COVID-19: What Have We Learned, and What Lies Ahead?
Just over two years ago, the World Health Organization declared COVID-19 to be a pandemic. New York City quickly became the epicenter, and the Mount Sinai community rose to the challenge.
Now, at this moment of cautious hope, a cross-section of the Mount Sinai community—front-line providers, researchers, and leadership—took a moment to consider two questions about the pandemic: What have we learned, and what lies ahead?
Here are thoughts from some of Mount Sinai’s leadership.
David Muller, MD
What have we learned?
Never to take each other for granted;
to say “thank you” and “I love you” as often as possible;
not to underestimate our capacity for rising to a challenge;
that those of us at the margins of society because of the color of our skin or our socioeconomic status always disproportionately bear the brunt of a crisis, and that this is a crime against humanity.
David Muller, MD, Dean for Medical Education and the Marietta and Charles C. Morchand Chair for Medical Education
Dennis S. Charney, MD
An excerpt from Relentless: How a Leading New York City Health System Mobilized to Battle the Greatest Health Crisis of Our Era, by Deborah Schupack:
As it ripped through New York City and, soon enough, across the United States—which throughout 2020 suffered the most deaths in the world—COVID-19 laid bare the challenges, strengths, and weaknesses of the American health care system. From its vantage point in the center of the storm, and with a history of leading at medicine’s progressive edge, Mount Sinai experienced the challenges earlier than most and responded in full force, building on foundations of strength to both respond immediately and begin to shape post-pandemic health care.
Mount Sinai rapidly established several new programs to address needs that the pandemic had uncovered or, more often, elevated–needs that were known, were already being addressed to some degree. But the greatest exogenous shock in more than a century dramatically accelerated several trends already in motion.
“We acted very quickly to understand the disease better, to understand the consequences of the pandemic,” said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System. “We put these findings into place almost immediately. We invested in understanding the effect of the disease on our front-line workers’ mental health, in understanding why people of color were having worse outcomes, in developing a data center to inform diagnosis and treatment, and in systematically monitoring and analyzing the long-term impact of COVID-19. This was not only the right thing to do, we had an obligation to act—not only for us, but for the nation and for the world. We were the epicenter of the epicenter.”
As it was caring for patients and conducting science, Mount Sinai was also aiming to shift the health care system, bending it toward racial equity and social justice, toward honoring health care workers as not just heroes but humans in need of help, and toward a true partnership with the patient, particularly in defining this novel disease, its symptoms and its acute and chronic impact. Mount Sinai was trying to ever shorten the bridge between medicine and science, leveraging big data and amplifying collaborations across all axes, including much valued public-private partnerships. And it was moving flexibly and nimbly at a pace never before traveled in health care, and urging a new focus on cultivating resilience—of systems, spaces, stuff, and staff—to sustain itself and the people it serves in a decidedly uncertain future.
Kelly Cassano, DO
For me, the pandemic has been about the people: the patients, staff, and our colleagues.
All of our relationships, individually and collectively, have been impacted in large and small ways. We have been humbled as individuals, as teams, and as an organization.
For what in moments of time seemed impossible, we endured and overcame many hurdles, together, to deliver the possible.
We are truly Better Together.
Kelly Cassano, DO, Chief Executive Officer Mount Sinai Doctors Faculty Practice
Senior Vice President for Ambulatory Operations, Mount Sinai Health System
Dean for Clinical Affairs, Icahn School of Medicine at Mount Sinai
Gary C. Butts, MD
These last two years have challenged us as a system, as a community, and as individuals in many ways, but in particular regarding equity as a core value. As spotlights have become more focused on the myriad racial injustices and inequities we face, locally and nationally, it has made us question our successes and the impact of our work on our broader Mount Sinai community and the many communities we serve.
It has become clearer that we must recommit and accelerate Diversity, Equity, and Inclusion (DEI) efforts—to establish a DEI learning community; to expand efforts for inclusive recruitment, mentoring, and development; and to enhance our capabilities to address care access and delivery and the disparities in health outcomes, among other important priorities.
