University of Wisconsin–Madison ⋅ Medical College of Wisconsin
WMJ

Lessons Learned From the Pandemic

Fahad Aziz, MD, FASN, WMJ Editor-in-Chief, Tripti Singh, MD; George Morris, III, MD

WMJ. 2023;122(5):308-309

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This double issue of the Wisconsin Medical Journal delves deeply into the intricate ramifications of the pandemic, meticulously examining its profound effects on microcultures across diverse levels – from local communities to the global stage. Through an array of comprehensive reports, enlightening studies, thoughtful reflections, and accompanying artwork, this issue sheds light on the myriad challenges and opportunities encountered by various segments of society. The field of health and medicine undergoes a seismic shift in epistemology, leaving an indelible mark on both the patient population and the health care workforce across numerous dimensions. As health care providers, we find ourselves not only fulfilling our professional roles but also navigating the intricate web of complexities that come with being essential employees, managing careers, caring for isolated patients, and serving as “experts” sought after by friends and neighbors as they grapple to comprehend the unprecedented events unfolding worldwide. This special edition serves as a testament to the intricate interplay of effects on individuals, patients, and health care professionals alike.

The issue opens with a report card by Patrick Remington, MD, MPH, reflecting which aspects of our response to the pandemic were successful and which were not.1 The fields of medicine, bioengineering, and public health services are given our enthusiastic endorsement. And it was back to the drawing board for communication and addressing the many emerging disparities. Although the massive private-government effort “led to significant lives saved” and was deemed by many a great success, it was not without casualties, prompting Remington to advocate for an enhancement of public health data and increased funding.

The other reports included in this journal converged into four overarching themes summarized here.

PATIENT CARE

First, we focus on understanding and responding to the evolving landscape of medical care in light of the virus. The reports cover a wide spectrum of scenarios, including the interconnectedness of violence and COVID-19 in Milwaukee,2 ocular care during Wisconsin’s “Safer At Home Order,”3 and creativeness in taking care of immunocompromised patients during the pandemic.4 Another investigation explores the effectiveness of a digital intervention aimed at enhancing the scheduling of annual wellness visits amidst the COVID-19 backlog, revealing challenges in implementing a noncontact version of medical care universally within our system.5 Even seemingly commonplace observations, such as delirium frequencies in hospital settings6 and the dynamics of pediatric care during the Omicron surge, emerge as valuable insights for future planning.7 This collective exploration underscores our capacity to adapt and learn from the multifaceted impact of COVID-19 on various aspects of health care, illuminating the path forward in navigating and enhancing our medical care system.

WORKFORCE

Next, we explore the deep effects of the pandemic on the workforce, revealing the complex function of vital employees and the devastating effects of infectious illnesses. Reflections on this theme by Vazirnia et al illuminate the pervasive sense of a loss of control and an uncertain future, leaving an indelible mark on clinicians.8 The personal vaccination decisions made by nurses take center stage in another perspective,9 and echoes of the crisis reverberate through examinations of the influence on career trajectories, productivity, and the shift to remote work,10 as well as training experiences during the pandemic.11
Indifferent to gender, the virus emerges as a ubiquitous disruptor, affecting workers across various occupations in this moment of chaos. Reports exploring the incidence of COVID-19 and worker’s compensation12 and mortality rates by occupation and industry13 demonstrate how work, life, and the huge problems caused by the pandemic are all connected in complicated ways.

PUBLIC HEALTH APPROACHES

Our third theme focuses on insights gained in the public health arena, including how specific conditions like breast cancer might influence SARS-CoV2 susceptibility14 and the concordance of health-related behaviors among romantic partners during the pandemic.15 In the early days of the pandemic when diagnostic testing was very limited, laboratory-developed tests served as a critical bridge until demand could be met with commercially available tests.16 Of course, COVID-19 rapid testing eventually was employed outside health care settings, and Temte et al report on the feasibility and functionality of testing in K-12 public school health offices.17

INEQUITIES RELATED TO COVID-19

Our final theme delves into the distinctive repercussions stemming from unequal access to health and medicine, further unraveling an already strained health safety net. These consequences manifest in various domains, illustrating the complex challenges inherent in addressing disparities. For instance, a study by Schell et al sheds light on the deleterious effects of inequities in vaccine access among individuals with inflammatory bowel disease in Wisconsin,18 while another study looks at the inequitable vaccine uptake among rehabilitation patients,19 and a third reports on the outcomes of a vaccination outreach program targeted at patients without access to their electronic patient portal.20 These reports and others in this section not only underscore disparities in vaccination rates, they also explore the ways in which COVID-19 affects other health behaviors, from breastfeeding to opioid and other drug use.

