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 those on the front lines at Mount Sinai.
Bernard Camins, MD, MSc
It has been more than two years since COVID-19 was declared a pandemic. Since then we have gained a tremendous amount of knowledge about a respiratory virus to which no one was previously immune.
We have learned that as a society, we must adapt and change our behaviors as more information becomes available. Science, after all, is the pursuit and application of knowledge based on available evidence.
For example, we learned that face coverings did prevent the transmission of SARS-CoV-2. Adherence to mask wearing not only prevented one from becoming infected but was considered an act of kindness by preventing others from being exposed in case a person was infected. We have also learned that even though an effective vaccine became available, viruses can develop mutations spontaneously that would render available vaccines less effective.
As another variant is moving through the country, we must always be vigilant that other variants may be forthcoming. We must never be complacent. We may have to start wearing masks in public spaces again if a new variant comes along that is more virulent than the Omicron variants. We may have to take another dose of the vaccine to keep up with the mutations. But then there is also hope that the worst may be behind us. One thing is certain, the world as we know it, will never be the same again.
Bernard Camins, MD, MSc, Medical Director, Infection Prevention, Mount Sinai Health System
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David Putrino, MD
Although acute COVID-19 numbers have slowed down for the time being, we are still in the midst of a mass-disabling event because of the sheer number of people experiencing Long COVID symptoms.
Throughout the pandemic, Mount Sinai has been at the center of research, advocacy and care for people with Long COVID. Over the coming months and years, it is critical that we strive for the same levels of clinical and research excellence that we have achieved during the first two years of the pandemic.
Investigating novel therapies, exploring mechanisms of underlying pathology, engaging in local and federal advocacy, and maintaining a high standard of interdisciplinary care will all be crucial to ensuring that people with extremely debilitating Long COVID symptoms have the best chance of a full recovery over time.
There are millions of people across the country depending on us to keep fighting, and we will honor that commitment.
David Putrino, PhD, Director of Rehabilitation Innovation
Tracy Breen, MD
What we have learned: it is impossible to overcommunicate.
Over the course of the surge, we were bombarded by an immense amount of new scientific information, clinical guidelines, regulatory requirements, supply chain challenges, and massive life disruptions. The speed at which all these factors changed on a daily, and even hourly basis, meant that we were continually operating in a dynamic and disrupted environment. One of the major takeaways for me was that is it simply impossible to overcommunicate with your teams. And for leaders, true communication involves not only pushing out information and updates but listening to the people who are doing the actual work and incorporating that expertise into your strategy and planning.
Our best moments involved harnessing our front-line teams’ insight and creativity and then rapidly getting them the necessary tools and support to innovate. In an acute crisis, this kind of dynamic exchange is easier to prioritize as other routine demands on leadership’s time and attention get put on hold. The opportunity for leaders going forward is how we incorporate and sustain that critical connection into our daily work; this is essential for us to succeed in the challenging times ahead.
Tracy Breen, MD, Chief Medical Officer, Mount Sinai West
Brendan G. Carr, MD, MS
We’ve been reminded how connected we all are. The lines are forever blurred between our professional roles and our roles as neighbors and family.
We’re all patients, we’re all caregivers, and our actions all impact each other.
It’s an enormous responsibility and an even bigger privilege to live and work alongside regular people quietly doing extraordinary things.
Brendan G. Carr, MD, MS, Professor and Chair, Department of Emergency Medicine
Heather Isola, MPAS, PA-C
The COVID-19 response allowed us to discover that compassionate care is the best of us coming together. When the time came to respond to the city’s and state’s call for help, the Mount Sinai Health System was there. The Physician Assistants (PAs) were the first providers to shift into areas of medicine that were not their own, to care for teams that became sick, and to address the surge of patients entering the hospitals. We learned that our skills, accumulated over time, are transferable and vital to help bring excellence to patient care.
Now, after the response, we know that PAs are integral to our health care ecosystem. It takes a village and optimal team alignment to answer to something bigger than us. Our PAs answered the call, and in doing so, elevated our care in the process. The PAs, along with our physicians, other providers, nurses, and staff have persevered through the unimaginable and have come out the other side as better health care workers and resilient citizens of the Mount Sinai Health System. We have learned, and will continue to learn, that continued teamwork and compassion for our colleagues, families, friends, and patients makes a difference to the health and safety of our community.
Heather Isola, MPAS, PA-C, Vice President PA Services, Mount Sinai Health System
Kristin Oliver, MD, MHS
The tide began to turn on the pandemic with the advent of COVID-19 vaccines, but vaccines work in arms, not in vials. With only 13 percent of people in low-income countries vaccinated, we must focus on global vaccine equity.
In the world of vaccine delivery, the phrase “the last mile” describes the immense effort and ingenuity required to deliver vaccines to people living in the most remote areas of the world. Google it, and you find images of vaccines carried on the backs of donkeys along rocky paths, on small motor boats across jungle rivers, and by foot through otherwise impassable terrain. These logistic challenges are surmountable, but first we must prioritize and appropriately fund global health care infrastructure and support policies to share vaccine technology and expertise with global manufacturers.
There is another “last mile,” one equally present in the United States. It is the mile that seems to separate the doctor recommending the vaccine from the patient who is afraid of side effects, the public health ad campaign from its target audience. This mile will be harder to cross, and the effort will require more than funding. It can only be bridged by trust. I don’t yet have the answers to how we will do this, but I plan to start by listening.
Kristin Oliver, MD, MHS, Associate Professor of Environmental Medicine & Public Health, Pediatrics, Global Health
The COVID-19 pandemic has left a mark on the psychosocial landscape of the Mount Sinai Health System. Our workforce has been devoted to delivering world-class, skillful patient care during unprecedented times, but we also know that this work has come at a cost. Nearly 40 percent of the front-line health care workers that we surveyed in April 2020 experienced symptoms of anxiety, depression, and/or post-traumatic stress disorder; 20 percent continued experiencing these symptoms seven months after; and nearly 30 percent reported experiencing persistent burnout.
Despite these challenges, we have learned that distress and resilience co-exist. In this same survey group, many front-line health care workers reported a greater appreciation of life and emotional growth after pandemic-related trauma. The uptick in mental health resource utilization also speaks to the resilience of staff at Mount Sinai, but we have learned that systems-level support is critical to maintaining a culture of well-being. Our team’s research has demonstrated that health care workers who received strong emotional and leadership support tend to suffer fewer long-term effects of work-related stress. As we emerge from crisis, it is hard to predict what lies ahead, but it is clear that our Mount Sinai community is poised to grow from these challenges to meet future demands.
We in the Office of Well-Being and Resilience look forward to participating and contributing to this psychosocial recovery and growth by supporting well-being, resilience, and mental health initiatives across the system.
The Office of Well-Being and Resilience
What lies ahead: We see a need to continue to support the emotional well-being of our colleagues, teammates, and students through robust multi-tiered and collaborative efforts. Expansion of outreach, resilience-building workshops, leadership engagement, and behavioral health care is essential.
The Mount Sinai Center for Stress, Resilience and Personal Growth