At the risk of belaboring the obvious, 2020 didn’t go according to plan – my plan, your plan, anyone’s plan.
The COVID-19 pandemic wreaked havoc on schools, physicians and hospitals, the economy, and the healthcare industry has, in my opinion, been forever changed. No one has been left unchallenged by the pandemic, many of us have had to make difficult choices, many have been devastatingly impacted by loss of income and life. Doctors and nurses caring for COVID patients have been forced to make unthinkable choices.
As I write this letter, COVID-19 is surging in nearly every state. Hospitals are filled with COVID-19 patients. Emergency departments in many places are turning away patients. More of us know someone who’s been hospitalized with COVID-19. Too many of us are on the verge of realizing that despite the very best efforts of physicians and clinicians, not all COVID-19 patients can be saved.
As alarmed as I am at headlines like this recent one from the Salt Lake Tribune, Utah’s hospitals prepare to ration care as a record number of coronavirus patients flood their ICUs, I cannot imagine being a physician or nurse caring for COVID patients who has to ask an intensive care patient who is not improving to move to a regular hospital bed. “Doctors will also be asked to clearly communicate with patients about do-not-resuscitate orders.”
Wear A Mask
Let me begin with my most fervent wish for 2021: that we all graciously wear a mask indoors and outdoors, accepting that this simple behavior will help save lives. In the words of Chris Christie, the former governor of New Jersey who recovered from COVID,
“When you get this disease, it hits you how easy it is to prevent. We are asked to wear cloth over our mouth and nose, wash our hands and avoid crowds. These minor inconveniences can save your life, your neighbors and the economy. Seldom has so little been asked for so much benefit.”
Also at the top of my 2021 wish list are effective, widely-distributed COVID-19 vaccines available to not only Americans, but throughout the world.
COVID-19 Bright Spots
Notwithstanding the immense pain and suffering brought on by the COVID-19 pandemic, there have been bright spots worthy of celebration.
- Unparalleled levels of healthcare collaboration.
As but one of many examples, Jayne Morgan, MD, a cardiologist and director of innovation at Piedmont Healthcare in Atlanta, GA, shared her experience,
“In Georgia, we had a lot of collaboration at different levels between Piedmont, Grady Health System, Emory Healthcare, and Wellstar Health System. In general, we are competitors. COVID turned our competitors into collaborators. We all had to come together to serve the community, to survive and to make certain we could protect our staff.”
- Massive research investments to identify and create COVID-19 vaccines and therapeutics.
Research has taught us much about COVID-19 in the nearly a year since the pandemic was declared.
- Older people and those with co-morbidities are more likely to experience severe impacts if they contract COVID.
- The disease is transmitted primarily from person to person through respiratory droplets when an infected person coughs, sneezes or talks.
- The vaccines being distributed first are the ones created with a new technology that was first approved for use in humans in November 2020, RNA or mRNA (messenger RNA).
“To produce an mRNA vaccine, scientists produce a synthetic version of the mRNA that a virus uses to build its infectious proteins. This mRNA is delivered into the human body, whose cells read it as instructions to build that viral protein, and therefore create some of the virus’s molecules themselves. These proteins are solitary, so they do not assemble to form a virus. The immune system then detects these viral proteins and starts to produce a defensive response to them.”
The best minds are working to develop COVID therapeutics and vaccines. I’m confident they will. Undoubtedly, their innovations will yield other unexpected benefits in the years ahead.
- Acceleration of digital health.
Nearly overnight, physicians began using telehealth to continue to treat patients during the spring lockdowns. In the months since then, it’s become clear that physicians and patients like virtual visits. Nearly three-quarters say “ telehealth helped them to provide quality care for their patients.” Seventy percent say they want to maintain virtual visits. About half of patients say they plan to continue to use telehealth for their physical and mental health. Even more will use digital heath machine or a wellness app in the post-pandemic period.
Given physician and patient expectations, I expect more healthcare organizations to embrace a digital front door strategy in 2021.
- Increased adoption of value-based care.
For the first time, many physicians felt the pain of fee-for-service reimbursement. Primary care practices were expected to lose more than $67,000 in revenue per physician in 2020. On the other hand, value-based care provides a repeatable, reliable revenue stream so physician practices can stay viable in times of uncertainty and continue to care for patients. The financial impact of the pandemic means more physicians have been, and will continue to be, receptive to the certainty of value-based care contracts.
As wide-eyed as I am going into 2021, I am bullish on the potential for the healthcare industry to positively impact lives and for a return to many of freedoms of pre-pandemic life late this year.