A Year of Loss or a Lost Year: Lessons Learned During the Pandemic

On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. At the time, many people had watched the news or seen reports on social media of the virus ravaging China and Italy. It then quickly made its way to the U.S. As March came in like a lion, the virus was unrelenting with three distinct waves, refusing to leave like a lamb even twelve months later.

During the past year, Americans have seen more than 525,000 friends, colleagues, and family members die. Millions have been infected, with some continuing to have long-term symptoms and neurologic effects. Countless people have lost their jobs, thousands of businesses have shut down, and a deluge of misinformation overwhelms an already vulnerable population. Some believe this was a year of loss, others a lost year. Perhaps it was a little of both. In that time, we’ve also learned lessons.

Today, viral cases and deaths are declining, although caution remains because we have seen the virus wane before. Could this just be the sea receding before the fourth wave? Fortunately, we know so much more than we did last year at this time. We have more tools to take on the virus – from adequate PPE and masks for the public to guidelines for social distancing and now, three vaccines. As I think back on where we have been and where we may go, I am left with five key takeaways:

1.   The COVID-19 vaccines are a medical miracle. As the virus expanded across the globe, scientists wondered, “How fast can we produce a vaccine?” Until COVID-19, every existing vaccine had taken years to produce. Delivering one in months was an almost inconceivable prospect. To do so would be an unprecedented scientific breakthrough. To the surprise of the world, the COVID-19 virus’ genetic code was cracked in early 2020, and in less than one year, two successful mRNA vaccines (which had never been used before in humans) were created, tested, found safe, and distributed. By January 2021, a third more traditional yet highly effective vaccine was developed. Today, all three vaccines show historically high levels of efficacy and have been proven to prevent hospitalization and death. While the vaccine rollout was initially slow and chaotic,  today, vaccination rates are improving dramatically with the expectation that we may reach herd immunity by the end of spring.

2.   Public health and hygiene measures work. For centuries, societies have recognized that when it comes to disease control, we must have a coordinated plan with a consistent message. And the message from this pandemic is clear—masking works. Washing your hands works. Social distancing, maintaining isolation when exposed, and quarantining when infected, works. One only needs to look at the influenza cases and deaths from prior seasons. The flu, which is transmitted much like COVID-19, is virtually non-existent this year with lower-than-average transmission and positive rates. Why? It’s simple. People have been masking, socially distancing, washing their hands and have avoided the workplace and travel. There is also a flu vaccine with reasonable efficacy rates. The low flu cases also demonstrate the power of a vaccine paired with hygiene measures. While we will likely deal with COVID-19 for years to come, leveraging vaccines and public health tools can significantly limit the threat of disease.

3.   We must prevent and combat misinformation. After scientists discovered that bacteria and viruses caused infections and disease, healthcare workers recognized the importance of personal hygiene and infection barrier devices (PPE). As a result, clinicians are wearing gloves, gowns, and masks to prevent disease transmission. Yet, somehow, the emergence of COVID-19 made mask wearing controversial for the general public. Would we accept a physician walking into an operating room and declare, “I will not wear a mask because I don’t believe in bacteria or viruses.”? Pervasive misinformation diluted the message about the importance of masks and the severity of the virus while thousands died. As we look to the future, we must determine how to combat the virus of misinformation. It is deadly and undermines the work our public health officials and healthcare workers do to protect us as individuals and as a society.

 4.   Home has become the center of all activity. As office buildings and schools locked their doors and gyms and restaurants restricted patrons, the home became the hub of all workplace, schooling, sporting, and social activities. Garages became gyms. Kitchen tables became virtual kindergartens. Living rooms became virtual boardrooms. Business trips and vacations ceased. The lines blurred between home life and work life. Many of us are left with the question – is this the new normal? Have families determined ways to reduce their commuting expenses? Will we trade in commuting time for time spent with friends and family? Have we learned new ways to connect, socialize and interact while saving time and money? Perhaps. As social beings, humans need connections. The number of in-person interactions or home-based activities versus virtual interactions or away-from-home activities will be challenged over the coming months as we emerge from the pandemic. Some will find the convenience of sweatpants on Zoom meetings is just too hard to trade in for tight-fitting slacks.

 5.   We have significant inequities in healthcare. We often hear, “We are all in this together!” However, the reality is we are not. The pandemic and vaccine rollout have clearly demonstrated this. Black and Brown communities have suffered far worse than White communities with higher disease burdens and more deaths. The cause is not genetic. It is due to factors that affect one’s health, like food scarcity, housing insecurity, medical access, and a host of other social determinants of health. However, recognizing why these determinants and drivers of inequity exist forces us to acknowledge the truth that racist policies of the past and present have caused, reinforced, and perpetuated these inequities. We have a moral imperative to fix the structural and systemic causes of health inequities and disparities. While morality should be reason enough, there are also societal reasons to address these issues. COVID-19 has taught us that isolationism does not work on an international scale, nor does it work in our communities when preventing or containing a disease. We must equitably address health as a public because healthcare inequities in one group affect the health of us all. COVID-19 continues to remind us of this fact.

Twelve months later, many of us in healthcare and on the front lines believe we deserve a blue ribbon, but not because we have battled this virus, saved lives, or confronted misinformation. There is a sense that we all deserve the blue ribbon because we survived. We have emerged with a greater understanding of a pandemic, our societal ills and, yes, our own resilience. The pandemic is far from over and has forced us to think differently, but there are glimmers of light at the end of this long tunnel. With effective vaccines and a focus on improving the health of everyone versus a privileged few, the future is bright.