Quick Take:

Dominican Hospital’s Paul Angelo was instrumental in making vaccine care and outreach a top priority in Santa Cruz County. He helped organize the distribution of vaccines in South County first and has continued on from there.

As emergency disaster management coordinator at Dominican Hospital in Santa Cruz, Paul Angelo’s job is to be prepared to lead the hospital’s response as it cares for patients injured by natural or man-made disasters. Wildfires, floods, mudslides, earthquakes, tsunamis, mass shootings, jail riots, multi-vehicle pileups.

Then along came a pandemic.

As COVID-19 hit Santa Cruz County, showing itself to be intractable and persistent and with no definitive cure in sight, Angelo had to put on his forward-thinking cap and figure out what could be done to curtail it.

While others were battling the harsh realities of COVID in emergency rooms, Angelo looked ahead toward vaccination.

Anticipating that a vaccine might be produced far more quickly than expected, he knew Dominican needed to have the capability to store and administer it to thousands of residents with zero hesitation.

Early in the pandemic, Angelo took a crucial step that proved fortuitous: He not only ordered ventilators but also an ultra-low-temperature refrigerator. At 7 feet tall and 3 feet wide, it can store up to 80,000 vials of vaccine.

“You don’t want to be the last administrator to try to procure an essential medical item,” Angelo said, “especially when supplies are scarce and in demand.”

As the free supply of vaccines from the California Department of Public Health increased from 1,000 vials per shipment to 10,000, Angelo took another proactive step that some hospitals later emulated.

Instead of waiting for county residents to show up at the hospital to be vaccinated, Angelo initiated an outreach program.

Paul Angelo at Dominican Hospital.
Credit: Kevin Painchaud / Lookout Santa Cruz

You don’t want to be the last administrator to try to procure an essential medical item, especially when supplies are scarce and in demand.

Starting on Dec. 16, 2020, Dominican began transporting the vaccine on ice to county residents at Salud Para La Gente medical clinic in Watsonville, the Santa Cruz County Fairgrounds, and school gyms. Tents were set up in nearby agricultural fields to vaccinate farmworkers.

The outreach program has resulted in 106 one-day clinics and the vaccination of 500-1,000 people per clinic day. Timing is key: A vial of vaccine that has many dosages must be used within about six hours once opened. So far, the program has served more than 39,800 residents.

“A priority is to help South County residents who were hit hardest by the pandemic to easily get access to vaccines,” Angelo said.

The outreach program had a lesser-known success story: Angelo recruited an entirely volunteer staff of physicians, nurses, paramedics and pharmacists to prepare and to administer the vaccines — and it was as much for them as for those getting inoculated.

An agricultural worker gets vaccinated in Watsonville on Wednesday.
An agricultural worker gets vaccinated in Watsonville on Wednesday. Credit: Kevin Painchaud / Lookout Santa Cruz

“This turned out to be a therapeutic effort for the professionals involved,” Angelo said. “They didn’t just want to manage symptoms. Seeing patients suffer and die from COVID was overwhelming. Health care workers wanted to do something to prevent illness, to directly fight the disease. They want to make a difference.”

Kirsten Palmquist, emergency room nurse and clinical education coordinator at Dominican Hospital, said Angelo’s commitment to the community and his drive to safely and efficiently vaccinate as many as possible has been exemplary. “He is not only an excellent clinician,” said Palmquist, “but he understands the science that underpins the vaccine program and he addresses people’s fears and hesitancy to get vaccinated.”

‘Improving interpersonal relationships’

As of Tuesday, 227 Santa Cruz County residents have died of COVID. And even though this is a small percentage of the county’s nearly 22,000 total cases, every death is still a traumatic outcome for Angelo and his colleagues.

Angelo, 49, believes the key to Dominican’s comparatively successful response to the pandemic — despite periodic shortages of personal protective equipment such as masks, gloves, face shields and goggles, as well as an alarming number of exhausted nurses and physicians — has been a continual focus on employee respect and morale.

Paul Angelo at Dominican Hospital.
Paul Angelo at Dominican Hospital. Credit: Kevin Painchaud / Lookout Santa Cruz

It’s the constant emphasis on improving interpersonal relationships every day that pulls you through when disasters strike. You need to develop trust, and then staff will go the extra mile for one another.

“It’s the constant emphasis on improving interpersonal relationships every day that pulls you through when disasters strike,” he said. “You need to develop trust, and then staff will go the extra mile for one another.”

Angelo, who has worked 28 years in health care emergency medicine, is supported by the hospital president, who is an infectious disease physician; the chief medical officer; and the chief nursing officer. If necessary, the team can be expanded to include a logistics officer to assist with procurement, a public safety officer, and an external communications manager.

“We can increase the team indefinitely to respond to a disaster here and in a nearby community,” Angelo said.

When a big rig plowed into vehicles at the “Fish Hook” where Highway 17 and Highway 1 merge, Angelo and his team were ready to care for dozens of victims but ultimately received just five patients, far fewer than the 20 expected. Patients in critical condition were airlifted to nearby hospitals that specialize in treating traumatic injuries.

Yet if a patient is having a stroke or cardiac incident or a diabetic or allergic reaction, Dominican Hospital is a first choice for treatment. It also has a noted neonatal intensive care unit.

“Paul is calm, cool and deliberate during any incident,” said Brenda Brenner, director of emergency services for Santa Cruz County, who has worked with Angelo for more than eight years coordinating the county’s response to incidents such as the Gilroy Garlic Festival shooting, the CZU wildfire and the recent atmospheric rivers. “He understands the nuances of emergency preparedness and response, is a great collaborator, and a smart problem-solver. He is always available 24 hours a day.”

Still, Angelo, who describes himself as an extremely social and caring person, needs to remain a bit detached from the pain and suffering he witnesses.

“I am hugely empathetic but I am not sympathetic on the job,” he said. “And it’s better for health care providers not to take their grief home, because that could lead to post traumatic stress disorder and you lose the ability to be happy.”

Weightlifting, long walks in Fall Creek — a unit of Henry Cowell Redwoods State Park — and home improvement projects such as remodeling the laundry room help keep everything in synch for Angelo, along with assisting his wife of 14 years, Megan McNamara, care for 12 resident rescue cats and a rotating crew of foster kittens.

Together, they address the cats’ complex medical and socialization needs. “Thanks to Paul, the cats even have an entire wall-mounted jungle gym in the house and a cat-safe yard that features a fence that he built,” McNamara said.

Angelo credits two cousins who were nurses for his career choice, though there were few male nurses in the 1990s when he gravitated toward the profession. “They had a passion and enthusiasm for the job,” he said. “And they appreciated that their patients were responsive to their attention.”

Angelo is never far from his work physically or emotionally. “The hardest part of the job is that people are coming to you at the worst part of their lives,” he said. “It’s easy to become consumed about what is happening to them and their loved ones.”