COVID-19: What Have We Learned, and What Lies Ahead?

Updated on Aug 20, 2025 | COVID Response, COVID-19, Featured

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

 

 

 

 

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Challenges Ahead: A research story from Miriam Merad, MD, PhD

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 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

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

 

 

 

“Lives reshaped”

Read a personal view from Arthur A. Gianelli, Chief Transformation Officer, Mount Sinai Health System

 

 

Michael Leitman, MD, FACS

In Graduate Medical Education, we have learned much from the COVID-19 pandemic:

  1. Residents and fellows, who are on the front lines of patient care, play a crucial role understanding and treating patients with this disease.
  2. Physicians learned even more about using current data in strategies to protect themselves from infectious diseases (personal protective equipment, vaccination, strategic isolation, treatment).
  3. 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.
  4. 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  

 

 

 

Read more insights from the Front Lines
Read more insights about Research
Lives Reshaped: A leadership story from Arthur Gianelli
We Were Resilient: A response from the front lines by Lucio Barreto, BSN, RN
Challenges Ahead: A research review from Miriam Merad, MD, PhD

Read more stories about Mount Sinai and COVID-19
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Arthur A. Gianelli: COVID-19: What Have We Learned, and What Lies Ahead?

Updated on Jun 30, 2022 | COVID Response, COVID-19

Arthur A. Gianelli

Years from now, when I’m long retired, the word “COVID” will evoke vivid and emotional memories.

Its occurrence disrupted our collective timeline, much as the assassination of President Kennedy did for a generation past. Yet COVID-19 wasn’t a moment frozen forever in time.  It has lingered with us, unwanted and lethal, reminding us always of the fragility of life and that a return to our pre-COVID existence will never be fully possible.

Too much has happened. Too many people have died.   Too many lives have been altered.  Too much water has flowed under this terrible bridge.

I remember a lot.  I recall the early days, when the hospital presidents would meet and review our grim statistics: how many patients died, how many were placed on ventilators, how full were our morgues.   You sometimes forgot—or you had to forget—that there were people behind the numbers.  I have flashbacks to the day we limited many of our inpatient units to serve only COVID-19 patients. We knew so little about the virus that seemed to be lurking everywhere.

We didn’t know its transmissibility or whether our intrepid front-line staff would succumb to its clutches.  I participated in a huddle on one of our COVID-19 units, and I recall just how young the care teams were. “Is this what it feels like to send soldiers into battle,” I thought.  I was scared for them, but so intensely proud at the same time.  I had a job to do.  It was important.  Theirs was important and courageous.

COVID-19 has taught us that our existence is vulnerable and fleeting; that our daily routines are simple but they matter; that masks and social distancing, though essential for a long time, inhibited our longing for interconnectedness; and that those of us who worked on the front lines of care were ordinary people who met the moment with grace, purpose, and humanity.

What lies ahead?  The rest of our lives—lives whose trajectories have been bent but not broken; lives that have been reshaped, repurposed, but not reduced by this disease; lives that, at long last, are moving away from grim statistics and daily uncertainty and pointing instead toward a future of hope and promise.”

Arthur A. Gianelli, Chief Transformation Officer, Mount Sinai Health System
President, Mount Sinai Morningside

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What Is the Latest Omicron Subvariant, and Why Does It Matter?

Mar 23, 2022 | COVID-19, Your Health

Headlines are appearing about a new version of the COVID-19 virus—a new type of the Omicron variant called a subvariant. The original Omicron variant is the one that that caused cases to spike in December and January. It’s too early to tell whether the new subvariant will produce another surge, but a Mount Sinai expert urges you to keep an eye on the situation and pay attention to public health advice.

Public health officials are closely monitoring this subvariant of the Omicron variant, which is called BA.2 and has been cited in reports of increasing infections in Europe. A subvariant means this virus has variations from the first Omicron variant that came through New York City, called BA.1.

“We can never really predict whether what’s happening in Europe will happen to us as well, so the best thing to do is to remain vigilant,” says Bernard Camins, MD, Medical Director for Infection Prevention at the Mount Sinai Health System, who has been tracking COVID-19 since the first cases were identified in New York in March 2020.

The new subvariant, BA.2, is more contagious than the other Omicron subvariant BA.1 and is replacing the latter among the region’s population, according to Dr. Camins.  But what’s most important to know is that existing vaccines still work against this new subvariant of Omicron to limit serious illness and hospitalizations. Antiviral medications are also effective and are now widely available.

Dr. Camins says you should continue to look to public health authorities such as the Centers for Disease Control and Prevention (CDC) and local public health agencies for official guidance on the Omicron subvariant and keep following any existing safety precautions that may apply to you.

