Minding the Gaps: Where COVID is Improving
As COVID-19 surges have taken clinicians and the U.S. healthcare system to the brink, the pandemic also has helped to identify weaknesses in the system and generated improvements in healthcare.
Those lessons learned range from appreciation for public health to the increased use of telemedicine. However, some issues are still waiting for solutions, such as eliminating racial healthcare inequities, dealing with nurse and physician burnout, and convincing people to believe in scientific advances.
How COVID is Improving Healthcare
Respect for public health and preparedness
While public health officials have been questioned and vilified by some, many Americans have come to a greater understanding about public health.
Health systems must change to manage future pandemics, according to an article in the International Journal of Infectious Diseases. Surge capacity, healthcare workforce shortages and other challenges during the COVID-19 pandemic should be addressed before the next pandemic hits. The current pandemic has led to resource allocation decisions, with ventilators and intensive care beds in short supply.
More than ever before, hospitals need a detailed disaster plan, as noted in a recent JAMA editorial. That plan should include how the hospital will equitably expand capacity, cancel elective surgeries and access additional staff.
Recognition of disparate views on science
A sizable share of the U.S. population has not been vaccinated against COVID-19, refuses to wear masks, and believes in misinformation about the infection and its vaccines. Many healthcare workers are angry, disheartened and frustrated with those unvaccinated people filling beds and waiting rooms.
The Kaiser Family Foundation reported in November 2021 that 78 percent of U.S. adults believe or are not sure about at least one of eight COVID-19 false statements, such as the vaccines causing infertility. The foundation calls for more efforts to accurately communicate evolving science.
Leaders in the scientific and medical community are discussing the need to rebuild trust among all sectors of the public in order to ensure successful rollouts of future treatments and advancements.
Spotlight on inequities
COVID-19 has showcased the racial/ethnic disparities in healthcare and brought calls for action to overcome them.
Centers for Disease Control and Prevention data show Black, Hispanic and American Indian or Alaska Native people are at higher risk to contract COVID-19, to be hospitalized for it and to die of the infection than White people in the United States.
Life expectancies for Black and Latino populations have declined two to three years respectively since COVID-19, as compared to 0.68 years for Whites, according to an article in Proceedings of the National Academy of Science of the United States of America. The reasons could include working in “essential” jobs, facing the public; lack of health insurance after job losses; living in multigenerational housing units; and higher rates of comorbidities, such as obesity and diabetes.
Demonstration of the value of nurses
The nation quickly learned the importance of nurses and other healthcare workers, who provide hands-on care for COVID-19 and other patients. Without enough nurses, some hospitals closed units, just when beds were most needed.
The data and intelligence company Morning Consult reported in October 2021 that 18 percent of healthcare workers have quit during the pandemic and another 31 percent have considered leaving. Nursing organizations and leaders are calling for additional investment in nurses to include improved compensation, benefits and staffing ratios.
While retaining nurses at the bedside should remain a priority, their mental health has been linked to quality of care, according to a Canadian study in Healthcare. The study also found higher mental health symptoms during the pandemic and lower ratings of quality and safety as compared with before the pandemic.
Necessity of mental health care for clinicians
The COVID-19 pandemic has taken a terrible toll on physician and nurse mental health. Resource allocation decisions are one of the many issues creating moral distress for clinicians.
Nurses also struggle with finding ways, such as on their cellphones, to let loved ones say goodbye to dying patients or for a priest to give last rites. Death has become pervasive.
Nurses and physicians were at a heightened risk of suicide, even before the pandemic, according to The Future of Nursing 2020-2030 report by the National Academies of Science. COVID-19 has increased that risk.
The American Hospital Association Physician Alliance has created resources to help physicians’ well-being and reduce suicide. The American Medical Association and American Nurses Association also have taken steps to understand clinician suicide and prevent it from happening.
Once this pandemic is over, some experts expect an onslaught of post-traumatic stress syndrome in the country’s healthcare workforce.
AMN Healthcare and the National Alliance on Mental Illness (NAMI) have entered into a StigmaFree Company partnership, demonstrating a commitment to addressing mental health and pursuing treatment for people who need it.
Normalization of telemedicine visits
Telemedicine visits existed prior to COVID-19, but their use soared during the pandemic, as patients were concerned about receiving in-person care. The federal government and commercial insurers removed many regulatory barriers to virtual visits. The use of telehealth visits has declined since the early months of the pandemic, but telemedicine still remains popular with patients and physicians who find it a convenient way to receive or provide care.
University of California, Los Angeles researchers reported in Journal of General Internal Medicine that patients think of telehealth visits favorably, even “slightly better” than in-person care. Yale University experts anticipate telehealth could become the new normal.
COVID-19 has called attention to deficiencies in the healthcare system, and it has led to some improvements, such as virtual visits. But more needs to be done to find and implement solutions to other vexing problems.
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