Reflections on Two Years of COVID-19

The unwelcome intrusion of COVID-19 has been part of our lives for more than two years, the disruptions forcing us to rethink and revise our routines in countless ways. We all have certain moments—the day we were told to work remotely, the results of a COVID test, the return to in-person classes—that flood us with memories and emotions. We asked College of Public Health students, faculty, and alumni to reflect on the past two years of living and working through the unpredictable twists and turns of the pandemic. Here’s a sample of their experiences and lessons learned.

AS A STUDENT, WHAT HAVE BEEN SOME OF THE BIGGEST CHALLENGES OF THE PANDEMIC? HAVE THERE BEEN ANY SILVER LININGS?

In addition to the trials faced by the general population (i.e. loneliness, confusion, a heated political climate), there are a few challenges that students have faced in particular. I am a strong believer that college isn’t simply about coursework— extracurriculars, connections formed, and other experiences shape students immensely, and these learning opportunities just aren’t the same in a virtual format.

For example, I was slated to intern at a research lab in Florida during the summer of 2020 to gain valuable genetic laboratory experience, but due to the COVID-19 shutdown, I pursued a virtual internship locally. I am fortunate that I made the connection with a research lab (which I continue to work in), but I know many other students who were not able to gain experiences that could have guided their career choices.

A silver lining, however, is how we were all going through this together. Faculty, administrators, and other students were more accommodating than ever for people with health issues and unstable employment/living conditions, and mental health recognition has been on the rise. This disruption on a global scale is something everyone has in common, and although it showed how our society needs to be improved, it also displayed how supportive we are already in the face of adversity.

-- Radha Velamuri, BS/MPH undergraduate-to-graduate student

WHAT HAS GONE WELL—AND WHAT HASN’T—IN THE PUBLIC HEALTH RESPONSE TO THE COVID-19 PANDEMIC SO FAR?

Among successes, we can point to the rapid development of highly effective vaccines, life-saving innovations in treatment, and the adoption of new technologies that support telework, increased collaboration, and expanded health services. Greater recognition of the critical roles of public health professionals, public health science, and health policy should be acknowledged as well—even though this heightened attention has sometimes felt harsh or even resentful.

Not surprisingly, the list of problems connected with the COVID response to date seems lengthier and easier to recount. Inequitable vaccine distribution. Communications miscues and polarizing political arguments, often grounded in misinformation. Widening health disparities, including notably those impacting rural populations. Worsened health status resulting from delayed health care. And the devastating toll on mental health, especially among young people and other vulnerable populations.

The severe breakdown in trust—particularly the distrust of scientists, health officials, and other leaders at the local, state, and national levels—may stand out as one of the most serious problems emerging from the COVID-19 pandemic. Public health leaders, including those of us in academic public health, need to take the lead in restoring the social connections and sense of shared purpose that have long been the underpinnings of our profession.

Public health has prided itself on being non-partisan, a bridge between various sectors of society, with the unique capacity to bring together various stakeholders to work on shared challenges. Now, more than ever, this convener role may be public health’s most urgent mission.

-- Edith Parker, dean of the UI College of Public Health

THE PANDEMIC HAS DEMONSTRATED HOW DIFFICULT IT CAN BE TO CHANGE PEOPLE’S HEALTH BEHAVIORS. WHAT ARE ONE OR TWO KEY LESSONS BEHAVIORAL HEALTH RESEARCHERS CAN GLEAN FROM THE PAST FEW YEARS?

The pandemic has provided many insights related to health behavior change. First, our ability to modify health behaviors is impacted tremendously by what is going on in our lives. Stressful and difficult emotional circumstances, such as those brought about by COVID-19, make it much harder to change behavior and maintain our resolve. This is partially because we often engage in unhealthy behaviors such as tobacco and alcohol use, snacking, and pleasurable sedentary activities to cope with stress and negative emotions. The self-control necessary to persist in sustaining behavior changes is also a finite resource that can become depleted from managing the many daily challenges imposed by the pandemic.

