Health Professionals React to the End of the COVID Public Health Emergency

In this exclusive video, Paul Offit, MD, director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia; Jeremy Faust, MD, editor-in-chief of MedPage Today; Sarah Warren, RN, a writer, speaker, activist, and mental health advocate in Florida; Payal Kohli, MD, medical director and founder of Cherry Creek Heart in Denver; and Zachary Rubin, MD, a pediatrician in Illinois specializing in allergy and immunology each discuss the one thing the COVID-19 pandemic has changed in their practice.

The following is a transcript of their remarks:

Paul Offit, MD: Here’s what I take away from this pandemic. I think that this virus, SARS CoV-2 virus, is about to enter the pantheon of winter respiratory viruses, joining influenza, respiratory syncytial virus [RSV], and others.

So do we need to treat it differently if, like these other viruses, it’s going to be causing hundreds of thousands of hospitalizations and tens of thousands of deaths every year like influenza does or RSV does? I think the answer is yes, to some extent.

I think if you are in a high-risk group, meaning people over 75, people who have multiple comorbidities, or people who have immune deficits, and you have upper respiratory tract symptoms — congestion, cough, runny nose, fever, chills — I think you should test yourself for COVID. If you’re positive, you should treat yourself with an antiviral.

If you’re not in any of those high-risk groups, if you’re a young, relatively healthy person and you have respiratory symptoms, I think you should assume that you have COVID or influenza or respiratory syncytial virus or one of these other viruses, all of which can cause people to suffer and be hospitalized, and treat that accordingly – meaning stay home until you feel better. If you can’t stay home, wear a mask until you feel better.

So that is sort of how I see myself changing my practice.

Jeremy Faust, MD: To me, it’s just amazing to think that we did not wear masks during cold and flu season, and even other times of the year when there are outbreaks, there are respiratory pathogens, there are droplet pathogens, that [transmit] either by breathing or by just putting your hand near your face. As healthcare providers, we are around sick people who can give us things, and we are around sick people who can’t afford to get those things.

Even though we don’t have to wear masks anymore, I still am for the most part in my clinical environment, because I do not want to be that vector. I want to be someone who is stopping chains of transmission.

That’s something that it took the pandemic to wake me up to.

Sarah Warren, RN: With the ending of the Public Health Emergency surrounding COVID-19, there are a lot of mixed emotions and complicated emotions that arise, especially for healthcare workers. I think it is in response to the burnout or moral distress that many of us haven’t even been able to unpack or address. That leads into what I’ve changed about my practice.

So in fall 2021, I actually went to therapy to address the moral distress and the symptoms I was experiencing that were directly correlated with my work at the bedside. I was diagnosed with symptoms of PTSD [post-traumatic stress disorder] and new-onset depression, as well as a triggering of my preexisting anxiety. Without taking those steps to take care of myself and prioritize myself and my own well-being, I don’t know if I would still be here today.

That is what changed about my practice as a healthcare worker: I began to put myself first.

Payal Kohli, MD: One of the most important lessons that I’ve learned as a healthcare provider that I’m going to carry through in my practice for years and years to come from the COVID-19 pandemic is the importance of telehealth.

Telehealth is something that I had never really used before as a way to see my patients, and now I’m finding applications for it everywhere I look. Whether it comes to seeing patients in the convenience of their home and learning about what their home life is like, or just seeing patients for a quick medication titration, I love having the convenience of telehealth in my office. In fact, I even use it sometimes when the weather is bad or someone is running late at work or what have you and they can’t make it into the office.

So, telehealth for me has definitely been one of the silver linings of the COVID-19 pandemic.

Zachary Rubin, MD: Even though the Public Health Emergency is ending, that does not mean that I’m going to stop masking with my patients in my clinic. In the last 3 years, I’ve only been sick once and I have not gotten COVID-19 during this entire time. I attribute a lot of that to just making smart decisions about what I do in my clinic, as well as what I do at home and with my family.

So I really feel that one of the best, most effective ways to help protect not only myself but my patients is to wear an N95 mask when I’m with patients, whether they are sick or well.