We are reminded that racism is an important underpinning and contributor to these ills and that addressing these successfully requires deep, broad, and enduring solutions and authentic commitment and accountability from all of us. Finally we have learned and witnessed the value of family, friends, and community, and the importance of wellness and balance to support our professional work and to sustain ourselves, particularly during times that stretch our reserves.
Gary C. Butts, MD, Executive Vice President for Diversity, Equity, and Inclusion, Mount Sinai Health System
Dean for Diversity Programs, Policy and Community Affairs, Icahn School of Medicine at Mount Sinai
David Reich, MD
What have we learned? We learned that the challenges we faced any particular week of the spring 2020 COVID-19 crisis were often completely different a few days later. Creating ICU and hospital capacity, building laboratory testing capability, developing new clinical protocols, including the world’s first anticoagulation dosing regimen, redeploying staff, and finding enough PPE were the overwhelming clinical and logistical needs at that time.
Perhaps more important, we learned that we could eliminate barriers and silos to leverage the collegial interactions of clinical physicians and nurses with virologists, data scientists, and the vast resources of the world-leading Icahn School of Medicine at Mount Sinai. We brought science into the real-time service of conquering a new disease and saving patient lives. This is the lesson that persists and has enriched our future.
What lies ahead? We see that change is a constant and that we must maintain and strengthen the linkages between our scientists and clinicians to succeed in rapidly changing circumstances. With the likelihood of new variants, vigilance and rapid adaptation by public health officials and health systems require seamless sharing of information.
Vigilance takes the form of closely monitoring laboratory COVID-19 testing, hospitalizations for severe illness, and the impact of less severe illness on maintaining workforces and vital services. Integrating artificial intelligence/machine learning and precision medicine are legacies that will improve our future.
David Reich, MD, President, The Mount Sinai Hospital and Mount Sinai Queens
Marta Filizola, PhD
“What have we learned?” Key elements that will help us better respond to future pandemics, specifically the need for: effective communication strategies, enhanced IT infrastructure/resources/expertise, workplace flexibility for all stakeholders at all career levels, and advocacy to facilitate the mobility of trainees.
Marta Filizola, PhD, Dean, Graduate School of Biomedical Sciences Sharon and Frederick A. Klingenstein-Nathan G. Kase, MD Professor Pharmacological Sciences, Neuroscience, and Artificial Intelligence and Human Health
Michael Leitman, MD, FACS
In Graduate Medical Education, we have learned much from the COVID-19 pandemic:
- Residents and fellows, who are on the front lines of patient care, play a crucial role understanding and treating patients with this disease.
- Physicians learned even more about using current data in strategies to protect themselves from infectious diseases (personal protective equipment, vaccination, strategic isolation, treatment).
- We live in a world without borders. A disease that impacts a corner of the world will eventually affect all of us. We must provide resources to employ prevention and treatment strategies to all people, regardless of where they live and their ability to pay.
- Public health is a precious right. Health care must be available to everyone and not based upon the ability to pay for it.
Michael Leitman, MD, FACS, Dean for Graduate Medical Education
Pam Abner, MPA, CPXP
We learned that we have to think differently and not rely on responses that are tailored for one group—treating people the same.
To be equitable and care for marginalized groups, we have to reach into our communities to include their input and perspectives in order to connect with them and consider their needs and concerns.
COVID-19 was eye-opening; it exposed how we truly needed to use new thinking and approaches to be equitable.
Pam Abner, MPA, CPXP, Vice President and Chief Diversity Operations Officer for Mount Sinai Hospital Groups
Jeremy Boal, MD
The COVID-19 pandemic has transformed our Health System in so many positive ways.
We are more resilient and more adaptable than at any time in our history. We are more trusting of each other.
We are much quicker to dive in and help each other. We are more willing to forgive each other’s mistakes and flaws. We have dropped so much of our baggage so that we can best serve those who need us most.
Jeremy Boal, MD, President, Mount Sinai Beth Israel Executive Vice President and Chief Clinical Officer, Mount Sinai Health System
