The COVID-19 pandemic is catalyst for integrating public health into the health system

By Dennis Archambault

Necessity is the mother of invention. So goes the ancient proverb – one that’s as relevant today as ever. The necessity that has come out of the coronavirus pandemic has compelled us to evaluate virtually every aspect of life, realizing what is important and how to address that importance in a safe, efficient way. The way we work, worship, entertain and live our lives have been radically altered to meet the urgency of the moment.

This moment is not only a health crisis, but a moral crisis for Americans in addressing issues of racial justice, especially as they play out in health equity. A lot has been written and spoken on this topic, and many cases people are getting down to the difficult work of making change.

The New England Journal of Medicine recently published a summary of clinical innovations that have occurred during the pandemic (https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0321?cid=DM97637_Catalyst_registered_users_HMO_HOC_HOO_HOU_HSM_LTC_MSP_OTH_PHC_PHO_PRS_REA_COL_ANC_COR_PTR_AMC&bid=247843774). One innovation – the dramatic increase of telemedicine – has been evidenced first-hand at Authority Health.

The NEJM commentary remarks on how the “public health lens” has become more prominent in the discussion of health care policy and delivery. “Covid-19 is the quintessential example of the way that public health interventions can extend the reach and efficiency of our existing health care system. Months ago, it would have been hard to imagine a situation that could have mobilized millions of Americans to pay avid attention to key epidemiological principles. Yet, phrases like ‘flatten the curve’ and ‘slow the spread,’ are now part of our everyday vocabulary and our children are playing ‘social distancing’ with their dolls. Millions tuned in every night to watch the White House task force (including the infectious disease expert turned cult-hero Anthony Fauci) use slides and pointers to explain the intricacies of hospital capacity, testing algorithms, and risk stratification. Laser-like focus on the allocation of scarce resources has required us to think about the needs of the whole population more than ever before.”

Suddenly, public health has become relevant in the context of health care. So, health disparities, as the public was presented with evidence of how COVID-19 has disparately affected the African American and other minority populations. Population health has never been more relevant.

“It is this population-level lens that will be required to truly transform our health care system. We are seeing this public health influence throughout the system, from sophisticated models that predict the impact of prevention measures to a sharper focus on the allocation of scarce resources like personal protective equipment and ICU beds using robust, new risk stratification and triage processes. We have been forced to think about the needs of the whole population more than ever before and that has drawn attention to these issues and helped us develop the vocabulary to discuss them. It is this population-level lens that will be required to truly transform our health care system.”

There are good things that come out of crises. This may be one of them.

Dennis Archambault is Vice President of Public Affairs for Authority Health.