The early days of the pandemic were full of uncertainty. How serious is the coronavirus? How virulent is it? How can people stay safe? But amid all the questions, one thing was certain: it was no longer safe to pack people elbow-to-elbow into a conference room.

In March, 2020, Johns Hopkins Medicine leaders held impromptu emergency planning sessions in the wide hallways of the Miller Research Building. Clarence Lam, interim executive director of the Department of Health, Safety, and Environment (HSE), recalls a scene near the building’s Monument Street entrance, shortly after the Johns Hopkins Hospital and medical campus were locked down to prevent the spread of the coronavirus that causes COVID-19.

“We were all standing up, far apart, talking really loudly through facemasks,” says Lam. “No one knew much yet about how the coronavirus spread. It was a little bit chaotic and kind of surreal.”

Lam’s journey was only beginning. Over the next year and a half, he, like many other Johns Hopkins employees, would work long hours fighting the coronavirus. But Lam also serves as a senator in the Maryland General Assembly. His work with HSE, which includes oversight of Occupational Health Services for the Johns Hopkins Health System, would inform some of the important pandemic-related legislation and policy enacted in 2020 and 2021 to keep Marylanders safe.

With a primary appointment as director of the preventive medicine residency program in the Johns Hopkins University Bloomberg School of Public Health, Lam was recruited to provide interim leadership to Health, Safety, and Environment beginning in August, 2019.

“Landon King asked me if I’d hold down this position while a committee searched for a new director,” Lam says of the executive vice dean for the Johns Hopkins University School of Medicine. “At first, it was only a few extra hours a week. Then the pandemic hit.”

Lam, whose duties also include seeing patients on the campus of Johns Hopkins University Applied Physics Laboratory, was elected to serve in Maryland’s House of Delegates in 2014, representing the state’s 12^th legislative district, which covers parts of Howard and Baltimore counties. Since 2018, Lam has served that same district in the Maryland State Senate. The chamber’s only physician, Lam is a member of the Senate’s Education, Health and Environmental Affairs Committee. Since the pandemic, he has also served on two critical General Assembly work groups: the Joint COVID-19 Response Legislative Work Group and the Senate Vaccine Oversight Work Group.

“It’s possible to do all those jobs at the same time. But I don’t recommend it,” Lam says with a laugh.

King says that Lam agreed to take on the additional role without hesitation.

“Clarence provided critical leadership and organizational skills in circumstances no one could imagine, much less prepare for,” says King. “The whole occupational health team has played a critical role throughout this time, managing numerous issues directly related to the surge of COVID 19 activity, but also maintaining support of our Hopkins community through the full set of normal services that occupational health provides. The team has performed heroically and Clarence has played a key role in our navigation of this crisis.”

Most Johns Hopkins staffers encounter Occupational Health Services during pre-employment health screenings. But the 40-member OHS team in East Baltimore is also responsible for a long list of safety precautions aimed at preventing employees from getting injured or sick. They are charged with treating all work-related injuries and illnesses on the East Baltimore hospital campus, as well as on the Johns Hopkins University Homewood Campus. They also administer the annual flu vaccinations.

In the early months of the pandemic, with no vaccine yet in sight, Lam says the OHS team, like so many other people at Johns Hopkins, operated under extraordinary pressure. In addition to designing and enacting safety protocols, they were responsible for the employee COVID-19 testing program and, when it became available, the administration of the COVID-19 vaccine to the thousands of Johns Hopkins faculty and staff members, as well as students.

“I don’t think any of us was prepared for the extraordinary level of complexity the pandemic presented,” says Lam. “The OHS team had to address the institution’s needs at a time of high anxiety. Our decisions had implications not just for the person in front of us, but for their co-workers, their families and their co-workers’ families.”

Occupational Health Services quickly set up a call center in the Armstrong Medical Education Building for employees who feared they may have been exposed to the coronavirus.

“That was the first weekend after lots of staff started working from home,” says Lam. “We were at the call center all day Saturday and Sunday, just figuring out where people should sit and how the tables should be set up.”