The impact of our physical and social environments has also become more evident. Our health behaviors—both positive and negative—are closely tied to where, how, and with whom we spend our time. Lockdowns, remote working conditions, and other mitigation efforts dramatically altered our routines and social interactions. This can mean spending greater (or lesser) amounts of time with people and in places that may either support or interfere with health promoting behaviors. This may be why we have seen such highly varied behavioral responses to the pandemic. Although increases in body mass, tobacco, and alcohol use have been widely reported, it is also true that many individuals made very positive changes. It is important for us to learn more about the ways in which these disruptions to our daily lives have the potential to both facilitate and undermine health behavior change.

-- Mark Vander Weg, professor and head of community and behavioral health

WHAT IS ONE HIDDEN STRENGTH YOU DISCOVERED ABOUT YOUR HOSPITAL DURING THE PANDEMIC?

Combined, MercyOne Elkader Medical Center and MercyOne Elkader Ambulance employ approximately 100 colleagues. When the pandemic started, the amount of preparedness planning needed for our hospital and ambulance teams seemed like an insurmountable task with such a small staff. However, we quickly discovered that our small, nimble, and mighty team is actually our greatest strength, and we were able to accomplish big things! With keeping the patient and community as our priority and applying an innovation mindset combined with undeniable determination, our team could tackle any challenge. There were many times that our team would already have processes underway or implemented before guidance would come out from trusted resources. This would infuse our team with motivation to keep going because we knew we were capable and prepared to meet the needs of our patients and communities.

Having resources and partners that we could tap into was critical when COVID cases were peaking and we had to keep patients that we would normally transfer to a higher level of care. We are grateful for the expertise of our MercyOne providers and colleagues across the state and nation in various clinical and public health roles. We were stronger because of the innovation and teamwork across the county, state, region, country, and world!

-- Brooke Kensinger (05MHA), CEO of MercyOne Elkader (Iowa) Medical Center

AS SOMEONE WHO WAS HOSPITALIZED FOR MORE THAN A MONTH WITH SEVERE COVID IN 2020, WHAT IS ONE THING YOU’D LIKE PEOPLE TO KNOW ABOUT THE DISEASE OR COVID SURVIVORS?

People should know that our COVID battle is not over—for patients, survivors, and for our public health profession. As a survivor, I continue to manage respiratory and neuropathic issues, and I’ve been prescribed respiratory therapy for the unforeseen future to optimize quality of life. Research shows that more than one in four COVID survivors continues to live with symptoms related to this disease over the longer term.

While the science of diagnosing, treating, and mitigating COVID has come a long way since 2020, there are still many mysteries. For me, those mysteries about my longer-term health status can create stress. It’s not over for public health professionals. Our College of Public Health is faced with many challenges—to investigate the origin and distribution of COVID, figure out its underlying determinants, and more effectively communicate prevention strategies to the public. The infrastructure of local, state, national, and global health organizations has been greatly challenged to deliver consistent and effective messaging. As a result, the prevalence of COVID and new variants seem to remain too high and for too long.

I’m most thankful for the remarkable care that I received during these uncertain times. Nurses, doctors, scientists, and all health care workers continue to deliver high performance medical care. Despite these victories, the health care system is under a great deal of stress. And it’s not over.

-- Kirk T. Phillips (05PhD, 02MS), adjunct associate professor of epidemiology

AS A STUDENT WHO GRADUATED THIS SPRING, HOW DO YOU THINK THE PANDEMIC HAS FOREVER CHANGED THE WORLD?

This is a hard question and to some degree I think we will continue to learn how the world has changed as we become farther removed from the beginning of the pandemic. However, changes have already occurred. In a professional capacity, I think the world now knows what public health is. When I tell people that I am a graduate student studying public health, most know what my field is now. I hope this improved understanding solidifies the importance and necessity of public health work on the local, state, and federal level.

Additionally, I think we all became more aware of the many cracks in our systems that were exposed during the pandemic, which I hope will inform how we engage with solutions to public health issues.

-- Sofie Dollison, 22MPH