When will state’s COVID outlook improve?
Described by some Connecticut doctors as “grim and dismal,” 2021 was a year of exhaustion and frustration for health care providers trying to keep pace with the COVID pandemic.
But as the omicron variant has rapidly spread across the state, driving up the COVID positivity rate to record levels and pushing hospitalizations to the verge of an all-time high, will 2022 be any better than last year?
Connecticut health experts aren’t so sure.
“I think this time last year, we were really looking forward to 2021,” said Dr. Rick Martinello, director of infection prevention at Yale New Haven Health.
“I think it reminded us that pandemics are not one-year events. Even with flu pandemics of the past, they are two- to three-year events,” Martinello said. “And it reminded us, too, that we're not in charge of this. It's the virus that's in charge.”
In the short term, Martinello said to expect things to get worse.
“In the near future, with the confluence of winter, with us having a delta wave, with omicron clearly coming into our community and with flu here, this is like this perfect storm for this winter,” he said. “Our hospitals are already at capacity. Our health care workforce is exhausted. While I think we're up to the challenge, it's not easy.”
‘Grim and dismal failure’
Ridgefield’s Arthur Caplan, who founded the division of bioethics at New York University’s Langone Medical Center, said “2021 represented about a B-minus in battling COVID.”
He said while the “vaccines were here and they helped,” the year also “represented a grim and dismal failure of public health being pushed to the side by ideology and politics in too many parts of the country, too many parts of the state.”
While there were tools available to stem the tide of the coronavirus infections, vaccines and masks among them, “2021 represents the epitome of stupidity in that we decided not to use them,” Caplan said.
“People wound up treating masking as if they were asked to walk around in chains,” he said. “It wouldn’t have been false hope except we took the weapon we spent so much time developing and threw it out the window.”
“A lot of dead people didn't have to be dead,” he said.
Charles I. Motes Jr. retired in 2018 after “54 years in federal, state and local health agencies,” in what he said was “a life career in public health and preventive medicine.” Most recently he was health director at the Bristol-Burlington Health District.
Motes said COVID in 2021 is a “tale of two countries.”
“One country consists of the states and people who listened to science and acted to protect themselves and others. They are the ones who are mostly well, or not too sick from COVID. They got the immunizations, wore masks, did social distancing and washed their hands frequently,” he said.
“The other country consists of the states and people who ignored or refused to accept science and acted foolishly. They refused immunization, refused to wear masks, crowded into bars, restaurants, venues and other indoor places, didn't practice social distancing, and didn't wash their hands. They ‘pooh-poohed’ medical advice and public health advice, got sick and died. They ignored or ridiculed those who took precautions, and they suffered severe illness and death. This continues today.”
Because of this divisiveness, Motes said he fears that the coronavirus “will mutate and more types and ‘flavors’ of the virus will develop and spread.” If that happens, “more people will sicken and die,” he said. “Hospitals will continue to be flooded with COVID patients. This pandemic will continue for an unknowable while longer.”
‘Missed opportunities’
Scott Roberts, associate director for infection prevention at Yale New Haven Health, said the story of 2021 was one of missed opportunities.
“It makes me just pretty sad that we're in this current state of affairs, in spite of having really the defenses and the toolkit necessary to reduce COVID to something that could, from a public health standpoint, not be nearly as severe as what it is right now,” Roberts said. “This time a year ago, I was very optimistic. The first vaccines were coming out with 90-plus percent reported efficacy, we knew a lot more about the virus, and it feels like a year later we’re kind of back to where we were in March 2020.”
But the lesson for public health professionals, Roberts said, is the importance of effective communication.
“What we as health care providers can do is really work on our communication and our marketing, that we already have the tools to fight this virus,” he said.
David Banach, infectious disease physician and hospital epidemiologist at the University of Connecticut, hit a much more positive tone.
“I think the COVID narrative is that the 2021 situation is far better than 2020 for a number of fronts, particularly here in Connecticut,” he said.
While Banach said vaccination “remains the primary way that we're going to prevent the overall impact on illness and mortality from the virus,” he also pointed to better treatment options, and better understanding of what mitigation strategies work.
“We have treatment strategies that improve survival for patients that get COVID,” he said. “We know what types of mitigation measures are effective in reducing transmission, we know some measures that probably are less helpful in mitigating transmission, so we have a better understanding on mitigation strategies.”
Mark Siegel, a pulmonologist at the Yale School of Medicine, said he’s heard colleagues in health care express exhaustion. But he called the vaccines “a miracle of science,” and “a miracle of technology.”
“We spend a lot of time focusing on the frustrations of the persistence of the pandemic and the missed opportunities to protect vulnerable people and to keep people safe. But lest we go too far with that, we should also acknowledge that the vaccines are truly a miracle. There are undoubtedly thousands of people who would be dead right now, if those vaccines weren't here.”