Looking back on the early response to the pandemic in the U.S., the first thing that came to mind for Dr. Richard Isaacs was a “striking lack of coordination” at the federal, state and local levels.
The initial lack of guidance left health systems competing with each other to buy masks and other protective equipment.
“There were significant problems across the country,” said Isaacs, CEO and executive director of the Permanente Medical Group, during a panel discussion at South by Southwest. He and other healthcare leaders reflected on the systemic problems that hampered the pandemic response, and hopes of change for the future.
Similar to the PPE problems, testing was also in short supply, with results taking up to 10 days to return when supplies were backlogged over the spring and summer. To solve this, Kaiser Permanente built a testing center in California that could process up to 20,000 tests per day.
Another sticking point was the clear health disparities in which communities were hit hardest by the virus, said Dr. Jennifer Mieres, chief diversity and inclusion officer at Northwell Health, New York’s second-largest health system.
“New York was the epicenter and we got hit really hard about a year ago. What was glaring to us was the disparities,” she said. “We figured quickly as we saw hospitals filling up… we had to create our own playbook, and had to partner with the community.”
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Northwell formed a coalition with faith-based leaders, and started offering testing at churches, education about the virus, masks and other protective equipment. This same taskforce has also been working to help roll out vaccines.
So far, the effort has been effective, Mieres said, when looking at Covid hospitalizations.
“We don’t see a glaring disparity as we see in other parts of the nation,” she said. “Underserved communities were getting hard and furious. The trust wasn’t there but the trust was built when we established this coalition.”
Hopes for future change
One often-cited silver lining of the last year has been the removal of barriers to using telehealth and other technologies. Lisa Suennen, head of Manatt’s digital technology practice and venture fund, said she wasn’t just interested in the rise in telehealth visits, but also at-home diagnostics and hospital-at-home care.
Looking to the future, she and the other panelists hoped some of those regulatory changes would stick.
“I do think we’re going to need to be more thoughtful about what we tolerate from the healthcare system. We did some pretty magical things during this pandemic,” she said. “We were able to speed up drug discovery and creation in a fundamentally interesting and positive way. We have empowered organizations to do care in communities, including retail pharmacies, but also cultural and religious organizations. We need empower them to keep doing that and get paid for the effort and the work that they do.”
Going forward, she and Mieres also hope that the focus the pandemic has cast on health disparities will lead to more substantive change. As more people talk about “getting back to normal,” Suennen worried that the U.S. will revert back to a system that doesn’t work for many people.
“If we could somehow remind people that we are all connected, and all in this together … we could move the needle on a better health system,” Mieres said. “But Lisa is correct in that the pandemic is fatiguing. People want to go back to some normalcy. And I think we need a multipronged approach.”
Photo credit: sorbetto, Getty Images
