As the COVID-19 pandemic enters its third year, health officials grapple with pandemic’s lingering questions

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As the COVID-19 pandemic enters its third year, health officials grapple with pandemic’s lingering questions


Amy Thoreson was the assistant director of the Scott County Health Department on March 12, 2020, when the COVID-19 virus arrived in the Quad-Cities. She and other public health officials met with school superintendents from across the county to discuss the possible courses of action.

For many people across the Quad-Cities, it was a time of unknowns and increasing anxiety.

Twenty-four hours before the meeting in Scott County, the University of Iowa, Iowa State University, and the University of Northern Iowa suspended in-person classes for two weeks. On March 13, Illinois Gov. JB Pritzker closed all schools until at least the end of March.

“It was a very uncertain time, and the information we were getting was changing very rapidly,” said Thoreson, who became director of the Scott County Health Department in 2021. “I remember the discussion was about if and when schools closed, one of the main questions was what would that look like for the greater community. The reality of the situation, for us at that time, was a lot of questions.”

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Another kind of reality hit Thoreson on her way home.

“I stopped into Target to pick up some things,” she recalled. “I remember standing in the toilet paper aisle and there wasn’t a single roll of toilet paper anywhere.

“I had been so focused on staying up with the public health side of things, I really hadn’t been paying attention to much else. I remember standing and thinking, ‘What is going on?’ It was eye-opening.”

Three days after that meeting, Iowa Gov. Kim Reynolds closed kindergarten through 12th-grade schools, saying they would be closed for at least a month. By March 21, Pritzker issued a stay-at-home order for the entire state of Illinois.

What followed was two years of uncertainties, mask mandates, controversies, vaccinations and booster shots, periods of widespread infection, widespread misinformation and the hope people could move on from the pandemic and get back to the way life was before anyone ever heard of COVID-19.

As we enter the third year of the pandemic, a number of public health and health care officials are still grappling with some questions raised by COVID-19.

What has been learned? What has changed?

That question, according to at least one local health official, may be premature.

“There have been a thousand possible impacts on public health already and it may be too early for even asking us this. The pandemic is not over and our ‘lessons learned’ are evolving and may materially change in coming months as it evolves,” Scott County Health Department Medical Director Dr. Louis Katz said.

Katz offered a broad perspective on where we’ve been and how that could influence where we go.

“The first thing one learns in ‘disaster preparedness and response 101’ is to have clearly defined and empowered command and control structures at every level. We did not have that in response to COVID from Day One, most damagingly at the federal level, even though it has been identified as critical for emergency response for decades,” Katz explained. “More than 2,800 state, counties, and large city health departments have operational public health authority, although often dominated by the state executive.

“We need to readjust federalism to allow ‘command and control’ to be more centralized, allowing broad and consistent evidence-based interventions and communications. This is a constitutional issue and will not be easy. A good start would be to return key public health appointments at the federal and state levels to the professional arena, as they used to be.”

Katz also stressed the need to “… rebuild the public health work force.”

While Katz focused on the broad aspects of what can be learned from the first two years of the pandemic, Barb Weber, chief operating officer, UnityPoint Health-Trinity, looked at a way the pandemic has changed procedure.

“During the pandemic, we saw a rapid rise in patients using telemedicine and expect that trend to continue,” Weber said. “It proved a critical tool during the height of the pandemic and continues to be a great resource for improving access to care especially in rural communities or to access specialty care. It has helped health professionals stay connected and monitor their patients safely.”

Doug Cropper, president and CEO, Genesis Health System pointed to changes Genesis made to meet the needs of its workforce during the pandemic.

“Probably one of the most interesting changes deals with the concept of ‘just-in-time’ inventory in supply-chain management. That concept goes out the window,” Cropper said. “The whole concept of global management of supplies and just-in-time inventory has to be rethought completely. In these days of global pandemics, or even global conflict if you look at Ukraine right now, can we truly have so many supplies that are critical for the United States produced outside of the country?

“Genesis decided early on, at the invitation of our buying group, Premier, to participate with 16 other health systems to invest in ownership of Prestige Ameritech in order to help ensure a steady flow of PPE supplies manufactured here in the United States.”

What is reality? Have communities fractured?

As the COVID-19 pandemic unfolded, sharp divisions — driven first by anti-lockdown sentiments and eventually issues like vaccine safety — appeared along political lines.

Rock Island County Health Department COO and Public Information Officer Janet Hill was one of the first local health official to speak out about how COVID-19 was being used as the political football.

“The amount of information — both true and false — that people are consuming about the pandemic has been staggering. From the beginning, public health has tried to be as consistent as possible, even when the situation was evolving quickly,” Hill said. “SARS-CoV-2 is a new virus, so scientists are learning about its characteristics in real-time. Sometimes, the information we passed along changed, which was confusing for many and allowed for seeds of distrust to be sown.

“Because of this avalanche of information, disinformation and misinformation, some people had trouble figuring out what to believe and what sources to trust. The politically-charged national media landscape and polarized social media feeds then allowed disinformation to be spread quickly, blunting proven prevention interventions, including masking, social and physical distancing, and, later, vaccines … . The pandemic never should have devolved into a political battle. Saving lives and caring for you, your family, and your community never should have been political.”

Katz was even more blunt. And he underlined a need for public health officials to find ways to better communicate with the public.

“We need to deal with the apparent inability for people to agree at a basic level about what is ‘true.’  Defining and confronting dangerous misinformation is a daunting task testing the appropriate balance between individual rights and public health — very difficult in the age of social media and the fragmentation of our communities that it both reflects and amplifies,” Katz said.

“We need to look very carefully at how, as public health officers, we convey and discuss the uncertainty that is the absolute and necessary nature of evolving scientific inquiry. This requires very clear, declarative statements about what we believe to be true that must especially include our ‘confidence intervals’ around the data that supports those judgments.”

Katz said public health had to help people understand how to critique evidence, and young people should leave schools with basic levels of critical and scientific literacy.

Much as sacrificed — but there is hope

As Thoreson recalled the start of the pandemic, she talked about some of things families sacrificed along the way. Hospitals and nursing homes closed visitation, leaving patients alone, or only allowed to look through a window at loved ones outside the facility. Medical workers changed their routines, with some living separated from family, to avoid bringing COVID home. Funeral homes started holding drive-thru visitations because larger gatherings could become COVID-spreader events and were off-limits. Schooling moved online, which proved helpful for some but difficult for many. Bus drivers in some districts continued their routes, delivering school lunches to students in need. Schools organized car parades to keep connected with students.

“The pandemic started to ramp up, and it was spring break time for a lot of families,” she said. “We had a family trip — including my dad — planned for Florida.

“Like a lot of families all over over the country, we canceled. As a public health official, I was starting to get a sense of just how dangerous that time was for people everywhere.

“And then the pandemic changes things bit by bit. My husband works in a hospital — so there was constant worry about what he could bring home. Our family changed — I was a public health employee during a pandemic. That came, in a lot of ways, before being a mom. I’m like a lot of parents out there — it’s like I’ve missed out on a lot of time with my family.”

Thoreson, however, holds on to hope.

“If you don’t have hope, there’s not a lot left for you,” she said. “We’ve weathered omicron. Things are better now, and maybe people will see that a tool like the vaccine can help things stay better.

“I have hope. I still believe we will get through this together.”



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