The coronavirus pandemic has dramatically altered the way we think about public health in the United States and how we deliver patient care, says Assoc. Prof. Emily Landon, a leading University of Chicago infectious disease expert.
In this episode of “COVID 2025: Our World in the Next 5 Years,” Landon discusses building a robust frontline defense against future outbreaks through a dedicated corps of epidemiologists that would respond to future outbreaks by using contact tracing on smartphones. She also argues that hospitals should rethink how they use Personal Protective Equipment (PPE) while building upon technology such as telemedicine to protect and empower medical personnel.
While we have learned a lot from this pandemic, Landon suggests larger shifts in public health are needed to better protect the population against future outbreaks. She argues that we must trust our public health experts, comply with health regulations, and build a more equitable health care system that benefits everyone in order to combat COVID-19 as well as address future epidemics.
EMILY LANDON: I’m really worried that five years after this pandemic people are going to be like, “Well, that’s over, and we’re probably not going to have one for another 100 years.” This is not a once-in-a-lifetime kind of thing.
ANNOUNCER: The coronavirus is changing life as we know it on a daily basis. In COVID 2025, we’ll explore how the pandemic is rewriting our future.
EMILY LANDON: I think it’s really important for us to understand that these sorts of diseases—zoonoses—as we’ll call them, or things that come from animals that can be transmitted to humans, are actually increasing in prevalence as we have climate change, and as more and more humans populate the Earth and move into these parts of the planet that we didn’t live in before. That’s where you can get some viruses or diseases to jump from animals into humans, and then cause more disease. It’s not like every single time you hang out in a cave with some bats, you’re going to pick up a new disease, but certainly some of these are going to turn into more illnesses.
It would be great if we had people who were part of some sort of reserve epidemiologist corps that could help be there in a bad situation, get things under control by doing this contact tracing, contacting everybody and making sure that the earliest cases were contained. Being able to be devoted to and have the kind of public health system that can really do the things that we need it to do early on, and then respecting them that when they say: “We got to do this now,” that we’re all going to be all in and do it together. Even if it’s hard, we’re not going to wait for things to look like they did in Italy or even in New York City.
Some of these apps that they’re using in some of the Asian countries, and Singapore, and South Korea, specifically are really cool. When someone gets a test result that’s positive, they can enter it into their phone. And then all the other people that were in a risk zone with them during their contagious period would be notified that they’ve been exposed. This is kind of like electronic contact tracing—there are a lot of concerns about privacy with them. And we don’t have a nationalized health care system, so there’s no national health data registry where test results could be downloaded from. So there’s a lot of barriers to implementing some kind of technology like that, but these are not barriers that we can’t overcome.
One of the things we need to work on is better technology for our PPE. So PPE stands for Personal Protective Equipment, and you’ve heard a lot about it in the news—about how we don’t have enough of it. And we really don’t, because in a respiratory virus pandemic, or really any transmissible disease, requires us to where a lot of different Personal Protective Equipment. Truth is that reusing these items as a lot of people have been doing, because they haven’t had enough of them, is not a great solution. I would really like to see us go back to using cloth gowns, like we used to use way back when. I also think it would be great if we could come up with a way to have fabric masks that can be reused, as opposed to needing to have millions and millions of N95s and surgical masks produced en masse in order to meet the need of an epidemic. If we had masks that were made with fabric and could be laundered and reused, that would be a really big improvement in health care. A way to make things reusable, but also sustainable.
We’ve changed literally everything about what we do and how we do it at the hospital. I mean, my job is completely different than it used to be: Not in terms of the content or in terms of the work that I do, but in terms of how I do it. Most of the consultations from experts and specialists like me are done via video conference now. And by calling patients on their phone, I think the video visit and the incorporation of
technology into medical care is huge. And it’s going to be with us forever going forward, and it got a real jumpstart from this pandemic.
What would be the worst-case scenario? If we decided that the real lesson that we were supposed to learn here was that we didn’t really need to do any of that stay-at-home stuff because nothing bad happened anyway. And the CDC, we didn’t need all those tests, we didn’t need all those instructions, and contact tracing. We got along fine without it, so let’s just, you know, defund these things and not spend so much time on them, then we’ll be even less prepared when there’s a problem again in the future.
One of the things that’s been really striking to me about this pandemic is how important it is that we trust science. I mean, this is a virus; it’s not a Republican or a Democrat. And as much as you want to fight with it or negotiate with it, it’s biology. It is going to follow the laws of science and the laws of transmission, and so we all have to work together to trust experts in these areas.
Best-case scenario, we’re able to transform our health care system into something that meets the needs of everyone. That we’re able to find a way to reduce costs and still provide access to everyone. That we commit to making sure that everyone—everyone—can get the care that they need, anytime they need it in the United States. That we have a public health system that we trust, and we respect. We beef up the CDC and our local public health departments and our state public health departments and treat them like the heroes that they are. And when they say something is a problem, that we jump into action.