Experts Address Health Care Gaps Exposed by COVID-19 Pandemic

Five years after the COVID-19 pandemic began, experts reflect on health care shortcomings revealed by the public health crisis and emphasize the need for future preparedness. Key challenges include personal protective equipment (PPE) shortages, misinformation, and widespread health care workforce burnout.

Featured experts include Jason Bellet, cofounder and chief business officer of Eko Health; Geoffrey Rutledge, MD, PhD, cofounder and chief medical officer of HealthTap; and Dan Nardi, MS, CEO of Reimagine Care.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

What were the biggest weaknesses in the health care system exposed by the COVID-19 pandemic? What steps are necessary to build resilience moving forward?

Bellet: I think one of the biggest weaknesses that was exposed, not only within a hospital and health system, but overall, was PPE and ensuring that we had access to technologies that would keep providers safe in really complex medical situations.

One of the things that Eko [Health] did very early on was release a feature within our product that allowed providers to listen through Bluetooth headsets. A provider could put on an entire protective PPE gown, getting ready to go into a complete isolation room, but what you didn't want to have happen was the provider needing to put stethoscopes into their ears and then have a tube connecting them to the patient.

[That was] a use case that, at scale, we really hadn't thought through. I mean, there were infection control rooms within hospitals, but we never really planned for the large-scale need for infection control in the case of a pandemic. We were able to quickly iterate and develop a solution that allowed providers to put headphones under their protective gear and then, via Bluetooth, stream to those headphones.

I think one of the things that it exposed is the need for preparedness in the event of a pandemic, or in the event of a need for large-scale infection control, to have alternative solutions to perform some of the most critical parts of the exam, ie, listening to heart and lung sounds.

I think, in general, they need to stockpile PPE. We were, as an overall world, and certainly as a health system, dramatically underprepared in terms of masks and protective equipment needed. I know that the federal government had a stockpile of PPE that was largely outdated and expired. This was a good crash course on keeping that up to date and making sure that the safety net is in place.

Rutledge: Certainly, [we] should be drawing lessons. People are pointing fingers after the fact at some of the decisions that were made. For example, there's been great criticism of the lockdowns, which I think, at the outset, were absolutely essential. Then the discussion really is, how should we decide and define how to unravel or roll back the lockdowns? I think such discussions in the future will be important.

I guess the other issue is understanding the power of misinformation. Early on, in particular, as these events [pandemics] occur, there is uncertainty, and how we manage that uncertainty, how we focus the discussion to be based on the facts at hand, ends up being important. There is this thing called the "fog of war," which I think applies to what happens early on when pandemics occur, where, in the midst of a crisis, information can be uncertain, and it can be challenging to make good decisions. Looking at how we made those decisions, I think it's important for us to consider how we would respond the next time around.

Nardi: I think there was a handful of weaknesses that were really brought to light. I mean, I think the workforce strain is one of them. I'm going to say that, combined with our over-reliance on a facility-based care, right? For decades, we expected patients to come in to receive their care, and we didn't really have as much, or at least not at scale, the ability to support patients at home, on the go, and virtually. I think that puts a lot of strain on the workforce.

I think you ended up having this already borderline burnt-out workforce, and then we had a pandemic that just asked even more of these caregivers. I think that put a lot of these nurses, frontline healthcare workers, providers, clinicians, it asked so much more of them because we expected patients to come in. I think that's one where we really have an opportunity to continue to build and make sure we're having the right support systems around that.

Also, I think equity and gaps in access in rural areas. Again, same type of thing, right? How are we supporting patients who don't live within a handful of miles of a hospital or their health care provider? Being able to ensure the right access to care is going to be extremely important as we move forward for patients in all locations, no matter their diagnosis, no matter what treatment they need to have.