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2020 Hindsight: 'There are some silver linings'

Editor's note: This is the second of an eight-part series looking back at what lessons can be taken from the tumultuous year of 2020.

In the beginning of the COVID-19 pandemic, few people predicted the virus would strengthen the local health care system.

“When it began, we were all pretty surprised. I recall we were reading about the virus affecting Wuhan, China. We didn’t think in a million years it would reach U.S. shores and impact us to the level it did,” said Dr. Jason Kuhl, chief medical officer for Providence Medford Medical Center.

He said few people were able to predict the virus would cause such widespread effects on health care, the economy and schools.

Scott Kelly, president and chief executive officer for Asante, said health care leaders suspected COVID-19 would be a long-term issue because there was no vaccine and no cure.

“We weren’t thinking of a year, but we knew it would be more than a few weeks,” Kelly said.

In the fall of 2019, before the pandemic hit, a large group of local health care leaders went to Alabama for Federal Emergency Management Agency training on how to set up a command center for a mass casualty event like a mass shooting or disaster, Kuhl said.

That training helped Southern Oregon deal with a year that brought both a pandemic and devastating September wildfires that destroyed thousands of homes. Health care workers were among those whose homes burned to the ground.

When the pandemic hit last spring, Kelly said local health care systems found innovative solutions. Asante, for example, was the first in the state to offer drive-through COVID-19 testing.

“I think we were fairly prepared as a community. I’m not sure as a nation you can be prepared for a pandemic,” Kelly said. “The community showed its adaptability and flexibility. We got on it quickly.”

One of the first problems to hit was a global shortage of personal protective equipment and medical equipment.

“That caught us all on our heels. We saw that play out in shortages of gloves, masks, gowns and ventilators,” Kuhl said.

The community responded with generosity and ingenuity, donating masks and other supplies they had on hand. Jackson County set up a donation drop-off site at The Expo in Central Point and helped distribute the vital supplies.

Local teachers, engineers, doctors, business owners, inventors and others used 3-D printers to make face shields.

Companies like Medford-based BioSkin retooled to make medical gowns and face masks, and crafty residents used their home sewing machines to help fill the face mask gap.

Manufacturing capabilities and supply chains were stronger by the time the second COVID-19 wave hit this fall, Kuhl said.

He said an important lesson from the pandemic is that masks and other personal protective equipment really work. Even though health care workers risk exposure to the virus on the job, when they have gotten infected, it’s usually been through family or community members.

Frequent, thorough hand-washing remains critical to infection control, whether there’s a COVID-19 pandemic or not, Kuhl said.

This year has brought better cooperation among Asante, Providence, Mercy Flights, local fire departments, Jackson County Public Health and other key players, Kuhl said.

“It’s horrible that a pandemic and wildfire had to occur to bring us together in that manner. But I’m looking forward to nurturing those relationships,” he said.

Kelly said health care facilities are communicating better with each other. Hospitals, for example, are working to balance the load of patients among themselves throughout the Rogue Valley.

“What we’ve done in the community will help us with any respiratory-borne illness in the future. We’re better off for having had this. What I’ve seen has been really amazing people working together to help others in Southern Oregon,” Kelly said.

Another lasting change will likely be the expansion of virtual health care visits, also known as telemedicine.

“It gained traction rapidly. There was fear about whether it would work and if we would be able to care for patients. It has worked really well. It could be a new norm,” Kuhl said.

Patients are able to visit with a health care provider from home. They don’t have to deal with transportation or mobility issues, and they don’t risk potential exposure to infectious diseases. Parents don’t have to arrange child care.

“It’s a big time saver. They don’t have to drive and sit in the waiting room,” Kuhl said. “It could be a big part of how we practice health care going forward.”

Kelly said health care systems have been pushing the use of telemedicine for years. But 2020 was the year more providers and patients learned how to do virtual visits and became more comfortable with the technology.

“It’s really accelerated some of the things we’re able to do as a health system,” Kelly said. “Telemedicine will be the wave of the future for sure.”

Of course, virtual visits aren’t appropriate for all kinds of care. But they can work in many scenarios, he said.

“There are some silver linings from COVID,” Kelly said.

