Emergency department entrance.

Pandemic Lays Bare Shortcomings of Health Care Institutions

By Lauren Oshry

In 1982, when AIDS was first described, I was a first-year medical student in New York City, the epicenter of the epidemic in the U.S. To the usual fears of a medical student — fears of failing to understand, to learn, to perform — was the added fear of contracting a debilitating and universally fatal infection, for which there was no treatment. But our work felt urgent and valued, and the camaraderie among medical students and our mentors is now what I remember most.

Nearly forty years later, my experience as an attending oncologist during COVID-19 has been different. Yes, I am older and less naïve, but also this pandemic has been managed in fundamentally different ways. Aside from the obvious federal mismanagement, my own institution has deeply disappointed me. The institutional shortcomings we had long tolerated and adapted to were laid bare by the COVID-19 pandemic, and massively failed our patients and morally devastated those of us on the frontlines.

As a provider in a large safety net hospital, I care for a predominantly minority population in the lowest economic bracket. These would be the individuals disproportionately affected by COVID-19, with highest rates of infection and worse outcomes. My patients have the additional burden of cancer.

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NEW YORK, NEW YORK - APRIL 05: Emergency medical technician wearing protective gown and facial mask amid the coronavirus pandemic on April 5, 2020 in New York City.

Don’t Call Me a Hero: How to Meaningfully Support Health Care Workers

By Molly Levene

“Heroes Work Here.”

Sometimes those three short words make me angry; other times they make me cry.

I was one among thousands of EMTs and paramedics who were deployed to New York through FEMA last year. Having studied public health in school and worked in EMS for over a year, I thought I had seen the extent to which we fail patients; I believed myself disillusioned enough to be prepared for any injustice or chaos I might encounter.

But last April, I quickly learned I was wrong. And when you feel complicit in such deep structural dysfunction, it is incredibly difficult to feel heroic.

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LOMBARDIA, ITALY - FEBRUARY 26, 2020: Empty hospital field tent for the first AID, a mobile medical unit of red cross for patient with Corona Virus. Camp room for people infected with an epidemic.

The Fourth Wave of COVID-19: The Effects of Trauma on Health Care Workers

This post is the introduction to our newest digital symposium, In Their Own Words: COVID-19 and the Future of the Health Care Workforce. All contributions to the symposium will be available here.

By Stephen Wood

On this day one year ago, World Health Organization Director-General Tedros Adhanom declared COVID-19 a pandemic, sounding the alarm about the international threat posed by the virus.

Today, one year later, I fear the end is not in sight. In fact, I believe that we are on the precipice of a fourth wave.

The fourth wave will strike the people on the frontlines of this pandemic — health care workers. It will be the effects of the trauma that health care workers entrenched in this pandemic have faced. And it is likely to have significant and lasting effects on our health care system.

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Bill of Health - Mask, calculator, and coins on eviction notice, covid housing evictions

The Long-Term Problem of Eviction Moratoria Without Financial Support

By Beshoy Shokralla

The COVID-19 pandemic has exacerbated preexisting vulnerabilities in the rental housing market and created a dire economic situation for both renters and small landlords. Prior to the pandemic, the poorest 20% of households were spending more than half of their income on housing costs with little to no savings.[1] Many renters who faced evictions often owed less than $600.[2] Now, due to the severe job losses brought by the pandemic, an estimated 30-40 million renters could be at risk of eviction.[3] The Federal Reserve Bank of Philadelphia separately estimates that of 7.5 million renter households with at least one worker who has experienced some unemployment, 1.34 million renters will owe $7.2 billion in rent by December 2020.[4] That’s approximately $5,400 in rent-related debt for each household. This burden does not only affect renters, as many small landlords have also reported feeling the pressure. One survey conducted by Avail[5], an app that helps small landlords manage their property, and the Urban Institute found that about 30% of respondent-landlords have felt increased pressure to sell their properties due to the strain that the pandemic has caused.

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Bill of Health - Andrew Cuomo, governor and executive power, conducts a COVID-19 press conference in front of a blue background during the pandemic

Government Authority to Respond to COVID-19, the Nondelegation Doctrine, and Legislatures vs. Governors

By Beshoy Shokralla

The most common response to the pandemic has been quick and decisive action from state governors to reduce the spread of COVID-19 through executive orders and state programs. At first, the orders were accepted and seen as necessary responses to the public health emergency. As time went on, however, and these orders continued to be renewed, state governors faced criticism from citizens, businesses, and even legislators for what many believed to be an improper exercise of power. Social media sites were littered with misinformation about how these executive orders were not laws, but mere suggestions that were unenforceable. Members of state legislators, believing these orders to be an exercise of legislative powers traditionally belonging to the legislative branch, began to rally against stay-at-home orders and call for them to be revoked. These debates were especially contentious in states where the governor was of a political party different from the majority of the state legislature. The pandemic has brought several important questions into the public dialogue and into courts, among them being: 1) does the government have the authority to restrict personal liberties during a public health crisis; 2) does the executive branch have the authority to respond to these crises; and 3) to what extent can state governors enact these responses?

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