COVID-19 has exposed countless weaknesses and inequities in our health care systems, with long-term effects that will be felt for generations to come. Yet it has also given us an important opportunity to improve where we have failed. Public health is now deeply embedded in our consciousness as a top priority. The pandemic has already helped facilitate long-overdue improvements in our health care system, such as the rapid expansion in virtual care and greater awareness of racial health disparities. But further progress will not be inevitable without more comprehensive reforms.
Some positive changes will come in the form of how we adapt our behavior to protect ourselves and others. After almost a year of vigilant hand washing, sanitizing and mask-wearing, many of us are recoiling at how unsanitary our pre-pandemic actions were. The idea of powering through a cold or illness at the office is no longer to be celebrated. Instead, we are left with much greater respect for employees who choose to work remotely when ill and employers who are willing to offer the flexibility or the sick leave to let staff stay home. Even mask-wearing – a hotly debated topic across the U.S. – may become the norm whenever anyone feels ill, much like in Asia, where it has long been encouraged. With a historical decline in influenza cases this season, we are already seeing the benefits of the approach. If we persist with better personal hygiene beyond the pandemic the trend could continue, potentially saving tens of thousands of lives every year.
The pandemic has also played an important role in destigmatizing mental health issues, turning a spotlight on the need for more integrated care, where attention is paid to the physical, mental and social needs of every patient. By talking more, as we are now, about issues like anxiety, depression, alcoholism and domestic violence, we have made it easier for people to ask for care. Now we need to build the infrastructure to accommodate the demand and ensure that patients can access and afford mental health care, either by incentivizing providers to accept insurance or through legislating better coverage for mental health care.
One critical improvement over the past year has been our ability to deliver care wherever patients need it most, often in their homes. Thanks to emergency measures to eliminate regulatory and insurance barriers, virtual care became standard for patients. Providers also explored other ways of delivering care outside the traditional hospital setting, like in ambulatory care centers. Now, we need to make these emergency authorizations permanent and ensure that health care providers have the training and technology to deliver optimal levels of care.
But training and technology for providers will get us only so far. To fully realize the potential of telemedicine, we need to ensure equitable internet access for all Americans, which opens up a whole new set of issues that have yet to be solved.
The rapid spread of COVID-19 demonstrated that stronger health systems that address health inequities benefit us all. You cannot control COVID-19 unless it is controlled across the entire population. This means every American, no matter their age, income or background, should be able to access affordable care. Health care costs have long been a deterrent in the U.S, leading us to worse outcomes and underperforming at a world standard. Stories of surprise bills costing thousands of dollars associated with COVID-19 tests acted as a deterrent to low-income earners from seeking out tests. The benefits of universal health care were never clearer than when a global health crisis coincided with millions losing their jobs and health insurance.
The COVID-19 pandemic gives us a clear mandate to invest in a long-term strategy to strengthen our health systems and improve public health. Public health has been chronically underfunded for many years. We need to seize this moment to build respect for the work of public health professionals and use the power of government agencies such as FEMA and the Department of Homeland Security to roll out public health initiatives. Not just so we can respond proactively to health emergencies, but also so we can address some of the rampant co-morbidities like diabetes and obesity that made our population more vulnerable to COVID-19.
Even with all that must be improved within our own borders, we cannot neglect what lies beyond. Assisting more vulnerable countries to strengthen their health systems to fight this pandemic and emerging threats will, in the end, help us as well. The U.S. should reclaim its position as a global health leader and foster greater collaboration and data sharing between all nations to build a robust surveillance system for chronic and infectious diseases.
The 1918 flu pandemic and the HIV epidemic have both revolutionized the way we approach health and deliver care, and so should this pandemic. America has a wealth of knowledge from universities, researchers and think tanks on best practices in health. The challenge lies in the funding and implementation, and COVID-19 provides the ideal momentum.