Lessons learned from COVID-19 pandemic

SAGINAW, Mich. (WNEM) - A Saginaw doctor said he feels joy to no longer have to wear a mask when taking care of his patients in the hospital.

“And so that has been an awesome thing to not have the masks every day,” said Dr. Matthew Deibel, medical director for the Covenant Emergency Care Center.

That change came with the winding down of the COVID-19 emergency, which officially ended on May 11 but it’s not just about face coverings.

Things have calmed down significantly at ER departments like Covenant Emergency Care Center in Saginaw, but while the COVID-19 emergency declaration is over, the pandemic has taught us plenty of lessons, and it’s left some noticeable changes in the healthcare industry.

“We were staffing 47 beds, but in the hospital, in the emergency department we normally have 65 beds,” Deibel said.

Walking the halls of Covenant’s pediatric emergency area, there are fewer staff and fewer patients too. What’s harder to count are the lessons and lesions left by the pandemic.

Deibel said it’s the shortage of workers that is causing the most issues.

“Right now, we see longer wait times in the emergency department. We see people not able to get to a hospital bed as quickly as normal. In the outpatient world, things don’t move quite as quickly and quite as smoothly because there are staffing challenges,” he said.

The World Health Organization has deemed this a public health crisis. It predicts a shortfall of 15 million healthcare workers worldwide by 2030.

The Michigan Health and Hospital Association found Michigan is trying to fill 8,500 job openings for nurses alone and more than 27,000 hospital staff vacancies.

“It’s been a rollercoaster ride in the hospitals,” Deibel said.

The “ride” started in March 2020 with Michigan’s first known cases of COVID-19.

“It was a scary time,” Deibel said. “I remember it was kind of like a ghost town as you drove to work.”

Dr. Bobby Mukkamala, the former president of Michigan State Medical Society, said the learning curve was pretty steep.

“So much of how communities across the country managed COVID was local,” Mukkamala said.

Mukkamala was president of the Michigan State Medical Society at the time and had hands-on involvement in the state’s response to stopping the spread.

“Yes, some things were national like access to PPE and things like that, but within Michigan, how Flint managed it is going to be different than how Detroit manages it or Lansing or Grand Rapids,” he said.

It is the management of the pandemic, the stay-at-home orders, mask mandates, businesses forced to close, and schools shutdown that started to create the most debate and division.

“You know, is it worth hurting the economy and people’s ability to make a living in order to keep more people alive? Then I would say life is more important than wealth,” Mukkamala said.

The price of the pandemic in Michigan was more than 40,000 COVID-related deaths. In Genesee County, more than 2,000, 1,100 in Saginaw County, nearly 700 in Bay County, and less than 300 in Midland County. There were more than 1 million deaths across the country.

“The projections were that there would be as high as a million people in the United States dying. I hoped and I wished and I worked as hard as I could to try to prevent that from happening. We ended up with that number anyway. I think it would’ve been much higher without the vaccines,” said Dr. Thomas Bender, the Bay County Health Department medical director.

Bender said there are four major takeaways from the pandemic.

The first takeaway is the importance of mRNA-based vaccines, such as Pfizer and Moderna. Doctors, like Bender, call the fast development of these vaccines the culmination of decades of research.

“There was really never a vaccine quite like these before. And as far as the time from the identification of the causal pathogen to the development of a protective vaccine, it was never done faster than this,” Bender said. “I hope and expect that there will be the development of other mRNA-based vaccines not just for respiratory pathogens like COVID-19, but for other conditions including, as I’ve seen recently, various types of cancer.”

The second is revolutionized testing.

“The rapid antigen test and the ability to use them at home or in schools or in workplaces offer a tremendous advantage,” he said. “The ability to take something that essentially works like a pregnancy test and gives you a result in 10 to 15 minutes is a tremendous achievement and to be able to mail those out.”

The third takeaway is indoor air quality cannot be underestimated. The CDC just released a recommendation in May that sets a target for how much ventilation inside of a building is enough.

“Improving indoor air quality either by using HEPA filters, opening windows, ensuring enhanced circulation of air, that’s really helpful,” Bender said.

A recent op-ed in the Washington Post notes this is, “the first time in history that the CDC has set a ventilation target to address respiratory infectious diseases.”

The fourth takeaway is messaging matters. Mukkamala and Bender noted different points in the pandemic when the messaging surrounding COVID-19 needed to be refined.

“One of the things that many people have failed to understand, and I think this is a failure of public health messaging, is it’s really not necessary to wear a mask outside,” Bender said. “That was one of the things that I think caused a lot of frustration, a lot of fear, was all the closure of public spaces. That probably could’ve been avoided.”

Mukkamala said one of the lessons learned is letting people know we don’t know what the right answer is going to be.

“We’re sort of learning this as we go,” he said. “There’s a little bit of uncertainty when you say it that way, but I think people would rather have that than have certainty in January about this and then have that change three months later.”

Some other lessons not expressed here, but understood in the medical community, COVID-19 will continue to keep doctors busy as they study its long-term effects and discover new treatments that work better than the last.

Should COVID happen again, they hope we take these lessons and use them.

“In the future, I guess I would like to see more respect for people’s opinions as opposed to the jump to criticize those opinions,” Mukkamala said. “Our concern for one another, our coming out to help one another get through this was wonderful, but also the division we saw, the lasting legacy of that, the friendships that have sort of been injured permanently because of this one issue.”

Bender said he looks back with some regret on how the pandemic was both politicized and became the subject of a great deal of misinformation and disinformation.

“I wish we could have had less of that,” Bender said.

Hospitals like Covenant are implementing programs to boost recruitment and retention. Deibel said regardless of staffing shortages, people should not delay care.

Doctors and health professionals are also continuing to encourage people to get vaccinated and boosted. There are options for the uninsured and insured, but now some may be susceptible to cost sharing or co-pay.

“There were a lot of sites you could go for free and health care plans or insurances would pay for those,” said Jim Milanowski, president and CEO of Genesee Health Plan. “They’re still going to pay for those but they’re going to be part of your health plan or insurance just like a flu shot would be or shingles vaccine. It’s going to be part of your regular vaccinations that you might do.”

Milanowski said 20,000 more people signed up for Medicaid because of the pandemic.

You can check with your local health department or GHP for assistance with health care and vaccinations.

Read next:

Nurses speak on proposed Safe Patient Care Act

MSU’s plan to combat doctor shortage

Schools undergoing a school nurse shortage

Poll: Nurse-to-patient ratio law could address staffing crisis

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