaccinated. While NHRMC has still been very cautious around the release of information that could identify individual patients, Novant Health has released more detailed depersonalized data on how much of the hospitalized, ICU, and life-support caseloads are made up of unvaccinated people (89%, 94%, and 94%, respectively) across the health system.

State-level messaging, including from Department of Health and Humans Services Secretary Dr. Mandy Cohen, has struck a similar tone.

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More detailed data on levels of hospital care for Covid-19 patients, sorted by vaccinated and unvaccinated, has been used to drive home the seriousness of the disease's impact on the unvaccinated population.

Some experts have suggested that the increased threat posed by Delta — which is more transmissible and appears to make people sicker, including younger patients in their 30s and 40s — is starting to drive more vaccinations. It’s not clear if messaging about hospital capacity itself has been as effective.

Friday evening Novant Health issued the following statement:

“The team members involved in this excerpt of an internal meeting are seeing the highest level of COVID-19 hospitalizations and deaths so far in this pandemic - despite having safe and effective vaccines widely available. This was a frank discussion among medical and communications professionals on how we can more accurately convey the severity and seriousness of what’s happening inside of our hospitals and throughout our communities. Specifically, the data we have been sharing does not include patients who remain hospitalized for COVID-19 complications even though they are no longer COVID-19 positive, so it does not provide a complete picture of the total impact of COVID-19 on our patients and on our hospitals. We continue to be concerned with the amount of misinformation in our communities and consistently strive for more ways to be transparent and tell the whole story. The continued rise of hospitalizations makes it evident that we have more work to do to reach our communities with these messages.”