Despite Setbacks, Reason for Hope Against COVID as 2020 Ends

MONDAY, Dec. 28, 2020 (HealthDay News) -- As 2020 careens to a close, one thing is clear: With infections topping 19 million and a death toll over 333,000, the COVID-19 pandemic has upended nearly every facet of American life.

As a new year nears, two leaders in the response to the pandemic talked over mistakes made, hard lessons learned and new reasons for hope.

No one can say the United States has performed well against COVID-19, said Dr. David Shulkin. He's former Secretary of Veterans Affairs for the Trump administration and a former CEO at the Beth Israel Medical Center in New York City.

"It's often hard to look back and to criticize what's happened, but in April it was already clear that we were already starting from behind," Shulkin said in a recent interview with HD Live!

For starters, he believes the United States dropped the ball on surveillance early on: Failing to recognize the scale of the virus' winter spread and then failing to quickly organize effective testing.

Since then, things have only gone from bad to worse, Shulkin said, so that today "we're looking at widespread escalation of the virus."

Overall, "I do think that this handling of the pandemic has continued to be worse than I think almost anybody had anticipated," Shulkin added, with the exception being vaccine development.

So, Americans are living through "a very interesting time right now," he said. It's a time "where we have so many people suffering, so many people dying, no real evidence that the infection is slowing, yet [we also have] the optimism of actually watching this vaccine being administered and knowing that it's a matter of time before we can get this under control."

However, the unprecedented speed of vaccine development isn't the only medical achievement worth acknowledging, added Dr. Joel Zivot, who also spoke to HD Live! He's associate professor of anesthesiology and surgery at Emory University. Zivot is also on the front lines of the pandemic, treating ICU patients with COVID-19 at Emory Decatur Hospital in Georgia.

He said that after caring for his first patient with a severe form of COVID-19 back in March, "I thought, 'We're going to be in trouble.' Truthfully, in the beginning, the wonder was, would all of these patients just die?"

Instead, scientists and health care workers have "risen to the occasion, to the extent that we can," Zivot said, and many lives are being saved now that might otherwise have been lost. Still, "we're stretched thinly, we are," he added.

"It's difficult and challenging, but we've learned a lot and we've helped people survive," Zivot said. "And for that -- even just for us to know that people could survive COVID -- that was a huge thing to recognize."

It's been a tough road, eased somewhat by the rapid pace of groundbreaking science.

"First of all there's been, of course, effective research that has shown some pharmaceutical interventions that have some benefit. We've [also] brought to bear some basic principles of critical care in caring for these patients. We've figured out how to don and doff our PPE, outerwear, masks," Zivot explained.

"And I think we [physicians] do a good job supporting each other," he added, including good support of health care workers from the medical institutions themselves.

Still, learning to navigate the pandemic has come at enormous cost, said Shulkin, and there's been "tremendous" stress among health care workers. That underscores the fact that the pandemic is ultimately "about emotional health as well as physical health," he said.

The lessons of 2020 mean that "health care in general is going to be changed forever," Shulkin believes, for "the health care professionals themselves, as well as the patients in terms of how they're going to want to get care in the future."

Staff "are getting burned out, staff are getting sick themselves," Shulkin said. "And many are experiencing emotional impacts of this pandemic. And therefore, we're seeing higher levels of retirements, and people just leaving the profession."

The breathtaking speed at which multiple safe, effective vaccines against the new coronavirus have emerged and been distributed is the one clear victory this year against COVID-19, both experts agreed.

And while "vaccine hesitancy" remains an issue among Americans in terms of uptake, there are signs that the shots are quickly gaining acceptance. Shulkin attributed skepticism about COVID-19 vaccines to "a lack of public confidence in our scientific institutions, and the questioning of science in general by some of our politicians."

But he believes that "the majority of Americans will choose to get this vaccine" if the U.S. Food and Drug Administration and other government agencies continue to reassure the public by embracing transparency, data-sharing and a cautious "no-short-cut" approach. Indeed, recent polls show the number of Americans now willing to get a COVID-19 vaccine has topped 70%.

Even so, vaccinating the whole country will take time, during which more contagious COVID strains may emerge. And some of those strains may even be more virulent, Zivot warned. So he stressed the importance of continuing to adhere to "non-pharmacological interventions, like social distancing, mask-wearing and hand-washing."

All are a bulwark against transmission, he said.

"These are not fancy things. They're not expensive things in the moment, but they are bothersome and difficult things. But now is the time, in particular I think, where we need to be certain that we are doing all of these things, so we can reduce the rapidity of spread," Zivot said.

More information

There's more on COVID-19 symptoms at the U.S. Centers for Disease Control and Prevention.

SOURCES: David Shulkin, MD, former-Secretary of Veterans Affairs (Trump administration), former-CEO, Beth Israel Medical Center, New York City; Joel Zivot, MD, associate professor of anesthesiology and surgery, Emory University, and clinician, intensive care unit, Emory Decatur Hospital, Decatur, Ga.