In two wide-ranging articles from the Austin American-Statesman, Austin Regional Clinic doctors and executives joined other area physicians in sharing their thoughts and perspectives on the COVID-19 pandemic; what we've learned, how the pandemic has changed the medical community, and what's next.
Anas Daghestani, MD, ARC CEO, and Amy B. Siegel, MD, ARC Internal Medicine and ARC Clinical Researcher, were among those who offered their thoughts and experiences from the last two years.
How pandemic changed medical community in Central Texas
Two years ago, when the pandemic started, it was tough to find information about COVID-19: how to treat it, how it spread. "We didn't know how deadly it was going to be," said Dr. Daghestani. "We didn't know how long we were going to live in this chaos."
At that time, no one could have imaged this pandemic would have killed more than 955,000 people in the US; almost 85,000 people in Texas, including more than 1,680 people in Travis County, more than 850 in Williamson County, more than 425 in Hays County and about 225 in Bastrop County.
Initially in March 2020, the CDC had developed a test for COVID-19, but it wasn't as accurate as what we have today. To get a test, people had to go through state or local public health departments. Sometimes they wouldn't get their results back for weeks.
Now testing has improved significantly, but even now, during the height of surges, like the recent omicron surge, testing centers like those at Austin Regional Clinic have only been limited by the number of staff hours they can make available and the capacity on the equipment they use.
The importance of portals and telemedicine
Medical portals became more important for sharing information as testing centers were at capacity and didn't have the bandwidth to personally call every patient with their results. Staffing issues, especially during surges, also made it easier to schedule appointments or consult with a nurse via a portal rather than calling a medical office.
"We make the assumption that if we change the process, it's going to be a challenge," Dr. Daghestani said. Relying more on portals, allowing for more online scheduling, conducting visits virtually, all taught him a valuable lesson. "We learned we could pivot and move very quickly and adjust our approach. We could be flexible, nimble, and adaptive."
"In the beginning, we had nothing to offer patients," said Dr. Siegel. "We knew so little." It wasn't until we got past the first surge, Dr. Daghestani said, that they effectively knew when to send someone to the hospital or when they could manage the symptoms at home.
Two years ago, there was mRNA vaccine technology, but not the sequencing and clinical trials to make it work for COVID- 19. "The whole world got behind this work to sequence the virus and then figure out targets to make a vaccine," Dr. Siegel said.
Smaller vaccine trials were happening in spring 2020 just as people were also learning about this disease, followed by larger ones in summer. Austinites were getting enrolled in the trials by August and September. "We got a vaccine coming out at the end of 2020 and the world shut down in March of 2020," Dr. Siegel said. "Nine months. Normally, that's years not months."
Communicating the facts
One of the biggest lessons of COVID- 19 has been a need to improve how the medical community communicates information and how the public is consuming information. Initially, there was not a lot of good information about COVID-19 because it was such a new virus. Dr. Daghestani said of the early communication on COVID-19, "There was a lot of noise. It was very hard to cut through the noise and come up with meaningful information."
COVID-19 also highlighted how often people were no longer relying on their primary care provider for their medical information, Dr. Daghestani added.
The future of the COVID-19 pandemic
So now, we've dealt with two years of COVID-19 in Austin. The question a lot of people are asking, Is it over yet? Not yet, but it is shifting from what we experienced in 2020 and 2021.
Dr. Siegel said that in a year from now we will be in an endemic mode, but "it's not ever going to go away." Siegel added, "I'm optimistic that we might be nearing the end of the pandemic where COVID- 19 is more like an endemic."
The difference between pandemic and endemic is that in a pandemic there is active fighting of an illness all the time and that the illness is winning. An endemic is like the flu, in which we have seasonal spurts, but it doesn't control us.
Waiting for the next variant
Viruses don't stay stagnant. They mutate all the time. Most of the time, they don't become more life-threatening. "We need to assume that there will be different strains and every strain will have its own personality profiles," said Dr. Daghestani.
Coming to terms with COVID-19
"People are saying, 'I'm over it,'" Dr. Siegel said. "They are done. They are frustrated. They want their life back." Everyone has their own comfort levels as well as their own risk factors, Dr. Daghestani added. Some people are ready to shed the masks. Some will continue to wear them. Some are ready to go to a restaurant or a crowded public place; some are still using curbside for all their shopping.
"It's OK to be more optimistic and take precautions, but there's no need to panic anymore," said Dr. Daghestani.
In a final thought, Dr. Siegel said, the virus is looking for a vector to multiply. Humans have to not be that vector. Sending vaccines around the world is the only way to stop the variants and the surges.