We Are on the Cusp — March 11, 2021

One year after COVID-19 was declared a pandemic, UMKC School of Medicine Dean Mary Anne Jackson, M.D., says we are getting closer to returning to normal.

The first reported cases of a novel coronavirus called SARS CoV-2 were in December of 2019, and on March 11, 2020 – one year ago today – the Director-General of the World Health Organization declared the COVID-19 outbreak a pandemic. Based on the spread of COVID-19 to 114 countries and alarmingly high case-fatality rates, the declaration came with a caveat: with detection, testing, treating, isolating, tracing and mobilizing a response, we could change the course of this pandemic. At that time in the United States, there were 1,762 cases. Today we stand at more than 29 million cases and 528,829 people have lost their lives. We have seen the disproportionate impact of COVID-19 on our Black, Hispanic, and Native American populations, and many Americans have lost their jobs, income and housing. People have suffered disruptions in family bonding and lost family members to this disease. The human toll and downstream consequences – related to many who have avoided routine medical care, routine immunizations and cancer screenings – will have a cumulative impact on both physical and mental health. This impact will likely be seen for many years to come.

Children, while less likely to have severe disease, now account for more than 3.2 million – or 13.2% – of the COVID-19 cases across our country. The pandemic has taken an enormous toll on our youngest, most of whom have not been able to attend in-person school and have been isolated from family and friends. Children have lost multiple family members, many are food-insecure, and all have suffered at least some degree of toxic stress from the pandemic. This result is now being manifest as an increase in emergency room visits for mental health and behavioral complaints. In our community, we are just starting to return to at least partial in-person education for those who attend public schools in both Missouri and Kansas. In most cases, a hybrid of virtual and in-person learning remains the norm of today. The cumulative loss in learning for a child could average 5-9 months by the end of the school year. And for students of color, who lack internet, devices and appropriate places to study, the loss could be as much as 12 months. We must invest in bridging this gap and make sure every child has an opportunity for success.

As the pandemic unfolded, we were forced to make changes, to adapt and quickly evolve like we’d never done before in the 50-year history of our medical school. We are proud of the curricular innovation we brought to meet student needs and to ensure teaching, supervision and assessment. We kept student advancement our top focus. And we celebrated our students who graduated in 2020 – the first-ever to finish their medical school journey with virtual electives – with an entirely virtual Match Day and an entirely virtual graduation sending them off to residency programs to join the front lines of care. Even as we brought back students to clinical rotations last summer, we continued with a largely virtual biomedical science curriculum taught by talented faculty who, too, were learning to optimize virtual learning while navigating the pandemic personally. We saw flexibility and resilience from all of our students, staff and faculty to move forward all students – medical students, physician assistant and anesthesia assistant students – in their medical journey. Our senior students who will celebrate Match Day next Friday, with a virtual ceremony, will now join our medical community as they pursue residency training in a new era alongside their physician assistant and anesthesia assistant colleagues who are starting practice.

Now, we will join our current senior students to celebrate Match Day next Friday – again with a virtual ceremony – to mark their steps into the medical community to pursue residency training in a new era.

There are many reasons to be encouraged. The pace of disease has slowed, and we are seeing the lowest number of new cases, hospitalizations and deaths since last spring. Prediction models suggest that a third of the population has natural immunity – I taking the number of cases we know, combined with the estimate of the number who have had asymptomatic infection. And there are some experts who suggest SARS CoV-2 may have a seasonality where summer may produce a natural reprieve. Add to that we are welcoming the era of COVID-19 vaccines – the clear path that will lead to the herd immunity necessary to stop the spread of this deadly virus. Today, we stand at three vaccines that have received emergency-use authorization and have all demonstrated the ability to reduce serious disease and deaths. Nearly 19% of the U.S. population has received a first dose of vaccine and 2.17 million doses are being administered every day as of March 4, 2021. While vaccine supply is not yet ready to meet demand, we expect enough vaccine from Pfizer, Moderna and Johnson & Johnson by end of April to fully vaccinate more than 200 million adults. That would put us on pace to have 50% of the population vaccinated by May 25. There is still a huge logistical challenge to providing equitable access to vaccination, and approximately one-half of those 65 and older have not yet received the vaccine. We need to prioritize getting vaccines to our seniors, as we know that age is a predictor of hospitalization and mortality from COVID-19. When compared to someone 30 years of age, it’s a 100 times greater risk for death in those 65 and older, a 1,000 times greater risk of death in those 75 and older, and a 10,000 times greater risk of death for those who are 85 and older. Ensuring access and reducing logistical challenges for this population is critical even as we open up access to more eligible populations.

As we vaccinate more and more Americans, the CDC provided new guidance this week: Those who are fully vaccinated can safety gather with family and friends. At the same time, experts are still recommending restrictions on travel. This caution relates to the increase in spread of vaccine variant viruses across the U.S. and the plateau of cases seen in many states. This may portend another surge of disease, even as we seem to be on the cusp of recovery. Vaccine manufacturers are already progressing on the work needed to provide a booster or multi-virus vaccine to address the variant spread.

So, on this day, one year into the pandemic that has disrupted all of our lives in ways we could have never imagined, know that we will return to normal. And know that we are increasingly getting closer to the point that we put the pandemic in our rear-view mirror.