I think we thought we saw this coming. And I think we tried to warn everybody.
Approaching 2 years into the pandemic, with hundreds of thousands of lives lost and millions sickened, it feels like we’re no closer to an effective public health system prepared to handle what comes next, instead of reacting to things as they occur, or worse, after they occur.
So many people, from front line healthcare workers to epidemiologists, from deep thinkers to public health experts, from community leaders to researchers, have all been sounding the clarion call that we need change, we need the tools to prevent and protect.
Suddenly, here in New York City and in so many other places around the country, we are seeing another surge, a cresting wave rising up before us. Suddenly, and not surprisingly, there are huge lines stretching around the block at COVID-19 testing sites. It seems like all that anybody wants for Christmas is a home testing kit for COVID-19.
Healthcare workers are overwhelmed and exhausted, physically and morally, not just from doing this work and bearing this burden, but from shouting from the rooftops, telling anyone who would listen that we need to do things better. Over and over, we are seeing comments on social media about healthcare providers being told to cancel their holiday vacation plans and get a booster so that they can prepare to take care of the holiday travelers who didn’t cancel their vacation plans and didn’t get a booster, or that didn’t even start their vaccine series.
Shouldn’t we as a society have been better able to figure out how to respond by now? To have built a better way? We’ve done this before with other real and existential threats, we’ve risen up as a nation, and as a society, and done the right thing.
Yes, what has been done with Operation Warp Speed and the incredible delivery of millions and millions of doses of COVID-19 vaccines has been incredible, and much of this has delivered in ways we didn’t think possible. And as healthcare workers have ridden each successive wave of this terrible virus, we’ve adapted, learned new things and new ways to take care of the sick and dying, and pushed the limits of science to find out how we can do more.
But here we are again, overwhelmed with headlines about the lack of availability of testing in this country, the lack of contact tracing, and festering fears about the impact of this virus on an economy that should have been better prepared to take care of something like this. So many other countries had done a better job of handling shutdowns and instituting cooperative protective measures, but we remain a scattered, disconnected network of efforts that are masquerading as a poor excuse for a public health system. Maybe it’s time we take healthcare in this country as seriously as we take some other things — things that get the attention before they happen, instead of afterwards.
We should have a system of surveillance that is second to none, finding out where a virus like this is starting to transform and evade us before it takes root and catches fire. We should have outreach to communities everywhere that gets our patients what they need, be it vaccines, medication, access to care, telehealth, or education about how to do things right.
Yes, if it gets bad again, we’re going to shut our practice down for everything except emergency visits, convert over to telehealth whenever possible, try and keep people away and safe at home, and re-open our COVID-19 outpatient practice, which has been mothballed these last few fairly quiet months. And our colleagues in emergency rooms and on the inpatient services will take a deep breath, grab another cup of coffee, do a little meditation or a wellness module, and then get back to it. Despite the burnout, despite the Great Resignation of 2020 which has left us so depleted, we will find a way to make do with what we have, and keep on fighting.
But it would be great if instead of having to do more with less, we were at this point able to do more with more. Somehow this message has to reach beyond the places we are all practicing and find the ears and hearts and minds of those who can make a difference, who can move this up to the front of the line and make it a priority for this country.
Only then will we be able to survive these things in a way that doesn’t leave the system bruised and battered, doesn’t pummel us again down to our knees. Maybe then we’ll be able to come out on the other side in a better place, proud of the job we’ve done taking care of everybody.
Instead of wishing that we were.
Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine from the perspective of his own practice.