Technology played another key role this year in allowing people to work virtually from home. Both Providence and Asante encouraged employees who didn’t need to work in person to instead work from home.

“Working from home has kept us safe,” Kuhl said.

Many employees found that working from home promotes a better work/life balance, Kuhl said, noting he can have a lunch break with his kids when he’s working at home and they’re doing school via the Zoom videoconferencing service.

Kelly said Asante has 1,200 people working remotely.

“We’ve learned how to make sure they have the equipment and tools to work from home,” Kelly said.

Not all of those people will be working virtually after the pandemic fades, but Kelly thinks allowing and encouraging work-from-home arrangements is a good thing.

Some people have said they don’t like working from home because they’re constantly being interrupted. For now, judging how productive workers could be while working at home post-pandemic is a bit of an unknown. Many working parents have also been juggling their kids’ virtual education while in-person schooling has been shut down.

“It makes it harder for sure for some people to find a quiet space to work productively,” Kelly said.

The importance of the Internet this year for both work and school has been unprecedented.

Kuhl said there is a dire need for more equal access to internet service.

“It should be a right everyone has access to rather than a privilege,” he said.

Students who lost their homes to the September wildfires have been especially challenged with remote schooling, but many families don’t have internet or reliable connectivity even in normal times, Kuhl said.

Fortunately, many people who do have access have found ways to manage their lives through the internet.

“We’re able to isolate and keep connected. That’s a strength going forward,” Kuhl said.

When it comes to health care buildings, facilities have been improved to bring in more fresh air and stop potentially virus-contaminated air from circulating into other areas, Kelly said.

Hospitals have recognized a need for more intensive care unit beds and are on a path to build more, he said.

With all the changes in the past year, is the community prepared to deal with another potential outbreak — especially if an extraordinarily dangerous disease like Ebola struck?

“That’s hard to answer. There is no crystal ball,” Kuhl said. “COVID is very virulent, but if we had something even more fatal and deadly, I don’t know how you prepare for something of that nature.”

The Ebola virus — which can cause bleeding, organ failure and death — runs through communities quickly with a high fatality rate. If patients can be quarantined, the spread of the disease can be stopped, Kuhl said.

COVID-19 is harder to contain. The virus has a protracted incubation period and some people have mild or no symptoms. They unwittingly spread the virus as they travel or continue going out into the community, Kuhl said.

Regardless of what type of virus could hit in the future, health care workers and the public now have more experience dealing with a pandemic.

The world also has the experience of developing and starting distribution of new vaccines for a disease previously unknown to humans — all in less than a year.

“That’s something that will be talked about for generations,” Kuhl said.

Kelly said the global cooperation to develop vaccines against COVID-19 is groundbreaking.

“It’s something that wasn’t done before. Companies from all over the world and the best scientists in the world were working together in uncharted territory,” Kelly said. “We really ought to work together as a world.”

Scientists tapped into existing knowledge about different coronaviruses as well as research on RNA, or ribonucleic acid, to fast-track the new vaccines.

RNA’s normal job is to deliver genetic instructions.

COVID-19 vaccines made with synthetic messenger RNA cause some cells in our bodies to make the spiky structures that poke out of COVID-19 viruses. Our immune system recognizes those spiky cells and learns to make antibodies that can deactivate real COVID-19 viruses.

Looking back over 2020 and the challenges that still lie ahead with vaccine distribution and post-fire rebuilding, Kelly said the community has shown its resilience and commitment.

“I’ve seen people caring for the community regardless of the cost,” he said.

Kuhl echoed those sentiments.

“I’m absolutely humbled by the workforce in this community, especially health care workers,” he said. “The resilience, tenacity and compassion they’ve exhibited coming in every day and putting themselves and their families at risk is amazing.”

Kuhl said people are pushing through the pandemic, the COVID-19 surge this fall and winter, the wildfires and their aftermath.

“This community is exceptional,” he said.

Reach Mail Tribune reporter Vickie Aldous at valdous@rosebudmedia.com. Follow her on Twitter @VickieAldous.

Registered nurse Libby Johnson dons personal protective equipment at the Asante Three Rivers Medical Center Emergency Department. Photo courtesy of Asante
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