For example, while new COVID-19 cases in New York City are rising slightly, they are still at low levels, so the current CDC guidelines for the region have no recommendations for masking in public. Dr. Camins advises that you should be sure to get vaccinated and boosted, and be aware that some people with weakened immune systems are at increased risk of infection so they may feel safer if they prefer to keep wearing masks.

The BA.2 news has prompted some to wonder about getting a fourth dose of the vaccine. On March 29, the U.S. Food and Drug Administration (FDA) authorized a second booster dose of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines for older people and certain immunocompromised individuals. A vaccine has not been authorized for kids under five.

Read more from Mount Sinai experts about COVID-19

SARS-CoV-2: Three Leading Microbiologists Discuss the Path Forward

Mar 8, 2022 | COVID-19, Featured, Research

From left: Florian Krammer, PhD, Adolfo García-Sastre, PhD, and Peter Palese, PhD

Microbiologists at the Icahn School of Medicine at Mount Sinai, who created the first and most reliable test to determine whether an individual has antibodies to SARS-CoV-2, have been monitoring the virus since it began circulating in Wuhan, China, in late 2019.

Now, Peter Palese, PhD, Horace W. Goldsmith Professor and Chair of the Department of Microbiology, and Florian Krammer, PhD, Mount Sinai Professor in Vaccinology— weigh in on the future of SARS-CoV-2 and its place in our lives. They, and their colleague, Adolfo García-Sastre, PhD, the Irene and Dr. Arthur M. Professor of Medicine, recently created a low-cost COVID-19 vaccine that can be manufactured wherever influenza vaccines are made—particularly in low-and-middle-income countries. The scientists are also working on a universal flu vaccine, which would confer immunity without having to be administered annually.

As we move away from this pandemic will SARS-CoV-2 continue to play a large part in our lives?  

Dr. Palese: Clearly the future is difficult to predict, but one likely scenario would be similar to the way we manage influenza viruses, which necessitates continuing vaccinations as we go into the future—perhaps once a year or once every two years. In this case, the virus continually changes but the effects can be ameliorated by vaccines, and those vaccines have to be changed. But they reduce fatality and hospitalization and the need for people to stay home.

Dr. Krammer: In this scenario the virus is not going to disappear. It’s just going to stick around and become the fifth coronavirus that circulates in humans. The other four coronaviruses make up about 30 percent of all common colds, and they’re seasonal; they come in the winter like influenza.

Dr. García-Sastre: Some of these common coronaviruses that cause the common cold have been with us for a long time and are very different from SARS-CoV-2. They are happily living with us, rarely cause any major disease, and do not cause a threat.

Dr. Krammer: Now, influenza typically causes more damage than these common coronaviruses which are typically causing mild infection, except in people who have problems with their immune system who are sometimes brought to the intensive care unit. I think SARS-CoV-2 will land somewhere between influenza and human coronaviruses—between those two extremes.

Is it possible that this virus will simply disappear?

Dr. Palese: You can never exclude the possibility that this virus will peter out the way the coronavirus (SARS-CoV-1) did twenty years ago, when it emerged to cause some really high fatalities but disappeared. On the one hand it was a nightmare, but then it was over.

Dr. Krammer: I don’t think the virus will just disappear, but it might. We didn’t think there would be so many variants this quickly, especially not something like Omicron, so there might be surprises. I hope for society’s sake that this fades into the background and we’re not afraid every fall that another wave is coming. The scenario I would like to see in six months is that Peter and I – as virologists – are concerned about it but that the problem is insignificant enough so that the public does not have to be. We’ll see if that happens.

How do we continue to ensure protection from COVID-19?

Dr. Krammer: We have to look at the baseline immunity that exists in the population. If a lot of people have immunity and there is less virus circulating chances are that you either don’t get infected or, if you get infected, your immunity will be protect you against severe outcomes. Then the disease and infections become less relevant. And that is what we hope for. Now, you can get there through vaccinations—that’s the painless way, or you can get there by having had the infections, and that’s the painful way. But both contribute to having higher baseline immunity in the population. Unfortunately, even in this scenario, immunocompromised patients are still at risk of severe outcomes although there risk of getting infected is lower.

Dr. García-Sastre: Vaccinations are still the solution to the problem. We should make sure that as many people as possible are vaccinated and boosted.

Dr. Krammer: I think we need to keep working on vaccines against SARS-CoV-2. Right now we have this situation where the vaccine protects very well against severe disease if you’re not immune compromised. But those vaccines are not protecting very well from infection anymore. They did against the original virus, but not with the variants. That’s why, for example, we need a variant-specific vaccine for Omicron. There are ways to make vaccines differently so you get more sterilizing immunity, which would suppress infections more, in general, and that would make the world safer for those who don’t mount good immune responses.