All of these reports – and the artwork interspersed throughout – help to illuminate the multifaceted nature of the challenges we faced during the pandemic and the imperative to address these challenges within the broader context of health care delivery. The intersection of research, health care access, and the unique needs of specific patient populations underscores the need for comprehensive and equitable strategies to fortify our health safety net and enhance health care outcomes for all.

We extend our gratitude to the WMJ publishing and editorial boards for their unwavering support in bringing this special issue to fruition. Their dedication and collaborative efforts have played a pivotal role in shaping the content and ensuring its quality. Additionally, we express sincere appreciation to our advisory board, whose guidance and insights have been invaluable throughout the entire process. Together, these collective efforts have contributed to the creation of what we hope is a meaningful, insightful special issue.

REFERENCES
  1. Remington PL. The COVID-19 stress test: results and recommendations. WMJ. 2023;122(5):xx-xx.
  2. Dove A, Kallies KJ, Hargarten S, Tomas CW. A Milwaukee syndemic? Penetrative injury and COVID-19. WMJ. 2023;122(5):xx-xx.
  3. Maganti N, Huang L, Banghart M; Channa R, Chang JS, van Landingham SW. Ocular emergencies during the coronavirus disease ‘safer at home order’ in Wisconsin. WMJ. 2023;122(5):xx-xx.
  4. Birkey T, Woodbury J, Aldrete S. COVID-19 infection outcomes and testing outreach efforts among people living with HIV in Milwaukee, Wisconsin. WMJ. 2023;122(5):xx-xx.
  5. Dong Y, Hanson R, Penlesky AC, Nattinger AB, Heinrich TW, Pezzin LE. Association between COVID-19 and delirium development in the general medical units at an academic medical center. WMJ. 2023;122(5):xx-xx.
  6. Penlesky AC, Dunn C, Hanson R, Lodes M, Nattinger AB, Singh S. Efficacy of a digital intervention to increase annual wellness visit scheduling amid COVID-19 backlog. WMJ. 2023;122(5):xx-xx.
  7. Melamed S, Lee J, Bryant A, Choi R, Liegl M, Pan A. Pediatric COVID-19 hospitalizations during the Omicron surge. WMJ. 2023;122(5):xx-xx.
  8. Vazirnia P, Luebke M, Abdelrahim MT, et al. Perception of burnout and its impact on academic hospitalists during COVID-19 and institutional strategies to combat burnout and improve wellness. WMJ. 2023;122(5):xx-xx.
  9. J Christianson, Johnson NL, Guttormson J, Sommers-Olson B, McCarthy M. COVID-19 vaccine acceptance or refusal among US nurses: a descriptive cross-sectional study. WMJ. 2023;122(5):xx-xx.
  10. Byrne S, Astor B, Djamali A, Zakowski L. The association between remote work during the first wave of the pandemic and faculty perceptions of their productivity and career trajectory: a cross sectional survey. WMJ. 2023;122(5):xx-xx.
  11. Bui A, Tesch S, Zwick M, Swanson KJ. Trainee experiences during COVID-19. WMJ. 2023;122(5):xx-xx.
  12. KKS Modji, McCoy KE, Creswell PD, Meiman JG. Incidence of COVID-19 and worker’s compensation Utilization among food manufacturing in Wisconsin. WMJ. 2023;122(5):xx-xx.
  13. Creswell PD, Modji KKS, Morris CR, McCoy KE. Work and life in the balance: COVID-19 mortality by usual occupation and industry in Wisconsin. WMJ. 2023;122(5):xx-xx.
  14. Pierro M, Zurko J, Szabo A, et al. Matched case control analysis of breast cancer-specific factors affecting risk of developing SARS-CoV-2 infection. WMJ. 2023;122(5):xx-xx.
  15. Papp LM, Kouros CD. Testing similarity in romantic partners’ COVID-19 experiences at the time of a pain-related emergency department visit. WMJ. 2023;122(5):xx-xx.
  16. Rehrauer WM, Yang D. Laboratory-developed tests: a critical bridge during the COVID-19 pandemic. WMJ. 2023;122(5):xx-xx.
  17. Temte JL, Barlow S, Temte E. Feasibility and functionality of SARS-CoV-2 rapid testing in K-12 school health offices. WMJ. 2023;122(5):xx-xx.
  18. Schell TL, Mailig MA, Almasry M. Uptake rates of three COVID-19 vaccine doses and risk factors for incomplete vaccination among patients with inflammatory bowel disease residing in Wisconsin. WMJ. 2023;122(5):xx-xx.
  19. Warden A, Liang J, Vanias KJ. High but inequitable COVID-19 vaccine uptake among rehabilitation patients. WMJ. 2023;122(5):xx-xx.
  20. Wu JF, Muntz MD, Maguire A, Beckius A, Kastner M, Hilgeman B. COVID-19 vaccination telephone outreach: a primary care clinic intervention targeting health equity. WMJ. 2023;122(5):xx-xx.
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