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'Vaccination is Key' Strategy Against Potential Twindemic

Analysis  |  By Melanie Blackman  
   November 04, 2021

Indu Lew, PharmD, executive vice president and chief pharmacy officer at RWJBarnabas Health offers insights on what this year's flu season may look like, how the COVID-19 pandemic has affected the pharmaceutical landscape, and offers leadership advice.

Editor's note: This conversation is a transcript from an episode of the HealthLeaders Women in Healthcare Leadership Podcast. Audio of the full interview can be found here.

Indu Lew, PharmD, serves as executive vice president and chief pharmacy officer at RWJBarnabas Health, where she manages the health system's pharmaceutical supply chain and provides strategic leadership over the health system's 25 pharmacy divisions, spanning acute care and integrated services.

She's a pharmacist by background and has experience working in the pharmaceutical industry and direct patient care. Lew began her career journey as a pharmacy technician at the New Jersey-based health system, left to work in the industry, and came back to the health system to serve as a clinical pharmacist at Newark Beth Israel Medical Center. She's also served as a biotechnology fellow and was promoted to director vice president, senior vice president, and most recently, as executive vice president.

In the newest Women in Healthcare Leadership podcast episode, Lew offers insights on a potential COVID-19 and flu"twindemic" we may face this fall, how the coronavirus pandemic has affected the pharmaceutical landscape, as well as shares her leadership style, and advice for future leaders.

This transcript has been edited for clarity and brevity.

HealthLeaders: What has been your experience leading as chief pharmacy officer during the COVID-19 pandemic? How has the pandemic affected the overall pharmaceutical landscape and the 25 pharmacy divisions that you oversee?

Indu Lew: One of the things that came to light is how integral pharmacy is in dealing with other divisions. The other thing we've seen is the resiliency of the pharmacy enterprise team with the other divisions. It was a difficult 2020. But the entire pharmacy enterprise came together with the sole purpose of ensuring that we were able to treat our patients appropriately.

What we found is that we needed to shift our way of thinking on how we manage supplies. We found ourselves at some critical medication shortages, and what we needed to do going further is we needed to ensure that we had the adequate supplies on hand. We do that now through a centralized warehouse.

HL: Recently The National Foundation for Infectious Diseases released data showing that 44% of adults in the U.S. are either unsure, or do not plan to get the flu vaccine for the 2021-2022 flu season, leading to a possible COVID-19 and flu "twindemic" later on this year. What factors could potentially lead us to this twindemic?

Lew: In 2020, the number of people being infected with flu were historically low. It was probably due to having good infectious disease practices. Because of the pandemic, we were masking better, we were social distancing, and we had good hand hygiene. When people were sick, we made sure that they stayed home. But what happens when we have low cases of flu, in general, is the people within the country have less natural immunity.

We know people are getting vaccinated with the COVID vaccine. But people are tired, they have pandemic fatigue. Hopefully what we won't see, is that people will mask less, social distance less.

Every year, the World Health Organization determines which virus will be included in the flu vaccine, and they essentially base it on a couple factors. They look at the viruses that have been circulating in the past two to three years, and they look at what's been circulating in the southern hemisphere in the current flu season. Public health officials don't have much to go on, because there hasn't been much flu circulating globally. Because they don't have much to go on, they're hoping that they're able to manage the flu better with the vaccine.

We're also still battling with the Delta variant of coronavius. We know the Delta variant is more contagious and more transmissible than the earlier virus strain. We know unvaccinated people are at greater risk. We've seen it within our hospitals. For people who are hospitalized due to COVID, a majority of them were unvaccinated.

We need to protect hospitalizations. We need to ensure that people are vaccinated. If they're vaccinated, it will decrease the potential strain that the healthcare system will see and will prevent this "twindemic" that could potentially happen. Vaccination is the key.

HL: In addition to ensuring vaccinations, what other steps can hospitals and health systems take to help curb COVID cases and flu cases during this upcoming flu season?

Lew: In conjunction with vaccinations, we have to ensure that people get tested because it'll guide you on the right path. If you do have COVID and you haven't been vaccinated, one of the key pieces that we found is you need to get to a site where they can give you a monoclonal antibody. Within our own health system, we've seen that we were able to avoid hospitalizations in 96% of the cases if they were treated with a monoclonal antibody.

The same thing goes for flu. If you have the flu, and you're tested early, then there are options for treatment that will shorten the intensity and the course.

HL: How would you describe your leadership style?

Lew: The most important piece of my leadership style is establishing a foundation of trust. If you, as a leader, establish a foundation of trust, people will come to you with new ideas and different ideas, and they won't be afraid.

If you establish that trust foundation, you then decrease the power distance. I trust the team, that they will come to me with innovative entrepreneurial types of ideas, and they trust that I will be able to clearly communicate what the strategic imperatives are. When you have that environment of trust, you're able to motivate them, you're able to inspire them, they won't be afraid of failing, and they won't be afraid to take a risk.

Within pharmacy, pharmacists are considered the most trusted profession. People place their care management in your hands as a pharmacist. So inherently, we go into the profession because we want to help people. We want to be a part of a team. We want to ensure that we are taking care of people.

HL: As a member of the Women's Leadership Alliance at RWJBarnabas Health, why do you think it is important for women to be leaders and to lift each other up?

Lew: It's so important that we grow women in healthcare leadership roles. We know that women make up a large majority of the healthcare workforce, right. We also know that women make up a large percentage of the purchase and usage decisions in healthcare. But we don't see a lot of women in healthcare leadership roles.

Women in healthcare leadership roles brings diversity to the playing field. Diversity enhances the overall functioning of the leadership team. Diversity brings better outcomes, more innovation, more creative solutions, and it allows to have different perspectives based on their experiences. But diversity needs to be purposeful.

RWJBarnabas Health recognizes the importance of diversity and having women at the table. Recently, the organization promoted six women of various backgrounds to the role of executive vice president, and with that promotion, they are now also included in the CEO's strategic counsel, and they're also included as members of the board.

HL: What advice do you have for women and others who want to serve in leadership roles in the healthcare sector?

Lew: Do not be afraid to take a calculated risk. We cannot be afraid to step into a realm that we may not have experiences in. We have to be able to take that risk.

It is critical to develop connections and influences, both internally and externally. We need to look to see at the senior leadership level, who we'd be able to either take on as a mentee or who can we make those connections with to be a mentor.

It's critical to bring your own unique perceptions, your unique perspective to the conversation, and help shape that strategy.

The other thing is that if the pandemic has taught us anything, it's important to be lifelong learners. During the pandemic, we saw things changing so quickly. Decisions that were made in the morning, would change in the afternoon, because new information was flooding in. Unless you're a lifelong learner, it's difficult to be dynamic, it's difficult to be fluid.

The last important piece is that for any leader to motivate and inspire, to make decisive decisions, you have to listen. You have to listen to the members of your team. They will bring you new ideas, new innovations, as long as they trust that the environment that they're in is a safe environment.

“"We need to protect hospitalizations. We need to ensure that people are vaccinated. If they're vaccinated, it will decrease the potential strain that the healthcare system will see and will prevent this "twindemic" that could potentially happen. Vaccination is the key."”

Melanie Blackman is a contributing editor for strategy, marketing, and human resources at HealthLeaders, an HCPro brand.

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