Dr. Palese: In creating our COVID-19 vaccine at Mount Sinai, we are using the Newcastle-disease virus in a vector-driven approach. If the FDA [U.S. Food and Drug Administration] is agreeable and allows the comprehensive use of genetically modified viruses, such as ours, then we can prevent the emergence of these new variants by vaccinating right away with the correct vaccine against the new variant, and we should be in good shape.

Do you think the public needs a fourth vaccine right now?

Dr. Krammer: For populations that don’t mount optimal responses or their responses disappear quickly, there might be an advantage in getting another dose. But for the general population, I don’t think this is useful right now. If there is a fourth dose, it should be variant-specific, an adapted vaccine that reflects what’s circulating right now.

For immunocompromised individuals, there are already a couple of important therapeutic treatments—including PAXLOVID from Pfizer Inc., operating under the FDA’s emergency use authorization—that can help them to greatly reduce their risk of a severe outcome.

Is it feasible to create a universal coronavirus vaccine—similar to the universal influenza vaccine you are developing?

Dr. Krammer: By universal you mean a variant-proof SARS-CoV-2 vaccine, I assume? One that would protect against all variants? We’ve made a lot of progress with the universal influenza vaccine in the last few years. But vaccine development has just started for coronaviruses and there are a lot of approaches out there. Coronaviruses are very diverse. A truly universal coronavirus vaccine would include protection against SARS-CoV-1 and other viruses in that subgenus and then you have a bigger genus of betacoronaviruses and, in addition, you have alpha-, delta-, and gammacoronaviruses (meant are the coronavirus genera, not the SARS-CoV-2 variants). So developing a universal coronavirus vaccine that would protect against all of them is a very big ask. It might be possible at some point, but it is small steps now and would take a lot of time. Of course, something that protects against variants that are around now or could be developed within the next five years, that’s actually possible.

Read more from Mount Sinai experts on COVID-19

As COVID-19 Cases Fall, Here Are Four Things to Keep in Mind About Masking and Safety

Mar 2, 2022 | COVID-19, Featured, Your Health

The CDC has assigned a “community level” of COVID-19 risk for each county in the United States, based on factors like total COVID-19 cases and hospital admissions. Right now the level is “low” in most of the New York City area.

The number of COVID-19 cases in New York is returning to the levels before the Omicron surge that began in December, and the Centers for Disease Control and Prevention has announced new guidance on masking.

We are heading in the right direction, and “there is reason for guarded optimism,” says Bernard Camins, MD, Medical Director for Infection Prevention at the Mount Sinai Health System, who has been tracking COVID-19 since the first cases were identified in New York in March 2020.

As the pandemic in New York approaches the two-year mark, here are four things to keep in mind:

  • Masks are still required in hospitals and health care facilities and on public transportation. N95 and KN95-type masks give you the most protection, followed by surgical masks, with cloth masks offering the least. We recommend you wear the best type of mask you are comfortable wearing that covers your mouth and nose.
  • The CDC has now assigned a “community level” of COVID-19 risk for each county in the United States, based on factors like total COVID-19 cases and hospital admissions. Right now the level is “low” in most of the New York City area. That means masks are not required in most places, but you can choose to mask at any time. If you have symptoms and a positive test you should isolate and stay home for at least six days and wear a mask when around others until you have recovered. If you have been exposed to someone with COVID-19, you should wear a mask around others until you are certain you have not been infected.  You can check your county’s “community level” on the CDC website.
  • Getting vaccinated and a booster shot is still recommended and is the best way to protect you and your family against the disease. Boosters are recommended even if you have already had COVID-19.
  • There are still many people who are at higher risk of infection: older adults, people with weakened immune systems (such as those who have been receiving active cancer treatment for tumors or cancers of the blood), and kids under five, as vaccines have not yet been authorized for young children.

One final note: Mount Sinai is committed to providing you with the COVID-19 information you need to keep yourself and your family safe and healthy. You can always find the latest updates from public health authorities and on our website.

Get more information from Mount Sinai about COVID-19
Read more from Mount Sinai experts on COVID-19

When Omicron Struck, Mount Sinai’s Students Signed Up to Help

Updated on Jun 30, 2022 | COVID-19, Featured, School

Arman Azad and Aliza Gross

Several days after Christmas, second-year medical student Arman Azad met with top administrators at the Icahn School of Medicine at Mount Sinai to plan how he and fellow students could help the Mount Sinai Health System handle the crush of COVID-19 patients falling sick from the Omicron variant.

As co-leader of the Student WorkForce at Icahn Mount Sinai, Mr. Azad says his job involved “helping the Health System deal with the most severe bottlenecks, as cases rose and staff were in isolation, and then organizing students to address those needs.” He and his co-leaders worked closely with their deans to mobilize students for appropriate roles, ensuring they had the training and protective equipment needed to stay safe.

