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COVID-19: Looking Back — & Ahead

Jan. 13, 2021

A Once-in-a-Lifetime Challenge for Research

Alison Cahill, M.D., is director of the Health Transformation Research Institute at Dell Med, which supports the translation of observations made in the laboratory, clinic and community into interventions that improve the health of individuals and the public. She highlights the critical role research will continue to play in answering the pandemic.

Cahill: Through a research lens, the challenge of a pandemic brought out some of the best in science and highlighted important opportunities. In response to an unknown, highly transmissible virus causing a deadly disease, the scientific community moved rapidly to help grow our understanding from mechanisms of disease and spread to identifying risk factors and developing treatments. This work enabled many things, including the development of a vaccine in record-breaking time and improvements to clinical care. The response to the pandemic also further widened disparities in health, which will require attention in future research to close them.

Looking forward to 2021, we anticipate research to help us understand many unanswered questions arising from the pandemic, including those about immunity to COVID-19 — both from the disease as well as vaccines — and the impact of care alterations such as telehealth on patients, providers and health outcomes. There is also the need to refocus research on other critical health conditions that received less attention in 2020.

Mental Health Care: Forging Ahead

Stephen Strakowski outside the Health Learning Building.

Stephen Strakowski, M.D., is Dell Med’s vice dean of research and associate vice president for regional mental health. A psychiatrist, he says the pandemic is highlighting the need for continued mental health services investment.

Strakowski: One of the greatest costs of the pandemic is that mental health has been put under intense pressure due to social isolation and disruption of normal daily rhythms. More than half of all people 18 to 44 years old in the U.S. report that their mental health has worsened. Compounded by social unrest, the need for robust mental health services is perhaps higher than at any point in the past two decades. It challenges an already inadequately prepared mental health care system in Texas and nationally.

In 2021, mental health challenges will persist or worsen until we can manage the pandemic more effectively. Even then, the mental health impact will persist. The good news is that with the upcoming Texas legislative session, there is an opportunity to support mental health access through wise investment and policies. Our intent is to continue building on past investments to finish the new Austin State Hospital (in 2019, the Texas Legislature approved $165 million in initial funding), continue to expand outpatient services and speak often and visibly about the mental health needs to eliminate stigma.

Cancer Prevention & Care, Virtually

Michael Pignone on Dell Med's campus.

Michael Pignone, M.D., is chair of internal medicine at Dell Med and director of the program on cancer prevention and control for the Livestrong Cancer Institutes. He notes how community collaborations and telehealth have proven essential in the fight against cancer throughout the pandemic.

Pignone: Delivering cancer screening and prevention services to Austin’s residents with unmet needs is challenging in a normal year. Doing it well during the COVID-19 pandemic has required unprecedented partnership among local organizations including Dell Med, Dell Seton Medical Center, CommUnityCare Health Centers and Lone Star Circle of Care, along with essential funding from the Cancer Prevention and Research Institute of Texas (CPRIT) and Central Health. Together, we implemented a series of campaigns to connect with 7,500-plus high-risk patients in this last year alone, by mailing them at-home colorectal cancer screening kits. The effort effectively doubled the existing colorectal cancer screening rate among the target population.

Before the pandemic, we were using initial cancer screening mailings to arrange in-person follow-up appointments. But with the onset of COVID-19, our team quickly pivoted, providing follow-up assessments and counseling via telehealth. We found that cancer prevention initiatives like smoking cessation services, counseling to reduce high-risk alcohol consumption and even instructions to prepare for a colonoscopy could be delivered effectively over phones or tablets. Patients and clinicians let us know that they appreciated the convenience, and reducing in-person visits allowed us to safely prioritize face-to-face care for patients with acute needs.

In 2021, we will continue to leverage technology to continue virtual care even after the pandemic and work to build on collaborative successes to reduce the burden of cancer for everyone in Central Texas.

​The Business of Health (For the Lonely)​

Mini Kahlon in the Health Learning Building.

Maninder “Mini” Kahlon, Ph.D., Dell Med’s vice dean for the health ecosystem, finds in the pandemic an opportunity for addressing the connection between loneliness and health in older adults.

Kahlon: In the last few years, we’ve seen an emerging interest in loneliness because of studies showing its significant impacts on mental health and a range of other critical health conditions. A 2020 National Academies report recognizes loneliness as a serious public health issue that affects a significant portion of the population, including at least a quarter of older adults. The COVID-19 pandemic has both revealed and exacerbated existing mental health challenges, including loneliness.

Our team at Factor Health, which is focused on catalyzing a new business of health with outcomes worth paying for, quickly adapted in response to the pandemic by working with Meals on Wheels of Central Texas to address loneliness in socially isolated older adults. While addressing a specific issue and need, the project also highlighted the complexity of mental health issues like depression and anxiety.

Moving into 2021, we expect a flourishing body of academic literature and new projects focused on solving problems related to the critical mental health challenges of our time — many of which, such as loneliness and isolation, were already there before COVID-19, but that the pandemic has thrust into the spotlight.

‘Herd Accountability’

Jewel Mullen sitting on a couch in the Health Transformation Building.

Jewel Mullen, M.D., is associate dean for health equity at Dell Med. She calls for corporate responsibility in protecting vulnerable people through COVID-19 and beyond.

Mullen: I have not heard one person say they were sorry to see 2020 end. For most people, it couldn’t end fast enough. But the harsh public health, social and economic realities wrought by the pandemic are still with us as we enter 2021. And for the most vulnerable members of our communities, it will take more than a vaccine, masks, social distancing and good hygiene to assure health and well-being.

As we hope for COVID-19 vaccines to bring herd immunity, I hope for Austin’s development of herd accountability: Accountability across our public and health care organizations, along with the business community, to create sustainable opportunities for everyone here to be as healthy as possible.

People can’t, on their own, create the housing, transportation, employment and educational opportunities necessary for them and the generations that follow to thrive. Or narrow the more than 10-year gap in life expectancy between communities on the east and west sides of town. Business leaders and their stakeholders have the resources and power to do so, increasing the chance for everyone here to live longer, healthier lives. Let’s make that the vision for 2021.