EXPERTS ADVISORY

March 11 will mark five years since the World Health Organization declared COVID-19 a global pandemic. University of Michigan experts look back on successes and failures in public health and medicine; discuss continued effects in education, business and society; and offer insights on how prepared we are for a future pandemic.

PUBLIC HEALTH AND MEDICINE

Gregory Eschenauer, clinical professor at the College of Pharmacy and an infectious diseases clinical specialist at Michigan Medicine, served as a Society of Infectious Diseases Pharmacists representative on the National Institutes of Health COVID-19 Treatment Guidelines Panel. He can speak to the change in pharmacies and the heightened role of pharmacists as health care providers during and since the pandemic.

“As with all health care providers, the COVID-19 pandemic was a time of profound stress for pharmacists. However, it was also a time where the instrumental and diverse roles pharmacists play in the treatment and prevention of disease were clearly demonstrated,” he said.

“The community is well-accustomed to pharmacists in outpatient pharmacies providing vaccinations, and this role was even more crucial once COVID-19 vaccines became available. Pharmacists in clinical settings, such as Michigan Medicine, also research new therapies to assess their safety and efficacy, manage critical drug shortages, develop models for effective and equitable stewardship of therapies, evaluate data to inform internal such as our antimicrobial stewardship program and external guidelines, and of course, provide clinical care to patients in the hospital and community.

“Accordingly, our service during the pandemic is also a period of pride for many pharmacists in that we were able to utilize our diverse skill set to help our community and patients at such a time of critical need.”

Contact: [email protected] or Kim North Shine, [email protected]

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Nancy Fleischer is an associate professor of epidemiology at the School of Public Health and co-director of the Center for Social Epidemiology and Population Health. She also leads the Michigan COVID-19 Recovery Surveillance Study, a joint effort between the School of Public Health and the Michigan Department of Health and Human Services to document Michiganders’ experiences with COVID-19.

“One of the most important things we have learned is that long COVID has continued to impact the health and well-being of Michiganders even years after their initial COVID-19 illness,” Fleischer said. “However, COVID-19 vaccination can reduce the risk of developing long COVID, which is another important reason to get the vaccine every year.

“We also learned that some Michiganders have been hit harder than others by the social and economic aspects of the pandemic. For example, Black adults had more severe disease and were more likely to be hospitalized due to COVID-19 than adults from other racial and ethnic backgrounds. We also found that Black adults and Middle Eastern and North African adults lived in households that were more likely to experience a loss of employment or reduction in work hours in compared to other adults in Michigan.

“This knowledge can and should be used to prepare and guide response during future public health emergencies, and to improve access to health and social resources for populations known to experience health inequities.”

Contact: [email protected] or Kim North Shine, [email protected]

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Adam Lauring is a professor of internal medicine and of microbiology and immunology at Michigan Medicine, and professor of ecology and evolutionary biology at the College of Literature, Science, and the Arts. He is a co-principal investigator of the Michigan Infectious Disease Genomics Center. Since the beginning of the COVID pandemic, his laboratory has studied the genomic epidemiology of respiratory viruses and the effectiveness of vaccines against them.

“Lately, I’ve been thinking about how, in the first year of the pandemic, there was a tremendous clinical, biomedical research and public health response to COVID, which led to the development of lifesaving therapeutics, protective vaccines, and efforts to reach the most vulnerable in our communities,” he said. “Sadly, these successes feel like a distant memory, as many have now turned against vaccines and we are currently witnessing an abandonment of our public health workforce and infrastructure.”

Contact: Kelly Malcom, [email protected]

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Sue Anne Bell is a nurse practitioner and associate professor at the School of Nursing. Her research focuses on the long-term impact of disasters and public health emergencies on health, particularly among older adults. She is clinically active in disaster response through the U.S. Department of Health and Human Services National Disaster Medical System, including the COVID-19 response.

“The COVID-19 pandemic brought unprecedented challenges to the nursing workforce,” she said. “Now five years later, many of these issues are still ongoing, having been made worse by the pandemic. At the beginning of the pandemic, PPE shortages placed nurses—as frontline health care providers—at extreme risk for COVID-19 infection.

“In fact, the International Council of Nurses reported that at least 1,500 nurses worldwide had died from COVID-19 by October 2020, though this is considered an undercount by many. Rapidly changing care protocols and policies were also a point of uncertainty for many nurses, as they struggled to adapt to new care practices, including learning how to care for patients in new ways while adjusting to wearing constrictive and bulky PPE.

“High workloads combined with nursing staff shortages led to dangerous conditions for both patients and nurses. These adverse working conditions resulted in nurses leaving the profession in droves, with dangerous nursing shortages still persisting today.

“Despite these challenges, the pandemic highlighted the resilience, adaptability and dedication of nurses worldwide. Five years later, research continues to advance in support of the nursing workforce, efforts to improve working conditions are ongoing, and the nursing profession has a stronger voice in advocating for both nurses and their patients.”

Contact: [email protected] or Morgan Sherburne, [email protected]

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Albert Shih is a professor of mechanical engineering and biomedical engineering at the College of Engineering, who led the production of N95 masks for the U-M hospitals during the shortage of personal protective equipment in 2020 and early 2021. He continues to lead research in flexible manufacturing of innovative PPE designs, including the melt-blown, nonwoven material that is critical for filtering and removing the airborne virus.

“In terms of PPE, we are better but not bulletproof prepared for the next pandemic. Innovations in PPE during COVID were not commercialized mainly because of the lack of flexible, cost-effective manufacturing for advanced PPE designs,” he said. “If the U.S. commits to fully sourcing its PPE supply domestically, we could produce masks that are more effective, more comfortable and biodegradable, improving both safety and quality of life for healthcare workers and reducing the impact on the environment.”