During this latest COVID-19 surge, 198 medical, PhD, and master’s students at Icahn Mount Sinai have logged roughly 5,000 hours performing various tasks. They have worked in the Emergency Departments at six of the Health System’s eight hospitals and have also helped run asymptomatic testing programs for staff in those locations. Students have assisted in the pop-up testing sites in the student resident hall. And at The Mount Sinai Hospital, which shares a campus with the school, they have delivered meals to inpatients and assisted in the urgent care center.

Their efforts represent the fourth wave of student involvement since Mount Sinai’s Student WorkForce was created in March 2020, at the start of the pandemic. Since then, the WorkForce has ebbed and flowed to meet the needs of Mount Sinai’s hospitals. Unlike in earlier waves, the students recently received an hourly wage for their work. Along the way, they have also honed their WorkForce model, sharing it with other schools and health systems throughout the country. Students published a paper about their contributions in June 2021 in Academic Medicine.

In addition to assisting staff, WorkForce members say the most gratifying aspect of their jobs is helping the patients who need Mount Sinai most. Many of Mount Sinai’s hospitals serve communities in New York City that have been disproportionately affected by the pandemic.

On New Year’s Eve, Mr. Azad worked in The Mount Sinai Hospital’s Emergency Department into the early morning hours, taking patients’ blood pressure and other vitals.

Calista Dominy and Brett Weingart

“It was a busy night and an opportunity to learn from experienced providers and offer relief to staff where I could,” he says. “The pandemic has brought to light many of the inequities in medicine, and Omicron only amplified that. For people who can’t access consistent primary care, the emergency room serves a critical role, one that was threatened by staffing shortages as COVID cases surged. I’m proud of my fellow students who did their small part to ensure the Hospital could continue providing care to those who needed it most.”

Shortly after recovering from COVID-19 herself, Calista Dominy—also in her second year of medical school—assisted in The Mount Sinai Hospital’s Emergency Department on New Year’s Eve, as well. Ms. Dominy says one of the things she loves most about Icahn Mount Sinai is its strong commitment to social justice and student advocacy.

“Working New Year’s in the emergency room is an experience I will never forget,” she says. “The Omicron surge brought many more patients through the doors on a night that is typically notoriously busy.”

Workforce member Jesse F. Mangold, who is a dual MD-PhD student with a specialty in microbiology, chose to deliver meals to The Mount Sinai Hospital’s COVID-19-positive inpatients.

Jesse F. Mangold

“Meal delivery may not be the first role that comes to mind when you think of a first responder, but it means a lot to patients who have reduced contact and need nutrition for recovery,” Mr. Mangold says. “There was this tremendous bottleneck because you couldn’t just enter their rooms with a tray. All of the safety precautions needed to be implemented. My task served two needs—to feed our patients and relieve our already taxed nursing staff.” Before he was able to enter a patient’s room, Mr. Mangold had to properly don his personal protective equipment and then properly doff it immediately after leaving.

In the Hospital’s kitchen, located in the building’s basement and through a labyrinth of hallways, Mr. Mangold worked alongside a staff member who was seven months pregnant. “She was putting the Hospital and its patients first and taking personal risks to bring meals to patients,” he says. “Every team member is essential. She is a health care hero.”

Second-year medical student Claire Ufongene helped Mount Sinai conduct asymptomatic testing of employees. “The asymptomatic testing program allows employees to regularly monitor their health and return to the hospital safely,” she says. “It’s been wonderful to work with members of the Mount Sinai community, including students and employees. I’ve been happy to contribute in a small way to facilitate a testing process that’s easy and accessible.”

Claire Ufongene

Early last year, medical student Aliza Gross became involved in addressing vaccine hesitancy and helping patients obtain COVID-19 vaccine appointments through the internet and their Mount Sinai MyChart apps. At Mount Sinai Morningside, on the Upper West Side of Manhattan, she recently helped counsel patients entering the Emergency Department about the benefits of receiving a vaccine.

“It was very meaningful to have patient contact after spending so much of our medical school career remote,” she says. During the most recent spike, Ms. Gross took on the role of Student WorkForce co-leader and started taking shifts in the Mount Sinai Health System’s Express Care center—an urgent care facility—helping administer COVID-19 testing to sick patients. “It was gratifying to help our staff where they were experiencing the biggest backlogs,” she says.

Now that the worst of the Omicron wave seems to be receding, Mr. Azad says students remain ready to respond to future COVID-19 surges. “One lesson from the pandemic is that all of us, no matter our training or background, can in some way help protect our Health System and those we care for,” he says.

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