Dr. David Rottinghaus had the unenviable task of serving as chief medical officer at Butler Health System during the first pandemic of the digital age. Five years later, his memories of the time remain vivid.

“It was an absolute grind, stretched out over a couple of years,” said Rottinghaus, who is now president of the physician network at Independence Health, formed from the merger of Butler and Excela Health in 2023. “The first couple years of the pandemic saw a lot of illness, death, suffering.

“There were days when staff lost many patients on their shift.”

When the dust settled, Butler County saw 55,929 positive cases of COVID-19, according to the Pennsylvania Department of Health, as of June 2023 — when the state stopped collecting data on the virus. Of those cases, 854 people died, making for a fatality rate of 1.53%.

Tuesday, March 11, marked a grim anniversary for the world — the fifth anniversary of the day the World Health Organization officially declared the fast-spreading COVID-19 to be a pandemic.

Before the end of that week, then-Gov. Tom Wolf shut down schools from kindergarten through grade 12 in anticipation of reopening the buildings before the end of the month.

Early the next week, Wolf announced an order that demanded all nonessential businesses across the state shutter their doors.

The closures, initially believed to be short-term, and their impact turned out more substantial than many first anticipated. The day Wolf announced the nonessential business shutdown, experts told the Eagle the financial woes wouldn’t last long.

Then, on March 23, 2020, Butler Memorial Hospital announced it had its very first case of COVID-19. At that time, the state health department was reporting 644 confirmed cases across Pennsylvania.

As the month ended, schools didn’t reopen; neither did nonessential businesses.

Instead, on March 25, 2020, Butler County recorded its first COVID-19 related death.

The full force of the pandemic’s impact hit Butler County.

Even before that climactic, society-changing month in 2020, the hospital systems which served Butler County were aware that the virus — then popularly called the “novel coronavirus” — could become a major problem and acted accordingly, system representatives told the Eagle in recent interviews.

When it made its debut, the health care professionals were ready and worked together to treat those who contracted COVID-19.

“All of the health care providers in our area, within a week of COVID being a factor, all got together and unified our efforts and shared information about our capabilities and everything we could do to share with each other, to really maximize our ability to care for the region in a very collaborative way,” said Dr. Don Whiting, chief medical officer at Allegheny Health Network. “It led to the sharing of resources and really helping the community as a group.”

A UPMC spokesperson said hospitals across the region were reaching out for best practices for caring for patients and preventing people who were immunocompromised from contracting the disease.

As the virus asserted its presence, hospital systems in the county shifted their attention to both containing and treating the virus, prioritizing COVID-19 patients to the point where nonessential surgeries were stopped.

At Butler Memorial Hospital, the month the pandemic became official, access to all but one entrance was closed off — except for emergency cases.

“We were at a point in the country where over 2,000 people a day were dying from COVID-19, so we were doing everything to try and mitigate the spread of the disease,” Rottinghaus said.

“In the health care world, it was all hands on deck,” Whiting said. “We needed everybody there who was able to care for patients.”

In the community, many sewed their own cloth masks before plastic shields and disposable masks were available everywhere.

Nonessential employees stayed home from work; essential employees had their temperature taken at the door after driving to work on near-bare roads; restaurants pivoted to takeout options; and schools got creative with online lesson plans.

Despite the community’s best efforts, the virus proved its superiority over mankind in the days before vaccines became available. On March 25, 2020, Butler Memorial Hospital reported its first COVID-19 death.

By December 2020, the hospital reached maximum ICU capacity and was forced to activate its “surge plan.” At one point in 2020, an anesthesia unit was converted into a COVID-19 care unit.

In terms of average rate of positive cases, Butler County ranked 29th out of Pennsylvania’s 67 counties, with a rate of 29,773 positive cases per 100,000 residents.

But while positive cases and deaths could be reduced into numbers, the pandemic’s impact on politics, business and — of course — medicine cannot.

For many of those working in the medical field, the stress of the COVID-19 pandemic was simply too much to overcome, and many health care providers hung up their scrubs for good, although the hospitals did their best to ease the mental health burden.

For example, Whiting said that AHN boasts a robust wellness program for all staff members.

“There was an exodus of experienced clinicians from every field, who decided to leave either during or right after due to the stress of the pandemic,” said Dr. Michael Fiorina, chief medical officer for Independence Health System. “This is one of the most long-lasting nonmedical effects of COVID-19.”

“We made efforts to provide resources to our staff, support their mental health through our leadership teams and employee assistance team, and ease some of the very high demands of bedside patient care,” Rottinghaus said.

According to Rottinghaus, the positions that are most in-demand as of 2025 are nurses, lab technicians, Certified Registered Nurse Anesthetists and certain physician specialties.

Further, all three hospital systems are still feeling the financial impacts of the COVID-19 pandemic to this day. Along with the staffing woes, inflation and stagnant insurance reimbursements have combined to saddle providers with millions of dollars in losses.

Butler Health System — which still files a separate financial report from its merger partner, Excela Health — sustained an operating loss of $23.24 million in the 2024 fiscal year, while AHN lost $147 million and UPMC lost $339 million over the same period. At the start of 2023, the former Butler Health System merged with the Westmoreland County-based Excela Health to form the Independence Health System.

Even as the pandemic subsided, those who were left in the medical profession could see its long-term effects play out in the region’s hospital beds — even for those who never caught COVID-19 at all.

“There was a bit of a period where people didn’t really seek health care as frequently as they did before,” Whiting said. “And then what happened was, we started seeing people have conditions that they’d not been really paying attention to. Conditions had gotten worse because they hadn’t been maintained.”

Despite all of the losses — losses of life, manpower and money — both Independence and AHN say they are ready in case of a resurgence of COVID-19 or another pandemic-level spread. UPMC only provided a statement that did not address this.

The two, along with other hospital systems in Western Pennsylvania, still meet monthly to share resources, according to Whiting.

“I think the single best thing we’ve done in the region to be prepared for another catastrophic medical event is to have developed that working relationship, so that now you get the benefit of all of the systems in the region working together for the community,” Whiting said.

“We certainly learned a lot of valuable lessons from the COVID-19 pandemic. I think that our greatest lessons were in that we needed to be nimble to respond to the new incoming information and demands that were presented to us,” Fiorina said. “We learned so much from the pandemic and have many policies in place to address another pandemic illness.”