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Now At Over 100,000 COVID Deaths, What Have We Learned?

Posted By Willie Oglesby, Thomas Jefferson University, Wednesday, June 17, 2020
Updated: Wednesday, June 17, 2020

It’s easy to forget that it was only a few months ago when the world first heard about an unusual pneumonia affecting a few dozen people in Wuhan, China.  Since that announcement by the World Health Organization in January, what eventually became known as the 2019 novel coronavirus disease (COVID-19) spread throughout the region, Europe, and the rest of the world at nearly unprecedented levels. 

Today, there are more than more than 5.5 million confirmed cases and 350,000 deaths attributed to COVID-19 worldwide.  Due to reporting discrepancies across countries (including in the US), uneven and inadequate testing, and other factors, many experts believe the actual numbers of COVID-19 cases and deaths are likely much, much higher. 

Recently, the US recorded it’s 100,000th death due to COVID-19.  Although the number of new cases in the US is currently declining each day, the total number of cases and deaths will continue to rise, and the daily number of new cases could accelerate again if testing and mitigation strategies fail.  At this difficult milestone in the epidemic, I took some time to look back over the last few months and share my observations on what we’ve learned—in hopes that we’ll apply these lessons to the next phase of the pandemic.

Our public health system is more fragile than we thought.  Early in the epidemic, the Centers for Disease Control and Prevention were unable to provide reliable estimates on how COVID was spreading due to poor reporting infrastructure and problems receiving data from state and local jurisdictions.  Even now, the agency is still trying to detangle the data they have to more clearly document those who have tested positive using the viral tests (the primary means of tracking the spread of the virus) and those who are testing positive using the antibody tests (the primary measure of tracking who ever had the disease—regardless if they are currently infectious or not).  Combined with the failures of its labs early on to create test kits necessary to track the spread of the virus, CDC has led many (including me) to seriously doubt its ability to effectively manage pandemics without sufficient infrastructural investments and perhaps a change in leadership at multiple levels within the agency.

The healthcare “safety net” doesn’t really exist.  In the US, we use market-based approaches to provide access to healthcare services rather than socialized or nationalized models that guarantee access for everyone.  Consequently, gaps exist for populations that are either too sick for insurance companies to want to insure or they simply cannot afford to pay the high costs for coverage.  To address these gaps, federal and state governments spend billions annually implementing a myriad of programs including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) and supporting access points for services such as Federally Qualified Health Centers, Critical Access Hospitals, and others.  What has all of that spending on healthcare given us during a time when we need it the most?  Some of the largest disparities in COVID-related morbidity and mortality ever seen in modern times.  How can we legitimately claim to have a healthcare safety net when the cracks are so large that entire populations fall through them to their demise?

We are more caring, hopeful, and resilient than it usually appears.  The political discourse over the last decade has grown increasingly vitriolic.  Supporters from all sides of an issue seem to revel in the idea of demonizing each other on television and social media—and the anger isn’t limited to words.  Political violence has increased substantially over the last five years and is beginning to rival the number of domestic terrorism events pervasive during the periods of significant political unrest in the 1960s and 1970s. 

In spite of the hate-filled cloud that seems to hang over every subject with more than one point of view, we did manage to come together in many interesting ways to support each other.  School teachers made house visits to check on their students; people around the world clapped and banged pots and pans to honor the sacrifices of healthcare workers; untold numbers of food bank volunteers literally fed hundreds of thousands of people in need; school administrators found creative ways to celebrate graduation; people from all walks of life learned how to sew countless masks for essential workers and their high-risk neighbors; mutual aid networks popped up to support the various needs of community residents; and the list goes on and on…

The biggest lesson that I hope we all have learned is that together, we are more powerful than we realize.  We stepped up when our leaders didn’t, we took care of each other when they couldn’t or wouldn’t, and we all contributed in our own way toward the same simple goal: helping each other when it mattered most. 

Now my question for you:  Can we learn to do this again?

 

Billy Oglesby, PhD, MSPH, MBA, FACHE

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