The mass COVID-19 shutdowns seem now in the distant past. So much has happened since.
Vaccines, fierce debates on school mask mandates, the highly transmissible delta variant, the even more transmissible omicron strain.
For two years, COVID-19 kept people from work or school, upended social calendars and emptied multi-floor office buildings. It filled intensive care units in overwhelming swells, necessitated ventilators and put names on obituary pages.
Friday, March 11, marked two years since the World Health Organization named COVID-19 a global pandemic, and at last it seems OK, even for the most cautious of healthy people, to shop without masks, or take families to museums or pizza parties.
What did the state and country do right? In what ways could public health and health care leaders have done better? The debris is still falling. For some, the trauma is raw, and it will take time, one expert said, to assess the response.
Here is what three doctors said they have learned so far:
The United States cannot rely on foreign countries to import personal protection equipment.
In the beginning, hospitals did not have sufficient masks, gowns or other items, doctors said.
A lot of the supply of respirator masks was coming from China, where SARS-CoV-2 was first discovered, and there were only a few businesses or sites in the United States that were making such items.
“I think this understanding we need to control our own supply chain for protective equipment. That certainly has changed,” said Dr. Russell Lampen, infectious disease specialist for Spectrum Health, based in Grand Rapids.
Public health messaging will be different next time.
Communication has been a “huge challenge,” said Dr. Courtland Keteyian, vice president for population health and a preventative medicine specialist for Henry Ford Allegiance Health in Jackson and president and CEO of the Jackson Health Network.
To those in medicine, the resistance to science was surprising, he said. They thought people would see the data or evidence and accept that as truth, as they do.
Scientists and public health experts need to be able to improve the way they communicate with the public, he said, “so there is more trust in the information.”
Misinformation gets in the way of eliminating the disease, Keteyian said.
“I think this pandemic went on so much longer than it needed to because we just weren’t doing the things that were demonstrated to work, and a lot of that was political.”
It’s about building relationships, about leading and guiding the community, local government and large employers so everyone is connected.
“You need to trust each other so that when you do face a crisis, you’re in a good position to do that.”
Collaboration can bring about rapid industry change.
One example: the rise of telemedicine, the delivery of health care at a distance, through technology. “There is no way that telemedicine would be as widely available today as it is if not for COVID,” said Dr. Nick Gilpin, who has led Southfield-based Beaumont Health’s infectious disease efforts from the start of the pandemic.
“It really jumpstarted that whole process.”
Health care systems had to reimagine how they deliver care. “People aren’t going to always be coming to us for their care. We need to come to them when they need it,” Keteyian said.
The system was stressed so people had to work together, said Lampen, who had never before dealt with, for example, those who handled the supply chain.
Organizations and communities quickly deployed “huge set pieces,” such as vaccine clinics and testing sites, Gilpin said. “Those were big infrastructure things. And those were examples of huge structural changes that ordinarily would take a lot of time and a lot of teeth-gnashing for us to be able to do... We were able to move those mountains really fast.”
Nothing prevents more suffering and death than vaccines.
Vaccines have eradicated diseases that plagued humanity for thousands of years, Keteyian said, noting the modern absence of measles and polio. “So, I think we learned that’s really clear in the data… It’s so unequivocal that the vaccines are effective.”
The COVID-19 shots saved countless people’s lives, he said.
From January 2021 to February, about 83% of people hospitalized with COVID-19 and about 80% of those who died of COVID in Michigan were not fully vaccinated, according to the latest data.
Public health measures work, even if they are controversial.
Masks are an “amazing tool,” Keteyian said. They help prevent the spread of disease.
In February, the U.S. Centers for Disease Control and Prevention released results of a study that found people who reported always wearing a mask in indoor public settings were less likely to test positive for COVID-19 than people who did not.
A respirator lowered their odds by 83%. A surgical mask lowered the odds by 66%, according to the study, which assessed 652 California residents who had received a positive test and 1,176 residents who received a negative test result from February 2021 to December, before the highly transmissible omicron variant came to be predominant. It was during the omicron surge that public health officials advocated strongly for more protective masks.
Masks may become commonplace in medical services and transportation, but probably not elsewhere.
Just like wearing gloves has become normal for dentists, mask-wearing will likely continue in health care settings, doctors said.
In crowded spaces, it also makes sense to continue to wear facial coverings, Lampen said. He would not be surprised if people elect to continue masking on buses, subways and airplanes.
“But I think we are going to see, pretty rapidly, an elimination of masks in public spaces. I think there are just too many people (who) like to take them off.”
Gilpin said at Beaumont, masks were expected to soon be optional in non-clinical areas, such as administrative buildings. However, if community transmission levels rise, this might change.
“And I think that’s kind of what the world is going to look like for a little while, is doing this kind of back and forth dance between masking and no masking.”
As history demonstrates, people will not stay away from central gathering places.
“For pandemics going back millennia. People have always returned to the theater. People have always returned to the Coliseum, to the stadium. We always need to come back. We always need to be with people. And that’s happened throughout history,” Lampen said.
Maybe someday, authorities will look back and realize maybe the shutdowns were not all necessary.
“We were dealing in scenarios. I think it’s important to give people a bunch of grace. We were dealing with scenarios where we didn’t have therapeutics. We didn’t have appropriate testing. We were working with so many blind spots, and so many limitations that you were doing your best.”
Lampen in the years since, like many, has been at times frustrated by some people’s behaviors and the unwillingness of some to think about those around them.
“But I’ve also been really impressed and inspired by people’s courage, by scientific discovery, by people’s willingness to think about people. So, it’s certainly have been both sides of the coin...”
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