By Gonzalo Bearman
Travel bans. School closings. Social distancing and mask mandates. COVID-19 upturned our lives two years ago.
To date, there are roughly 6 million deaths globally, with nearly 1 million in the United States alone.
As we approach the two-year anniversary of the pandemic, it’s important to reflect on the lessons we’ve learned and how we begin to chart a path forward.
As the chief of the division of infectious diseases at VCU Health, I’ved on critical efforts to address the COVID-19 pandemic on research, clinical and operational fronts, and I want to share the top six lessons from the pandemic.
1. Pandemics are recurrent in the history of mankind.
Human history is filled with epidemics and pandemics. These include smallpox, the bubonic plague, yellow fever, cholera and tuberculosis. In the last 100 years, there was the great flu pandemic of 1918, the swine flu (H1N1 virus) and many more.
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COVID-19 is never going away entirely. The only infectious disease that has been eradicated in the history of humankind is smallpox. Like measles, polio and so many others, SARS-CoV-2 is here to stay.
It is important for us to learn from these experiences and apply to future outbreaks of our advances in diagnostics, prevention via nonpharmacologic methods (masks and social distancing), and vaccine and treatment developments. We also should strive to improve public health communication to minimize the erosion of trust.
2. An old family of viruses can present in new ways.
We’ve known about coronaviruses for nearly 100 years. Yet new versions have resulted in SARS, MERS and now COVID-19. These viruses can further mutate. This is what led to the delta and omicron variants of COVID-19.
3. Our understanding of COVID-19 transmission evolution.
We’ve learned that transmission predominantly is through large droplets that travel less than 6 feet and are not predominantly airborne (traveling longer distances and remaining suspended in the air). We also have learned transmission can occur prior to symptoms, and variants can mutate and become more transmissible. This occurred with an omicron.
4. The pandemic amplified underlying issues in health inequities in the US and worldwide.
Infections commonly are associated with inequities. The risk of COVID-19 infection was not the same for all. Public transportation personnel, grocery store staff members, and other essential workers who were unable to work remotely carried a higher risk of infection. Individuals with limited access to health care typically had worse outcomes due to delays in diagnosis and less timely treatment.
5. Mitigation strategies worked.
The first step in an outbreak is to identify the infectious agent and the mode of transmission. From there, mitigation strategies are applied, including quarantine, isolation, hand hygiene, social distancing and the use of face masks.
These mitigation strategies are part of a layered approach to a pandemic. Of course, vaccines and treatment also play a massive role in disease transmission. Without these interventions, the number of infections and deaths would have been much greater.
6. High-quality science should guide decision-making. Misinformation is dangerous.
Outbreaks require a prompt and nimble public health response, guided by the highest quality science available. We saw low-quality papers or poorly performed studies published with inconclusive or misleading evidence. This was harmful and led to the prescription of unnecessary antibiotics and antiparasitic medications. Misinformation is dangerous: It reduces the impact of public health interventions, leads to unnecessary treatments and fuels anti-vaccine movements.
As we are ongoing observe decreases in COVID-19 infections and hospitalizations, I want to share some words of hope. Greater levels of immunity through the vaccines and natural infection will move us toward herd immunity, and reduce the transmission and the severity of future infections.
The development of new antiviral pills, if widely available and accessible, will significantly reduce the severity of illness, and rates of hospitalization and transmission. Widely available tests, both at home and at health care centers, will allow for timely diagnosis, isolation and treatment.
development, we need to continue to be aware of our individual roles in this pandemic. Few decisions occur in isolation.
Choosing not to get vaccinated, going to work with a viral illness and refusing to wear a mask in crowded environments might harm other, more susceptible individuals. Choosing to stay safe is good for you, but it also is good for those around you and your loved ones. Show compassion — both to yourself and to others — as we move forward with this pandemic.
I am optimism. The COVID-19 pandemic won’t be over next week, but I’m hoping that in the next six to 12 months, we’ll be in a more endemic situation.
Gonzalo Bearman, MD, MPH, is chief of infectious diseases at VCU Health. Contact him at: firstname.lastname@example.org