Five Years After the COVID-19 Pandemic Was Recognized, What’s Changed?
Five years ago today, on March 11, 2020, the World Health Organization (WHO) declared the coronavirus—COVID-19—outbreak a global pandemic. An article published in Acta Biomedica by Domenico Cucinotta and Maurizio Vanelli on that date began thus: “The World Health Organization (WHO) on March 11, 2020, has declared the novel coronavirus (COVID-19) outbreak a global pandemic. At a news briefing, WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, noted that over the past 2 weeks, the number of cases outside China increased 13-fold and the number of countries with cases increased threefold. Further increases are expected. He said that the WHO is “deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,” and he called on countries to take action now to contain the virus. ‘We should double down,’ he said. ‘We should be more aggressive.’”
As Ronda Kaysen wrote today in the New York Times, “Sometimes seismic cultural changes with a sudden fury. On March 11, 2020, the World Health Organization declared Covid-19 a pandemic, Tom Hanks, America’s Dad, announced that he and his wife, Rita Wilson, had the disease and the stock market was tanking. Overnight, home became everything. Balconies and windows transformed into kitchenware drum circles to cheer the health care workers. The streets were shockingly silent, lest for the endless, heartbreaking sirens.” And then, of course, within weeks, hospitals were filled to overflowing, and patients were dying by the thousands every day.
The heroic healthcare workers—physicians, nurses, techs, everyone—in hospitals, clinics, hand health systems, leaped into action, caring for those afflicted with COVID, and managing virtually impossible patient loads, work hours, exhaustion, and crises of every kind. It wasn’t for numerous months until vaccines were available, and the first few months were devastating for virtually the entire world.
How was the healthcare sector impacted over time? The costs of caring for so many patients at such high levels of acuity were overwhelming, and it was only through federal legislation that hospitals nationwide were saved from going under financially. Meanwhile, hospitals in particular struggled to retain nurses, a large cadre of whom left hospital care delivery altogether, leaving an ongoing shortage that is impacting hospitals even now.
The entire supply chain to hospitals and all patient care organizations was severely disrupted, for numerous months. And of course, the leaders of all types of patient care organizations had to scramble to put into place hygiene and infection control protocols that could work under terrible circumstances.
In addition, telehealth/remote-based care leaped in a nanosecond from being the small-scale, still-experimental phenomenon it had been, to providing care delivery for huge, huge numbers of patients. Indeed, even though telehealth volume has declined since the pandemic eased, it remains at far higher levels of utilization than it had been at the beginning of the pandemic, and is fully operational virtually everywhere now.
Hospitals in particular are still struggling with some of the after-effects of the COVID-19 pandemic, with major nurse staffing shortages even now, as well as a growing nationwide shortage of physicians, particularly in specific specialties and subspecialties. And hospital finances in particular are still in an active-recovery phase, though as the analysts at Kaufman Hall have been reporting, hospital organizations are more financially stable now than they’ve been in five years. What’s also true is that the pandemic helped to catalyze a further push into value-based (including risk-based) contracting, as the leaders of organizations that had been primarily discounted fee-for-service in their reimbursement, realized quickly that some form of capitation or value-based payment offered a better financial basis in uncertain times, than being almost entirely discounted FFS.
The leaders of hospitals, medical groups, and integrated health systems also realized that they could move far more quickly than many had expected they could, when they needed to stand up entire telehealth systems within days. So that was a win.
And the pandemic ended up turbocharging consumerism, as patients were further drawn into areas like self-scheduling, and interactions with clinicians outside of physician visits, through newer technologies that had been ready for the pandemic.
No one wants to go through what everyone went through in the spring of 2020. But the fact is that healthcare leaders are in fact better prepared for whatever might come next in terms of public health crises, then they were in February 2020. And that is something to express some satisfaction over.
