Reflecting on lessons learned in COVID

On this episode, we hear from Dr. Jim Wright, OMA chief of Economics, Policy and Research on what the association and its members learned from the worst health-care crisis in generations. From the importance of building trusting alliances among stakeholders and government officials to updating a pandemic plan every five years, this experience with COVID will not be forgotten.

Transcript

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Georgia Balogiannis: In this podcast the Ontario Medical Association looks at current issues of interest in health care. Spotlight on Health gives you all the straight talk. We're Ontario's doctors and your health matters to us. I'm Georgia Balogiannis for the Ontario Medical Association. 

Most COVID-19 restrictions have been lifted and there's a general sense that the worst of the pandemic may be behind us. Dr. Jim Wright, chief of economics, policy, and research at the Ontario Medical Association, looks back at lessons learned from the worst health crisis in generations.

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Dr. Jim Wright: COVID-19 has shown its ability to mutate, which means that it continues to circulate. We're done with, likely, the massive waves of infection, with large spikes in hospitalization, and possibly the public health measures such as widespread lockdowns.

And at some point, what is called a pandemic becomes an endemic. So, it shifts from a massive wave to infection to a much more ongoing infection. And of course, we live with colds, and we live with flus — these are endemic diseases. And it certainly appears like COVID-19 is going to become endemic and likely will be with us into the permanent future.

Now, this is barring a major genetic shift like a major mutation, which would take us back to the beginning. That remains always a possibility. The worst part — I believe, I am hoping, I am reasonably confident — is over. But is COVID gone? No. 

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Dr. Wright: The initial response to this infection was a little bit slower than perhaps, based on our experience with SARS — would have thought we were attuned to the risk of a novel infection coming into our society.

The command structure, who's in charge, who's setting up those, making those initial decisions? That seemed to take a longer period of time than probably it should have. The public health system did not have that kind of coordination and perhaps support that it needed to rise to the challenge. And the alignment of all of the various stakeholders. How do we bring all those players together — the physicians, the nurses and the other health care professionals?

In Ontario, in Canada, and unfortunately, I think worldwide, we didn't really recognize the extreme vulnerability of our long-term care sector. And of course, that had horrific consequences to our most vulnerable of our population. There was a lot of confusion about movement, who was going to do what. Unfortunately, that's where much of our mortality came from, and we could have done collectively a much better job.

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Dr. Wright: Physicians bring an enormous breadth of expertise in public health and infectious disease and health system transformation. And I would say that COVID has accelerated the ability to bring that voice into various aspects of the COVID-19 response. Of course, we've got to deal with the aftermath of the backlog in clinical care, we have to deal with the implications of COVID related to long COVID, and the need for probably ongoing vaccination, as well as there are major challenges to the healthcare system which were there in advance of COVID. And they haven't gone away either. While tragic in many ways, it's been an opportunity for us to really contribute to addressing this crisis for the system.

I think we've really demonstrated our role in providing a important, constructive, comprehensive and accurate role in addressing the pandemic. We have Ontario Health, we have the ministry, we have various branches. So, we've shown that we can work with all of those groups, because together we're much more powerful in addressing of healthcare system. 

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Dr. Wright: One of the challenges in a crisis like this is people are flooded with information. They are stressed, they're dealing with their patients, they're dealing with transitioning to virtual care. They're trying to figure this all out at the same time. 

We advocated for really important steps in responding — vaccination of healthcare workers. I don't think there was a single physician on the frontline who succumbed to COVID. We have 34 autonomous public health units. We have a chief medical officer of health, we have Ontario Health, we have the ministries. We were working really hard to bring all of those people together, complementing what the government was doing to say, okay, we're much stronger together, and let's try and not and confuse the system.

So, in the meantime of a crisis, that doesn't mean these other issues go away. So, if there are overall and geographic issues that need to be addressed, urgently — let alone prior to the pandemic, particularly post pandemic — I would say those issues are now front and centre. The challenges of the North and addressing the North, the lack of support for public health, the need to enhance the integration of healthcare systems.

So, these problems have come raging to the forefront, and that gives us a mandate to perhaps tackle the mental health issue. The phrase, "you don't want to lose the value of a crisis," that sounds trite, but it's brought those issues forward in a way that I think we can hopefully really tackle them in a meaningful way. That was started prior pandemic, but now we've made it clear where we really need to take action.

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Dr. Wright: We have the nurses and the pharmacists and all of the players within the healthcare system. So, our ability to work as a partner? It's how we're going to solve what seems like an overwhelming set of problems that were there beforehand. But I am confident, working with everyone, that we can make a substantial impact on the healthcare system and hopefully fundamentally change it in a way that prepares us for the future challenge, of which there will no doubt be many.

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Balogiannis: This podcast is brought to you by the Ontario Medical Association and is edited and produced by Jodi Crawford Productions. To learn more about the Ontario Medical Association, please visit oma.org.

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