Health Care Changes; Looking Back on the Pandemic

It’s been over a year since the pandemic first started. With COVID-19 running rampant, spreading globally and mutating into different variants, it wasn’t long before health services had to kick into overtime to mitigate its spread and mortality rate. To no surprise, because of the threat that this disease posed, along with developments of vaccines and other remedies, health care as a whole had changed.

“The pandemic accelerated a lot of changes that were kind of percolating in the background,” said Matthew Eisenberg, an associate professor of health policy and management at John Hopkins Bloomberg School of Public Health. He studies neoclassical economics(“Supply and Demand”), and its application to health care. The outbreak of COVID-19 can reasonably be considered as a catalyst to many of the alterations and inequities to already budding health care, it ultimately is up to policymakers and the status of the supply-and-demand cycle of health care to decide what remains and what gets phased out.

One such example of tools that were greatly amplified in use was telemedicine; the act of video calling your doctor rather than visiting in person. While this practice existed before the pandemic, it was COVID-19 that turned this from an uncommon and obscure practice into the norm for health care services. With how common telemedicine was becoming, policy changes made during the pandemic made telemedicine not only more readily available, it helped its providers actually get paid for it. Private insurance companies such as Medicare relaxed their policies on telemedicine reimbursement for health care providers because of COVID-19. Because of supply-and-demand, naturally, the more health care providers get paid for telemedicine, the more incentive there is to provide it, and the more supply there is for patients.

Patient Portal, another tool for health care providers and their patients. A simple, yet effective medium that allows patients to directly message their doctor’s via their dedicated inbox. According to a report published by JAMA, which took instant messaging data between patients and their providers from March 2020 through June 2021, the number of patient messages increased, despite fewer patients seeking care in some specialities. Even older patients, whose relationship with technology is often a less than harmonic one, are sending their doctors messages and embracing telemedicine, says Dr Megan Mahoney, a family medicine doctor and the chief of staff at Stanford Health Care.

Naturally, it wouldn’t be a discussion on the progression of health care in recent years without referencing the vaccine race. The quick development of Pfizer, BioNTech’s vaccine and Moderna authorised just after, were available to the first round of eligible adults in the US within a year of the country going into lockdown. According to Nature, the previous discrepancy between an outbreak and a vaccine being produced was in 1960 for mumps, and that took four years from development to approval. Although Moderna and Johnson & Johnson received emergency use authorization, that still makes these vaccines the quickest to hit the shelves in history. Arguably, despite its fast production, it is not a perfect solution. For countries outside of the US, vaccines have been accessible to only 8.9% of people in low-income countries. The Yale School of Public Health reports the vaccines have saved about 279,000 lives and prevented 1.25 million hospitalizations as of early July 2021.

Despite the advancements or evolution of health care recently, the pandemic has also magnified our shortcomings and has disproportionately affected the same people who have been mistreated by the medical system for years. Black and Hispanic Americans have been hospitalized with COVID-19 and died from the disease, in much greater numbers compared to white Americans. Dr Shantanu Nundy, a primary care physician and author of the book Care After Covid: What the Pandemic Revealed Is Broken in Healthcare and How to Reinvent It, told NPR in a May 2021 report that the pandemic scrambles to find a testing site, get a vaccine appointment or access preventative care exposed those who might not have ever experienced it to the perils of health care.

Another shortcoming of the pandemic because of COVID-19 was the US public health response, and its subsequent communication to the public about what to do when you’re sick. When the pandemic struck, public health agencies were relying on “old methodologies” in terms of quarantine requirements and testing rules for COVID-19, says Michael Urban, an occupational therapist and program director at the University of New Haven. Compared to other countries, we have issues with containment and quarantine restrictions that don’t always prevent people from spreading the virus, he says. The CDC’s latest isolation guidance for people who test positive for COVID-19, for example, has been criticized by some for being too relaxed and not requiring a negative test. In the US, there’s a one-and-done mentality. “You do a one-time test, you’re cleared,” Urban says. “Have a nice day.”

With the threat of COVID-19 slowly but surely being mitigated, the alterations to health care is likely to stay. Eisenberg says that we may see specialised mental health services, including some practices that are virtual-only, and some that are a hybrid of in-office and virtual visits. Additionally, there may also be a shift away from medication treatments for mental health conditions and more provider-focused psychotherapy.

While there are structural and policy changes needed to ensure everyone has autonomy over their health, the pandemic has certainly altered the way providers approach health care. Now, more than ever, there’s an emphasis on public health.