'This was our moonshot': Science leads way, readies for what's next
Mar. 14—A year ago, the disease didn't even have a name.
Cases of a novel (new) coronavirus, the same family of viruses that causes the common cold, were first reported in Wuhan, China, at the very end of 2019. By the following March, the illness that would become known as COVID-19 was seeding the worst global pandemic in more than a century.
The response of the worldwide scientific community, like the illness itself, was unprecedented. New testing technologies, treatments and vaccines had to be developed, tested and distributed.
"This was our moonshot," says Dr. Michael Calderwood, an infectious disease specialist who is the chief quality officer at Dartmouth-Hitchcock Medical Center. "This was all hands on deck: We need this and we need it quick."
It worked. Millions of Americans already have been inoculated with one of three approved COVID-19 vaccines, and other vaccines are on the way. It's what President Joe Biden called "a true miracle of science" in his address to the nation Thursday evening.
Huge medical advances have come out of the crisis, said Dr. Benjamin Chan, New Hampshire's state epidemiologist and part of the public health team that has steered the pandemic response here. "Probably the most striking is our collective ability to develop and roll out vaccines in such a rapid timeframe," he said.
More than 300,000 Granite Staters have gotten at least one dose of COVID-19 vaccine. "We've made pretty impressive efforts to get the vaccine out there, which I think many see as the way that we're going to ultimately control this virus and get back to normal life," Chan said last week.
The response to COVID-19 has been a massive undertaking. Public health experts worked closely with hospitals, nursing homes, schools and businesses to create safety protocols and guidelines early on as much of the economy shut down and now again as it begins to reopen.
Brave volunteers came forward to participate in vaccine trials, and later others stepped up to help with vaccination clinics.
As vaccines were approved, companies that are normally fierce competitors agreed to work together to produce as many doses as possible.
The state and nation had faced threats from new pathogens before: Ebola and Zika, MERS and SARS, the H1N1 influenza pandemic. What was different about COVID-19, Chan said, "is how it spreads and the fact that it created a worldwide pandemic.
"It's a difference of scale and magnitude of response."
No corners were cut during the vaccine trials, Chan stressed. Rather, he said, "We're seeing new vaccine technologies being used that have helped to speed up the process of rolling out the vaccine."
Scientific study has continued, said Calderwood, who expects vaccine manufacturers will produce boosters that will be effective against new variants of the coronavirus.
"This is an ongoing effort and I think that is a huge win," he said.
Telemedicine
There were other breakthroughs.
The crisis that forced schools and businesses to adopt new, virtual approaches also pushed the health care system to finally and fully embrace telemedicine.
And that, Calderwood said, "has provided access to a lot of people who had difficulty getting into a health care facility, whether because of mobility or transportation issues or just distance."
It wasn't only our physical health that was threatened by the pandemic. Stress, isolation and fear mounted as the months wore on.
Ken Norton, executive director of the National Alliance for Mental Illness in New Hampshire, said the pandemic has brought a renewed focus on mental health.
Funding for services was included in the relief bills Congress has passed, and in his recent budget address, Gov. Chris Sununu talked about efforts to address the state's mental health crisis, which he said has been exacerbated by the pandemic.
Again, telemedicine has played a key role in helping people cope. Clinical appointments, therapy sessions, 12-step groups and even yoga are now accessible online, and health experts think that will continue even after we can gather safely in person again.
With more people working and learning from home, Norton said, cancellation rates for psychiatric appointments have gone way down over the past year, as the availability of remote services has erased some barriers to care, such as transportation, child care and work conflicts.
Some of the support groups and educational programs NAMI offers now draw attendees from a broader geographic area because they're offered online, Norton said. Professional conferences that used to require travel and time away from work and family are now streamed remotely, an option he expects will continue even after it's safe to gather in person.
"We're not going back," Norton said.
Still, remote care has its limits.
Even as telemedicine has helped connect people to services, Chan said, "At the same time I think we're also learning collectively as a society about the importance of social interaction and not conducting everything through electronic applications.
"So I think there's a balance to be found there."
It's not over
When history looks back at this past year, DHMC's Calderwood said, "The story of this rapid development, where you had multiple phases of trials going on at the same time, will be a real success."
But it's too soon to declare victory, he said.
In today's global economy, he said, "Disease anywhere is disease everywhere."
COVID-19 is not going to go away just because Americans are getting vaccinated, he said. "It doesn't stop at the U.S. border. We need to vaccinate everyone so that we're all safe."
The rise of another global health threat is likely, Calderwood said.
"We like to think of this as a once-in-100-years event," he said. "But there are some who are saying we're going to have something like this every 10 years.
"I'd like to think it's somewhere in between those two. We'll have to see."
Public health experts say the medical advances made in response to COVID-19, including new vaccines, tests and treatments, will serve us well when the next public health threat emerges.
Calderwood said he hopes what the nation has been through for the past year will lead policymakers to invest more resources in a public health system that has been "massively underfunded" for years.
"That's what we really need to do to learn from this, to say public health is critical not just when an emergency comes along, but it is critical for our everyday lives, as well as our preparedness as we think about whatever is going to come down the pike in the years ahead," he said.
NAMI's Norton wonders how history will tell the story of who we were during this time of pandemic. "Will we look back on it as an era of resilience and strength? That it was an incredibly difficult period of time but we got through it?Albeit a half a million of us didn't."
He thinks about the mental health implications for those families — 1,199 in New Hampshire alone — who have lost loved ones to COVID-19 and who "weren't able to have funerals and memorial services and grieving."
And he worries about the "missing children" — students who could not adjust to remote learning and who may now face lasting consequences from delayed learning and social isolation.
But Norton also has seen many people gain a sense of perspective after the ordeal of the past year: "Being grateful for the things that we do have, and how we think about life, and what's important to us."
Calderwood agreed that some social benefits may come with time and distance from the crisis.
"I think that we were at a point where everything was 'go, go, go' and as people have looked at the past year, they said, 'Well, you know what, maybe I didn't always need to be running around so much, and maybe some of these newer technologies will allow me ... to spend time with the ones who are most important to us,'" he said.
"And I think that we don't want to be forever stuck in, as some termed it, 'Covidlandia,' but there is this sense of taking stock of what is important."
One thing state epidemiologist Chan hopes will continue after the pandemic ends is our heightened sense of collective responsibility for protecting others, particularly our most vulnerable neighbors.
"That's the ultimate goal of public health," he said.