Contact: [email protected] or Katherine McAlpine, [email protected]

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Laraine Washer is clinical professor of internal medicine and medical director of infection control for Michigan Medicine.

“As I reflect on my experience during the early part of the COVID pandemic, I first recall and honor the many lives lost and families disrupted by the pandemic,” she said. “I celebrate the resilience and teamwork of our health care workers, the dedication of public health professionals who reached vulnerable populations with education and vaccines, and the biomedical scientists who rapidly brought forward lifesaving tests, vaccines and therapeutics during the most uncertain periods of the pandemic.

“I hope we will not forget lessons learned around effective health communication, the importance of viral disease surveillance, and building vaccine confidence to promote better health in normal times as well as future epidemics.”

Contact: Kelly Malcom, [email protected]

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Herek Clack is an associate professor of civil and environmental engineering at the College of Engineering and co-founder of Taza Aya, a company that is developing a device that protects users from airborne pathogens with a curtain of disinfected air flowing around the face.

“Like most everyone else, I recall just trying to hang on, day by day. So many demands, duties and expectations related to home life, classroom instruction, research, supporting the health care system and pivoting a startup company,” he said. “For the first few years, every night’s sleep was cut short by anxiety and racing thoughts. But, honestly, for me, the anniversary of the WHO declaration cannot be separated from the initial guidance that encouraged the public to take actions like using hand sanitizer to wipe down store-bought fruits and vegetables.

“As much as I will take time to remember the anniversary of the WHO declaration, I’ll also be remembering all of the confusion around routes of transmission and how, for aerosol scientists, it seemed we needed to catalog and comment on every reported localized outbreak in the hope that the notion of airborne transmission might be taken seriously. In addition to the March 2020 declaration, I’ll be recognizing the October 2020 acknowledgement by CDC of the possibility of airborne transmission of COVID.”

Contact: [email protected] or Katherine McAlpine, [email protected]

EDUCATION

Elizabeth Birr Moje, dean and professor at the Marsal Family School of Education, teaches undergraduate and graduate courses in secondary and adolescent literacy, cultural theory and research methods.

“The discourse around learning is focused on ‘catching up’ as a result of the pandemic’s negative impacts on student learning. Although it is true that average math and reading scores have declined across all groups, achievement scores are only a partial glimpse of what children are learning,” she said. “More worrisome data show that children’s confidence in their abilities to engage in mathematics and reading has been shaken during the pandemic years.

“Educators need to focus on a wide range of learning outcomes to ensure that all students will be equipped to handle the demands of a new era. To that end, schools cannot fall back on the rote instruction in an attempt to ‘catch up.’ Educators should turn to evidence about how people learn best. And evidence shows that the best instruction engages children in real-world questions and problems as a way of learning foundational, critical thinking and team skills.

“Moreover, schools need to address trauma and mental health challenges among children, even as they focus on improving skills. Finally, teachers will need support in learning to navigate rapidly emerging educational technologies and generative AI tools. Teachers need to learn how to advance children’s capacities for using such tools in everyday life, so that the tools do not use them.

“These—and more—current realities demand historic investments to increase and retain well-prepared educators who are equipped to redress the challenges wrought by the COVID-19 pandemic and to meet the challenges of a new era.”

Contact: [email protected] or Bernie DeGroat, [email protected]

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Christina Weiland is a professor at the Marsal Family School of Education and professor of social policy and co-director of the Education Policy Initiative at the Ford School of Public Policy. Her areas of focus include early education and educators, preschool and kindergarten. She is particularly interested in the active ingredients that drive children’s gains in successful, at-scale public preschool programs.

“We are still grappling with significant staffing shortages in early education classrooms. This is a major challenge for quality for educators, and for parents,” she said.

Contact: [email protected] or Bernie DeGroat, [email protected]

BUSINESS AND SOCIETY

Jerry Davis is a professor of management and sociology at the Ross School of Business, where he also serves as faculty director of Business+Impact. He has studied the effect of crises on business for years, and the ways in which commerce has fallen into but fought its way out of crushing events like the Great Recession.

“COVID created an economywide test of ‘What kinds of work can be done remotely and what kinds must happen in person?’ and we are now witnessing some of the results,” he said. “In many cases, businesses realized that if the work can be done remotely, it can be done in India or the Philippines as well as in the U.S., and it can be done by remote contractors as well as W2 employees. It will be seen in the future as a major turning point in the organization of the labor market and a vast expansion of gig work at all levels of the labor market—from food delivery to telemedicine.”

Contact: [email protected] or Jeff Karoub, [email protected]

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Michael Traugott is a research professor emeritus at the Center for Political Studies and professor emeritus of communication studies at the College of Literature, Science and the Arts. He studies campaigns and elections, voting behavior, political communication, the use of polls to construct news and survey methodology.

“Health behavior, as other forms of behavior, has become politicized in our current polarized environment,” he said. “We showed that willingness to be vaccinated for COVID or speed of vaccination was related to partisanship and support for the Trump administration’s policies. Such reliance on political attitudes rather than scientific knowledge has important public health consequences.”

Contact: [email protected] or Jared Wadley, [email protected]

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Information compiled by Jeff Karoub, Kim North Shine, Fernanda Pires, Morgan Sherburne and Jared Wadley of Michigan News; Jim Lynch and Katherine McAlpine of the College of Engineering; and Kelly Malcom of Michigan Medicine.