Disney World is open! So where do we go from here? Are we back to normal, or is this something new? My guess is that we’ll be living in a slightly altered environment compared with the good old pre-pandemic era, and that the long-term changes will be subtle. For instance, masks will go away, but during flu season, it won’t appear strange that some people will revert back to them at the office, in Costco, or on a flight. Further, I think that people will be more aware of touching publicly exposed surfaces and will carry Purell more often. I would also guess that many of these residual sensitivities will fade over time, as have the reactions to previous mass tragedies like the 9/11 attacks. But in the healthcare universe, it’s another story.
Reshaping the Future of Care
Providers have made changes, many of them long overdue, that will persist and expand in the new environment. Foremost among these is the ability to rapidly increase capacity and responsiveness in the event of a future emergency that taxes the system. This includes space and bed expansion options, improved isolation protocols, improved testing, supply and equipment reserves (shared and owned), a robust virtual care program, scalable digital scheduling, contact tracing, and infection control. The interesting thing about infection control is that it is not something new. It has been a big issue for hospitals for a very long time, given the high number of nosocomial (hospital acquired) infections, particularly as they apply to debilitating lung pathology and wound development. COVID merely brought this problem into the spotlight. This is not dissimilar to the 9/11 event. We weren’t suddenly enlightened as to the threat of domestic terrorism on that Tuesday. Our antennas were already up in the wake of the World Trade Center bombing in 1993 and the constant warnings from the FBI. I recall one very credible threat pertaining to Times Square leading up to the New Year’s Eve Y2K celebration. But it took 9/11, nine months after Y2K, to get everyone’s attention. So now, expect to see a persistent focus in healthcare facilities and the workplace related to the sanitization of shared equipment (especially IT-related) and surfaces, as well as the promotion of non-contact entry, tracking technology, seasonal temperature checks, and expanded smartphone interaction.
I suppose the biggest shock to the healthcare system has been the mainstreaming of virtual care (telemedicine), a subject on which I have written extensively. It is currently uncertain as to the form this category will assume once the emergency officially ends (particularly in the areas of reimbursement and cross-state coverage), but you can be sure it is here to stay and will inexorably expand to align with new technological developments in the areas of remote diagnostics and treatment.
Another game changer is the explosive use of CRISPR (gene-editing) technology, which has now been validated in the areas of both vaccine development and testing. Adopting the World War II mantra “never again,” the capability to quickly develop a vaccine (the COVID-19 vaccine was developed over a weekend after Chinese scientists quickly mapped the coronavirus genome), gives the world a rapid response mechanism in its arsenal for future pandemics, biological warfare, and emerging environmental factors that can cause cellular mutations. The additional potential benefits of CRISPR are vast, including finding revolutionary testing and treatments for cancer, and eradicating ravenous diseases like ALS, Alzheimer’s, Crohn’s, Sickle Cell Anemia, and Multiple Sclerosis.
Finally, the pandemic has also amplified the previously existing need to promote population health, the primary objective of which is to prevent and/or manage chronic diseases in individuals more effectively, especially in the aging population. One only has to look at the comorbidity vulnerability associated with COVID-19 as a convincing argument to address this need.