6 Ongoing Challenges with COVID-19

Unit Authored by:

  • Jenette Allen-McCombs, PhD, LMSW. Assistant Professor, Department of Social Work, York College – City University of New York.

  • Sharon Beaumont-Bowman, SLP.D. Graduate Program Director, Department of Communication, Arts, Sciences and Disorders, Brooklyn College.

  • Michael Bergen, AuD, CCC-A. Director, Speech Language and Hearing Center, Brooklyn College and CUNY Doctoral Audiology Program, Founding Faculty Member.

  • Clarence Chan, PT, DPT. Director and Professor, Physical Therapist Assistant Program, LaGuardia Community College – City University of New York.

Goals:

  • To identify ongoing challenges of the COVID-19 pandemic.

  • To provide evidence of the personal experiences of individuals affected by COVID-19.

  • To suggest personal, health and social lessons learned through COVID-19.

 

I. Introduction

Individuals with COVID-19 may be asymptomatic, severely sick and/or die. These varied experiences of the disease affect not only individuals, but the family and community as well.

The patient stories presented below provide some evidence of the significant effect of COVID-19 on human lives. COVID-19 also presents many challenges to the public health system in the United States. From the initial crisis to the present day, there is confusion about guidelines for mask-use, testing, care, and treatment. This is confounded by the misinformation and disinformation that proliferates through social media. Ultimately, the public’s confidence in science, the government and the health care system are affected. Indeed, some health communication experts state that there is parallel pandemic of COVID and misinformation/disinformation. These and other ongoing economic, social and health challenges illuminate the inequity and injustice that exists in our society, but was long present before the emergence of COVID-19. Clearly, there are lessons to be learned from the pandemic and it is hoped that COVID-19 will provide an opportunity for individuals and society to move toward a more just, cohesive, and healthier existence.

 

II. COVID-19 – Through Patients’ Eyes

Johns Hopkins Medicine collected patient stories that captured individuals’ experiences during COVID. NBC News published a collection of illustrated narratives titled “COVID Chronicles.” It describes the COVID-19 challenges through the lens of the patients and the health care professionals that were caring for them.

CUNY students’ experiences associated with COVID-19

Brooklyn College collected a series of “Autoethnographies of a Pandemic from Brooklyn’s Epicenter” with personal accounts of COVID experiences among Black communities, immigrant communities, poor Americans, and undocumented individuals. These autoethnographies, written by students are available through the Brooklyn College COVID-19 archive. This project was also associated with the collections from the Brooklyn COVID project, a collaboration between the Brooklyn Historical Society and Brooklyn Public Library.

A LaGuardia Community College student  examined the pandemic with a study on how the case rate and death rate from her neighborhood in Jackson Heights differed from the borough of Queens and Manhattan. It was an illustration of the impact of socioeconomic disparities on health outcomes.

Ting Man Tsao, a professor at LaGuardia Community College, captures his and his students’ experiences during the pandemic and movingly describes the students as “wounded storytellers.

Accounts by long-haul COVID patients

To tell the story of being a long-hauler, a physician from Massachusetts General Hospital in Boston described her experience as a patient living through COVID and the post-illness trauma. Further discussion of being a long-haul patient is presented in 5 Women Share Their Stories About Being A COVID-19 ‘Long-Hauler.

These personal journeys illuminate how we all suffered and triumphed during the COVID. Of course, it was especially difficult for those who are less privileged and with fewer economic and social resources.

 

III. Public Health Challenges: Changing Policies and Guidelines in the Healthcare System and the Impact of Disinformation

COVID-19 challenged the health care delivery system worldwide. In the US, where the health care system is intrinsically linked to employment, a pandemic of this magnitude illustrated the social inequities among communities at different working environments and socioeconomic levels. This inequity, along with the inadequacy of the government policies in responding to the pandemic underscored the importance of the need for a genuine and meaningful reform of the health care system. This article outlines how we may consider the Healthcare Reform in a Post-Pandemic World – CUNY Academic Commons

The development, management, and deployment of vaccination against COVID-19 are among the most significant issues that challenged the public health system in the United States. Vaccine development was a huge success on the scientific front. However, vaccine management and deployment underscored the fragmentation and questionable decision-making by the government in the early days of the pandemic. There was considerable confusion and hesitancy. For example, how to achieve “herd immunity” through vaccination was defined differently by health care experts and the federal government. Agencies and organizations’ decisions to manage vaccine distribution and work requirements were often inconsistent with the guidelines provided by health officials.  The paper “Vaccinating Urban Populations in Response to COVID-19: Legal Challenges and Options” explores legal and policy perspectives on this massive undertaking during the emergency period.

