PHP: Can you talk about your experience as an emergency physician during the pandemic?

Megan Ranney: I was working in our emergency department in February 2020, when our first identified COVID-19 case came in for treatment in Rhode Island. There was a sense of fear and unknown. There was a quick realization that out healthcare workers were going to do what was needed, despite the fact that at that point we were putting ourselves at risk, despite the emotional and physical cost.

One of the most frustrating things about this pandemic is that although some of the problems that we experienced the first days of the pandemic have been mitigated, new ones have taken their place. Our staffing is at an all-time low, and our morale is also at an all-time low, and our ability to care for patients is being hampered. The precautions that we put in place to keep people out of the hospital are being dismantled and defunded.

What resources and attitudes are missing as we manage the pandemic around the United States and the world?

We have challenges with having access to adequate data. We have lack of mechanisms for adequate information sharing and communication. On a systemic level, we have not done a good job of translating the science into terms that the public can understand. We’ve also not done a good job of fostering trust around our communication of data. The next bucket of issues is around disparities, around socioeconomic, educational, and geographic disparities in access to prevention and treatment. The last bucket is about failing to recognize that prevention and treatment are two sides of the same coin. Prior to COVID, any of us working in public health or healthcare had created Band-Aids to help stop the oozing from these wounds so that we could still function and take care of patients. COVID ripped those Band-Aids off, reopened and deepened the wounds to the point that the system is now bleeding out. We need to address that systemic dysfunction instead of just putting Band-Aids back on the problem.

What do we need to do to prepare for the next pandemic? What advice would you give to hospitals around the United States and the world?

There is no guarantee that we are through this pandemic. I actually think differently, which is how do we take advantage of this current lull, to shore up what we have learned over the last two years and prepare better for the next surge, whether of COVID or of other infectious diseases.

How do we make it easier for people to engage in prevention? Number one, we have to have good data, good monitoring of what’s out there and when there are surges coming. The second thing is that we have to keep a great eye on what are the risk and protective factors and be constantly developing and ready to roll out interventions. That includes the ability to potentially deliver future booster shots or other forms of vaccines, the ability to have adequate supplies of those medical treatments, on hand. It also includes those interventions around behavior change and thinking carefully now around when and how we need to put non-pharmaceutical interventions, like masking, back in place. We need make sure that we have good ways to share what we’re learning and what we’re recommending with the public.

Ranney will appear as part of the April 8 Public Health Conversation cohosted with the Boston University Center for Emerging Infectious Diseases Policy and Research. Register here.

Nahid Bhadelia, director of the Boston University Center for Emerging Infectious Diseases Policy and Research and associate director, National Emerging Infectious Diseases Laboratories, will moderate the morning panel at 10:30 a.m. featuring Natalie Dean (CAS’09), assistant professor, Department of Biostatistics, Rollins School of Public Health, Emory University; Angela Rasmussen, research scientist, Vaccine and Infectious Disease Organization, University of Saskatchewan; Maria Sundaram, associate research scientist, Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute; Rajeev Venkayya, chief executive officer of a new venture-backed company developing therapeutics against SARS CoV-2 and other viruses with pandemic potential.

Matthew Fox (SPH’02,’07), professor in the Departments of Epidemiology and Global Health, Boston University School of Public Health, will moderate the afternoon panel at 12:30 p.m. featuring Krutika Kuppalli, medical officer for COVID-19 Health Operations in the Department of Epidemic and Pandemic Preparedness and Prevention in the Health Emergencies Program, World Health Organization; Ranney, professor of emergency medicine, Alpert Medical School; academic dean, School of Public Health, Brown University; Jeffrey Shaman, professor, Department of Environmental Health Sciences, Columbia University Mailman School of Public Health; and Tara Smith, professor of epidemiology, Kent State University.

Photo provided by Megan Ranney