March 15, 2021
Originally published in The Salt Lake Tribune.
The COVID pandemic in Utah has been tragic, putting thousands in the hospital and leaving nearly 2,000 dead (at last count). We should honor the memory of those who lost their lives by learning from the pandemic to prevent unnecessary deaths from contagious diseases moving forward.
That means changing how we care for the sick and beginning preparations for the next public health emergency immediately after the current one recedes.
Caring for the sick
Based on Utah Department of Health data, the current flu season has brought a dramatically reduced rate of reported cases of the flu, with hospitalizations due to influenza virtually nonexistent. Pandemic response measures — social distancing, masking, increased hand washing — seem the likely cause of this positive public health outcome. Some of those measures, such as how health care providers diagnose and treat those with flu-like symptoms, can and should continue once the pandemic is over.
Pre-pandemic, a fever, chills and a sore throat often led to a doctor’s office visit and a test for the flu or strep throat. This resulted in both healthy and sick patients sharing the same air in entryways, waiting areas and exam rooms at the doctor’s office, with coughs and sneezes putting bacteria and viruses in the air or on surfaces for others to breath in or touch and potentially become infected.
COVID-19 brought with it a new way of getting diagnosed and treated that largely cut off this avenue for the sharing of contagious respiratory diseases. Flu-like/COVID symptoms instead meant being directed away from a doctor’s office toward a standalone COVID-19 testing location.
There are good public health reasons for health systems and clinics to continue this practice of applying the principle of social distancing to disease diagnosis and treatment. Patients with flu-like symptoms could be directed to a telemedicine service provided by their doctor specifically for those with such symptoms, with the doctor potentially sending the patient for relevant testing at standalone (ideally drive-through) testing centers. A positive test would automatically generate any necessary prescription being sent to the patient’s pharmacy.
This will require investment from providers in telemedicine and testing infrastructure. But given this year’s flu-season data, it merits at least a trial from providers to explore its effectiveness in reducing the spread of contagious disease. A secondary benefit is that it would make providers better prepared to respond to potential pandemic diseases, with a system of diagnosis already founded on the principle of social distancing.
Planning for the next public health emergency
Policymakers should take the fresh experience of the current pandemic and begin preparing immediately for the next similar emergency. If the pandemic has taught us anything, it should be that delay in serious preparations for a potential public health emergency means lost lives and economic hardship when that emergency arrives. That should no longer be acceptable.
Preparations should take federalism seriously. As we learned in 2020, it is a terrible gamble to rely on federal government experts and leaders to be adequately prepared for a disaster. The state could invest in its own stockpile of predictable public health necessities such as medical face masks, respirators and other basic medical supplies required for a pandemic.
Preparations should also recognize the difference between an expert and a good decision-maker. Some have advocated “listen to the experts” as an approach to the pandemic, but that fails to take into account that being an expert doesn’t make you a good public-health decision-maker.
Dr. Anthony Fauci, for example, decided at the outset of the pandemic to advise the public against wearing masks, before later stating that everyone should be wearing masks. This questionable decision generated confusion when understanding was needed – and fueled later opposition to masks.
If we can learn the lessons of the COVID pandemic to improve public health regarding respiratory diseases and become better prepared for the next pandemic, we will ensure that those whom COVID-19 has taken will not have died completely in vain. What has been a dark time for many can light the path toward a better future. We all could use that right now.
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