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Nine months ago, we gathered in our conference room to talk about COVID-19 and what it may look like in the coming months. When you put a bunch of data geeks with healthcare expertise in a room the opinions were diverse, to say the least.  One person ventured to say that they thought we would be wearing masks at Thanksgiving, while others wondered if the virus would be around the following week.   We talked about being back in the office in a matter of weeks and the potential of needing to reschedule some meetings we had planned in the coming days.  Nowhere in my wildest dreams did I think that the journey would have turned out like it has and nearly a year later we are still out of the office and wondering when we will go back in.

The world has been changed with over 1.5 million lives lost to the virus in the first year.  Countries chose their paths to fight the virus, some strictly locking down and not allowing visitors while others ignored the existence of the virus and went on as if nothing happened.  Between political banter, social activism and virtual schooling, the United States of America has had to pivot to survive.  Hundreds of thousands of Americans have died from the virus, the business world has been forever changed and many of the freedoms that Americans have cherished have been put on hold.  Weddings have been canceled, sporting events played without fans, and eating out at a local diner is not a normal activity any longer.  Church services have been moved outdoors and at times during the pandemic singing was outlawed.

It is easy to get caught up in all the bad things that have happened during this pandemic, but there must be some bright spots that we can find especially as it relates to our health and the healthcare system.  Let’s put aside all opinions on the origin, management and rules related to COVID-19 and look at some of the good things that will help shape our future.

Medical Testing has improved dramatically since COVID-19­ forced the world to a halt.  Not only COVID-19 testing but medical testing in general has found ways to process faster and be administered remotely. Tests that used to take days or weeks to get results have shifted to taking minutes or hours.  Testing companies have found ways to make tests more affordable so that tests are available to all people at all socioeconomic levels. Mail-in testing used to only be available to those willing to pay cash, and now they are becoming very much the norm for insured members.     

Virtual Medicine has seen dramatic increases since the pandemic.  The pandemic caused virtual medicine to be put on fast forward and the progress that has happened in the last nine months could not have happened in years under normal circumstances.  There are now medical offices that have been set up to be virtual only.  According to the CDC[1] virtual visits in March of 2020 were up 154% over March of the previous year.  According to the Journal of the American Informatics Association[2] virtual urgent care visits saw an over 680% increase between March and April 2020 and virtual non-urgent visits saw an increase of over 4,000%.   One interesting finding related to telehealth is the higher-than-expected adoption rate for seniors (>65).  Most would assume that seniors would not embrace technology, but a recent survey[3] showed that over 50% of seniors are open to using virtual medicine and like the potential convenience and cost savings.  Virtual medicine is not only a convenience for the patient, but it is also a large cost saving to the providers and insurers.  There are many overhead items related to the office setting that are not in the virtual setting.  Offices can be smaller, less staff, no need for waiting rooms, and doctors could essentially do a visit from most anywhere they or the patient are.

Vaccine Development is faster and more effective than ever. Under President Trump’s Operation Warp Speed’s vaccine development has gone from years to months and looks poised to meet its goal of producing and deliver 300 million doses of safe and effective vaccines by early 2021.  This undertaking brought together the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Biomedical Advanced Research and Development Authority (BARDA), and the Department of Defense (DoD) to deliver on its promise.  The vaccines being developed have shown very high effectiveness and should encourage us all that literally the whole world can come together and work together when needed to deliver important things such as vaccines.  It does not matter about political party or what country you are from, when things need to get done, almost anything is possible. As will be talked about in delivery services, there have been many other non-medical companies shifting what they are doing to assure the prompt delivery of vaccines.

Sanitation and Cleanliness have become a priority.  From buses and airplanes to gyms and restaurants, everything is cleaner than it has ever been.  People are washing hands more often and are more socially aware of their own chances of getting others sick.  Sanitation businesses are flourishing and through their effort’s confidence will continue to grow about the safety of moving back to life as normal.  Things that were never sanitized before are being thoroughly cleaned and prepared before the next person can use them.  When stepping on a plane you can clearly smell the sanitation products that were used.  It is amazing to think that though you can cram hundreds of people in a small area for hours on end, there have been nearly no confirmed issues related to COVID-19 on an airplane.  Planes have always placed a priority on HEPA filtration, but the move towards more sanitation and disinfecting seems to be a good thing for all.

Anxiety and depression are on the rise, but I feel that the community spirit of taking care of other people’s health needs is increasing as well.

Social Health Awareness of your own health and the health of others has increased.  Mask wearing, though politically charged, has helped decrease the spread of germs. People may not believe in the use of masks or how it protects themselves, but most are wearing them to help the common good.  It used to be that you would never see people wearing a mask other than a random person in an airport, but now you cannot go more than a few feet without wearing one yourself.  “Social distancing” was not a well-known term before COVID-19 but now, most people think about most social situations in 6ft increments and how safe it may be.  People are more concerned about others and their own health than before.  I love hearing the stories of people grocery shopping for elderly people or running errands as a way to help others.  Neighbors are looking out for neighbors more and kids are making better decisions in light of how it may affect their parents or grandparents.  Anxiety and depression are on the rise, but I feel that the community spirit of taking care of other people’s health needs is increasing as well.

Delivery Services have become the norm and are only growing.  It was not too many years ago that if you were hungry and did not want to leave home, all you could get is pizza or Chinese food.  Today almost every restaurant is related to a delivery service.  This is related to healthcare as many people’s health limits their ability to leave their houses.  Now they can sit in the comfort of their house and order groceries, dinner and even supplies from their local home improvement store and have them delivered in minutes. DoorDash recently had an initial public offering and is now valued at more than $70 billion, further proving that delivery services are only going to grow.  Food delivery services did not exist a few years ago and now they are worth more than most of the restaurants that they service. Delivery services have become very important to vaccine distribution as well.  Companies such as FedEx, UPS and United airlines have pivoted to be ready to transport vaccines in the controlled environments that are required.  Medications are now delivered to doorsteps and many drugs that were only available in a hospital setting are not administered and delivered to homes.

COVID-19 has caused us all to change the way we do life.  This article has attempted to show some hope in a time of darkness.  Just as my mother used to say, “if life hands you lemons, make lemonade”, I believe that we can all see some good in the COVID-19 journey if we take a long-term perspective and see how it has changed some things for the good.

Endnotes

[1] Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic — United States, January–March 2020 | MMWR (cdc.gov)

[2] COVID-19 transforms health care through telemedicine: Evidence from the field | Journal of the American Medical Informatics Association | Oxford Academic (oup.com)

[3] Telehealth Index: 2019 Senior Consumer Survey – Amwell

About the Author

Joshua W. Axene, FSA, FCA, MAAA, is a Partner and Consulting Actuary at Axene Health Partners, LLC and is based in AHP’s Temecula, CA office.