Osterholm: COVID Revealed Major Flaws in American Healthcare that We Must Fix

Blog Post
Friday, November 18, 2022

This week on Facing the Future, we had the privilege once again to welcome Dr. Michael Osterholm back on the program. Dr. Osterholm is the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, and is one of the world’s leading experts on infectious disease and epidemiology. He has served as a key advisor to the Biden Administration on dealing with the COVID-19 pandemic. He and other colleagues who advised the administration on the pandemic recently wrote an op-ed in the New York Times entitled: “We Advised Biden on the Pandemic. Much Work Remains to Face the Next Crisis.” We have focused on the pandemic from time to time on our program because of its profound impact on both the economy and our federal budget, and the inflation we are all seeing now is in large part due to pandemic-related supply chain disruptions. 

I was joined in the conversation with Dr. Osterholm by Concord Coalition Communications Director Av Harris, who in his previous role oversaw communications and government relations for the Connecticut Department of Public Health during the first year of COVID-19. As it stands right now, hospitalizations and deaths from the pandemic are not spiking anywhere in the United States. However there is a very high level of hospitalization from other respiratory viruses such as influenza and RSV. But Osterholm says what troubles him is that only about 12% of the eligible population in the United States has taken advantage of the latest generation of COVID bivalent booster shots that are very effective at preventing severe infection from some of the newer variants.

 

“We’ve actually seen a very unfortunate and surely unnecessary change in the number of people dying in this country by their risk category,” said Osterholm. “Early on in the pandemic, the predominance in deaths were largely among communities of color. People who were in essential working jobs where they went to work every day in grocery stores and front line locations because they had to. And then they would come home often to a multi-generational apartment or home where they often transmitted the virus. Now along comes the vaccine, but vaccine acceptances actually really vary tremendously not just by geographic area but by who lives in those areas. And today, the number one reason for dying with COVID is not being vaccinated. And largely, it is White populations in middle class or more affluent locations who just refuse to get the vaccine. As has been labeled by some, it’s now the middle class Republican population that’s now dying.”

Dr. Osterholm says he understands what President Biden was trying to say in September when he claimed that the pandemic was over, but he does not agree with that assessment. 

“The pandemic’s not done yet,” said Osterholm. “We really have so much we can do in terms of vaccine. We also have the antivirals which have now been demonstrated - paxlovid particularly - to not only reduce the seriousness of illness and the likelihood of dying, but it’s actually now been shown to reduce the likelihood of developing long COVID. To me those are really important new data. But yet, if the public won’t take it, if they won’t accept it, then we will continue to see this unacceptable high level of serious illness and deaths occurring in this country, even if they’re not the big spikes of cases that we saw earlier in the pandemic.”

 

Osterholm and his colleagues say the pandemic has revealed some glaring weaknesses of the American healthcare and disease surveillance system, that we must work to fix in order to be ready for the next public health crisis.

 

“There is so much we can do,” said Dr. Osterholm. “Building ventilation, for example, and what we could do to reduce the risk of transmission in public places by just improving building ventilation. What we could do if we had better kinds of masking. Ones much more comfortable, ones where people could feel the confidence if they wore them, they could really do a lot to reduce the risk of transmission. The healthcare system - we are in worse shape in many hospitals around the country today in terms of lack of beds and adequate health care workers for kids in particular who are critically ill with RSV and influenza. Did we really do anything to fix our healthcare system? No we didn’t. As much as we want to move on and we want this to be behind us and have our great grandchildren read about it in history books someday but let's just get done with it, ok? But it’s not that simple. If we don’t learn these lessons from this pandemic, we are going to repeat them again.”

 

It will cost money to make these improvements, but Osterholm says dollars spent today will save billions and trillions in the future and save more lives. Among the challenges Osterholm and his colleagues outline is a major need to improve the efficacy of viral testing as well as sharing and collecting disease data and making that readily available on a digital platform so public health officials could make far more effective and targeted recommendations for individuals and governments to follow. He also says one of the biggest mistakes we made in the beginning of the pandemic was pushing for lockdowns and transitioning schools to remote learning.

 

“What we were really trying to do is flatten the curve, meaning keeping people from getting infected until we could get them to vaccine,” said Osterholm. “Well, we lost sight of all that. It’s almost as if lockdowns became the default position. And with that, I think we burned a lot of good will and capital with the public. It made no sense, and the public reacted accordingly. With schools, the virus ended up acting very differently in kids over time. If you look at the earliest cases, there was not much evidence of severe illness in students. But as time went on, more and more got infected with each new variant, such that omicron basically overran schools. Well, we went from closing them down early, to then reacting and saying well we’re never going to do that again, to then omicron coming, and we couldn’t field teachers or support staff. They were all sick. Now that’s when you could argue the school could have closed down, because efficient education wasn’t happening anyway. And yet, at that point people said we’re going to keep our schools open at any cost.”

 

Later on in the program, we heard from Concord’s chief economist Steve Robinson and policy director Tori Gorman about the latest economic news with year-over-year inflation finally starting to decrease. Steve also discussed his latest analysis of the Biden administration’s moves to expand who is eligible for student loan write-offs.

 

Hear more on Facing the Future. I host the program each week on WKXL in Concord N.H., and it is also available via podcast. Join our guests as we discuss issues relating to national fiscal policy with budget experts, industry leaders, and elected officials. Past broadcasts are available here. You can subscribe to the podcast on Spotify, Pandora, iTunes, Google Podcasts, Stitcher, or with an RSS feed. Follow Facing the Future on Facebook, and watch videos from past episodes on The Concord Coalition YouTube channel.