Helping Keep the State House Safe

The outbreak struck during Maryland’s annual 3-month legislative session. Lam, like all elected officials, swore an oath to “diligently and faithfully … execute the office of senator.” No matter how busy his day job, Lam’s commitment to his constituents and the rest of the state could not be put off.

He says he had a late-afternoon meeting with new Senate President Bill Ferguson only a few hours before the state health department announced Maryland’s first case of COVID-19. Ferguson had gotten an early briefing on the situation and asked for Lam’s advice.

“Naturally, the original meeting agenda went right out the window,” recalls Lam. “We scrapped whatever it was we were supposed to discuss and we talked about how to keep the Senate safe.”

During that 2020 legislative session, Lam provided ad hoc safety advice to Ferguson for the remainder of the General Assembly’s time in Annapolis. He also sponsored legislation to expand unemployment assistance during the pandemic, protect the state’s workers from being fired because they were ordered to quarantine, and mandate that all COVID-19 tests be provided free to Marylanders.

“We were able to get that legislation through both the Senate and the House in about 10 days,” says Lam. “That’s a lot faster than usual.”

Lam says his roles overseeing a residency program and occupational health, along with his Senate duties, were all-consuming. He says it helped that professionals in the health care field are used to working long hours.

“I knew I could do a lot of my Hopkins work in the early morning and evening hours,” says Lam. “In the health care world, we’re used to jamming meetings in wherever they fit. We’ll have 7:00 am meetings and 7:00 pm meetings. Those are definitely not legislator hours.”

“We Made It Through”

When Maryland’s General Assembly convened again in January, 2021, the coronavirus was infecting thousands and killing dozens of Marylanders every day.

“By then, we knew a lot more about not just how communicable the disease is, but also how dangerous it is,” says Lam. “I was concerned that, even with all the precautions we had in place in Annapolis, that somebody — a senator, a delegate, a staff member — would come down with COVID-19.”

Remarkably, none did. The usual after-hours bustle of receptions and networking in Annapolis during the months of the legislative session gave way to online meetings and other safer methods of gathering.

The House and Senate chambers were outfitted with plexiglass barriers to separate the lawmakers from one another. Committee meetings were held virtually and the majority of staff members did their jobs from their homes. Still, the session was not without its risks, says Lam.

“If you’d asked me at the beginning of that session, I’d have said it was far more likely than not that someone would get COVID-19,” he says. “But the protections worked. Everyone was cautious. We were all in it together and we made it through.”

But across the country, the pandemic had infected nearly 24 million Americans by the first days of 2021, resulting in more than 411,000 deaths. Despite the tragedy, there was hope: news that a vaccine had been developed, approved and fast-tracked for use in humans.

Occupational Health Services worked closely with the Johns Hopkins Medicine Supply Chain, Health IT, Ambulatory Services and the Department of Pharmacy to assemble vaccination protocols and a program to quickly vaccinate as many Johns Hopkins Medicine employees as possible.

Lam was present when the first Johns Hopkins employee received her first dose of vaccine on Dec. 16.

“It was just amazing to be able to get our frontline staff vaccinated,” he says. “They were seeing patients day in and day out on our COVID units, risking their own health. The sense of relief we saw on their faces when they got the vaccine was a great, great feeling.”

As more people are vaccinated and restrictions loosen, Lam says that Occupational Health Services continues its work to keep employees safe, not just from COVID-19.

“Before too long, we’ll be preparing for this year’s flu season,” he says. “And after that, we may have to prepare for a COVID-19 booster program.”

Lam says the knowledge and experience he has gained as part of Johns Hopkins’ vaccine team served him well when Maryland began designing its vaccination program.

“We were able to apply what we learned at Hopkins to the state,” he says. “All the details about handling the vaccines and how long it could last outside the freezer, all the issues around work flow and documentation — it was really helpful to have just been through all that at Johns Hopkins. There aren’t a lot of people who can actually say they’ve set up a vaccine clinic.”