Misinformation and disinformation also frustrated the public. The World Health Organization (WHO) referred to the prevalence of misinformation/disinformation during the COVID pandemic as a “massive infodemic” Together with the United Nation and numerous international agencies, they called on nations around the world to implement action plans to counteract the harmful impact of disinformation and to prevent its spread. In an effort to counter the “disinfodemic,” UNESCO published two policy briefs. Part I- Disinfodemic: Deciphering COVID-19 disinformation, defined and differentiated the terms misinformation and disinformation. This first volume aimed to disempower the spread of harmful and incorrect information. Part II- Disinfodemic: Dissecting responses to COVID-19 disinformation, examined the emerging responses to the proliferation of misinformation and identified key challenges and opportunities in responding to the production, distribution, and retention of COVID-19 disinformation.

 

IV. Ongoing Effects of Inequality on Mental Health Following the COVID-19 Pandemic

The COVID-19 pandemic has had adverse effects on many people’s mental and physical health. Anxiety, Uncertainty, and Resilience During the Pandemic Period – Anthropological and Psychological Perspectives explores research, theories, biopsychosocial perspectives, and intercultural studies about the pandemic with the ultimate goal to promote better quality of life, resilience, and psychological well being of the general population during this period.

Burnout and Post=traumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions discusses the relationship between acute stress disorder, post-traumatic stress disorder, and burnout through a literature review focusing on the mental health impact on health care providers after prior epidemics and natural disasters.

Since the outbreak of COVID-19, emerging data suggests that all types of violence against women and girls, particularly domestic violence, has intensified. This video on the shadow pandemic of domestic violence during COVID-19 illuminates the increase in intimate partner violence during the 2020 lockdowns and the adverse effects on physical and mental health for women worldwide.

There have been a greater number of caregivers lost to COVID-19 in BIPOC communities. Researchers recently found that Black children are disproportionately affected. The article Estimates and Projections of COVID-19 and Parental Death in the US explores the scale of COVID 19 mortality and the effects on bereaved marginalized children.

 

V. Health Equity and COVID: The Twin Pandemics – Racial Injustice and COVID

The health inequities experienced by immigrants, refugees, and racial/ethnic minorities have been aggravated during the COVID-19 pandemic. These vulnerable populations were at increased risk of contracting COVID-19 and experiencing significant morbidity and mortality. Clearly, the ongoing burden of the COVID-19 pandemic is disproportionally higher among these groups.

The utility of syndemic theory is that it directs attention to possible interactions not only between diseases (at the individual level) but also between epidemics (at the population level), taking social context and political-economic inequities into account. Systemic racism, chronic health inequities, and COVID‐19: A syndemic in the making? explores pandemic related health inequities through the lens of syndemic theory.

COVID-19: A syndemic requiring an integrated approach for marginalized populations illuminates how the health inequities experienced by immigrants, refugees, and racial/ethnic minorities have been exacerbated during the COVID-19 pandemic.

COVID-19 has killed 1 out of every 800 African Americans. One study found that Black people ages 35 to 44 were dying at nine times the rate of white people the same age. It is discussed in How COVID-19 Hollowed Out a Generation of Young Black Men.

 

VI. Lessons Learned: Optimism and Future Trends

While the COVID-19 pandemic is gradually and slowly moving toward a more manageable level, public health experts around the world agree that it is unlikely to see this global event disappearing in the foreseeable future. As a community, the public has gotten more knowledgeable and more familiar with many of the public health recommendations, which are important steps for a community “to prepare for the next outbreak.”

Perhaps one positive outcome of the pandemic is that we learned how rapidly we can develop, mass produce, and distribute vaccines.  Medical breakthroughs such as mRNA development may have the potential to make COVID-19 the last pandemic. Its potential applications toward the management of many other pathologies will likely be beneficial worldwide. The challenge remains however, to communicate the safety and efficacy of the vaccines to a large proportion of the population who remain skeptical of these advances.

COVID-19 also suggested how we may better balance and integrate work into our lives. As a society, there are also lessons such as “5 Minutes on Why COVID-19 is An Opportunity” where individuals and organizations, in public and private sectors, can learn to reinvent practices that will accommodate and help more people succeed.

Throughout the pandemic, many wondered when and how we can return to the pre-COVID way of life. After more than two years into the crisis, questions about the balance of public health concerns and economic well-being remain. McKinsey & Company recently outlined Ten lessons from the first two years of COVID-19 to share some ideas of how a society may reemerge from the pandemic and regain a level of normalcy going forward. Some experts suggested COVID-19 provides an opportunity for government and businesses to reexamine their practices and learn how to do capitalism differently. These are important considerations toward building a more equitable community.

COVID-19 is and will likely remain an ongoing challenge globally. Every community in the world has suffered from the devastating impact of this pandemic. We also bear witness to the human potential for social good. Collectively, the many hard lessons learned should inform nations, communities, and individuals on how to move forward and emerge as a more caring and compassionate society.

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CUNY Teaching Resources on COVID-19 Copyright © 2022 by Jenette Allen-McCombs; Diane Banks; Sharon Beaumont-Bowman; Michael Bergen; Clarence Chan; Lesley Green-Rennis; Michele G. Greene; Nicole Kras; Jan Oosting; Fabienne Snowden; Grace Tursi-Wenzler; and Kathleen Karsten, PhD, RN is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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