Thinking About the Next Pandemic
Good morning!
First, I want to say welcome to all the students – those who are returning and those who are at UMMC for the first time this semester. We are glad you are here! I wish the circumstances were a bit different, but we will make the best of it and get through this. Indeed, your enthusiasm and energy are a breath of fresh air and an antidote to our nearly constant focus on the virus.
I don’t know where we are in the SARS-CoV-2 pandemic. The halfway point? Two-thirds of the way back to normal? Just beginning? (Heaven help us!)
No one knows.
But I do know this: This is not the last pandemic we will see. The next one might be next year. It might be 20 years from now. But chances are, we will confront a novel, never-seen-before pathogen again in our lifetimes.
When this pandemic is finally on the wane, there will be plenty of time to take a deep dive in evaluating our response – as an academic medical center, a state and a nation. What went right? What didn’t go so well? What can we do better?
As an AMC, I think we (you!) have performed very well in terms of preparedness, execution and improvising solutions. We learned a lot from Katrina and used that learning to be better prepared for this crisis.
Going forward, here are a few major themes – not an exhaustive list – that ought to be considered:
It’s a small world. Current evidence suggests this particular virus originated in China. But where the next one comes from matters far less than how we react to it. In our interconnected, global community, a pathogen in one part of the world can quickly spread everywhere. We need to be engaged with the global health community so that we can have advance warning and as much head start as possible to prepare.
Let the science lead. Science isn’t the answer for everything, but in determining how to respond to a new biological threat, it’s really the best thing going. Still, science takes time. By its very nature, it’s trial and error. Attempts to discredit science or scientists, to hide or distort the data, or to take advantage of a deluge of information – some legitimate, some not – to advance an individual agenda are unconscionable and shouldn’t be tolerated.
We need a coordinated, unified response. We don’t need a 50-state response to a pandemic. State governments play an important role, and one size doesn’t necessarily fit all. But the federal government must play a significant leadership role, setting a national strategy and ensuring that it is carried out. In particular, the federal government should play a key role in procuring and distributing supplies, mobilizing testing strategies and fast-tracking safe and effective vaccines.
We neglect public health at our own peril. In recent years, public health has been underfunded at every level of government. As has been widely reported, funding was slashed for the Centers for Disease Control and Prevention’s pandemic preparedness initiative. Closer to home, within the last few years, state support of the Mississippi Department of Health was reduced by a third. These funds not only support needed services; removing them has had the effect of hollowing out an agency, limiting its ability to gear up to respond in a crisis. Looking at rankings of states by the amount of public health funding per capita, Mississippi ranks 50th at $16 per person. Colorado spends $51 per person and Alabama spends $54 per person. We also rank at the top of the list in two recent rankings of worst states for health care (Becker’s and America’s Health Rankings).
Lack of access to affordable health insurance is never good, but it’s especially bad during a pandemic. With the dramatic increase in unemployment, many people lost not only their jobs but their employer-sponsored health insurance. Just when they needed it the most. This is a tragedy for these individuals and families, and it’s also tough on providers. Our proportion of uninsured patients has ticked up two percentage points – from 12 to 14 – since the pandemic began and will almost certainly go higher, to a point where it may be financially unsustainable. On an annualized basis, a 1 percent increase in uninsured patients equals nearly a $10 million negative impact on our bottom line. At least we’re large and have diverse revenue streams. Many small, rural hospitals are already beyond the breaking point.
Mississippians’ poor health status makes them a target. What many of the COVID-19-related deaths have in common is that the patients suffered from diabetes, obesity, hypertension, cardiovascular disease - or all of the above. We know that we pay a price for having one of the most obese populations in the country. These diseases often are the direct result of being obese and they wreak havoc on our citizens in non-pandemic times. In most cases, they are also preventable by maintaining a healthy diet and regular exercise. COVID-19 should be a wakeup call to do better.
We need to bolster our defenses. When the Ebola virus threatened our state, UMMC quickly fashioned a two-bed biocontainment unit to manage any patients sent to us. Fortunately, we didn’t have to use it. For the current pandemic, we have converted 127 patient rooms to negative air pressure, so that ambient air is filtered out of the facility. For the next pandemic, we need a more robust solution. We have proposed that the top floors of University Hospital and the critical care hospital, both currently shelled-in space, be outfitted as biocontainment units. These would include an 18-bed intensive care unit, a 28-bed step down unit and a 32-bed acute care floor. An investment in this facility would go a long way toward curing the capacity issues that threaten to cripple our state’s health system when the next pandemic hits.
All this is food for thought that can be addressed when we have emerged on the other side of this crisis. The one thing we don’t need to do is nothing, and go back to business as usual because the threat is no longer imminent.
Two quick reminders:
If you haven’t taken your Health Risk Assessment survey, please consider doing so. This survey gives our UMMC Everyday Wellness team valuable, de-identified information that helps us better meet the wellness needs of employees and students. Find the survey here.
Also, if you are free today at noon, tune in to the virtual Town Hall meeting I’ll be hosting with Dr. Alan Jones and Molly Brasfield. We’ll be answering your questions about the pandemic and our new remote working policy, among other topics. If you respond to this VC Notes you might hear your question answered today!
Until next time, let’s all stay safe and #UMMCStrong.