Five years later: How COVID changed healthcare

John Sullivan, chief medical officer of St. Clair Health System, spent 33 years in the Navy. And when he thinks back to this week five years ago, he likens the early COVID-19 days to a military deployment. "I still get a little PTSD talking about this, honestly, thinking back on that week," he said. "We were scared for our own lives, working longer hours than we ever had before. For all of us leading health care systems, we were making enormously consequential decisions, often many every day, without really any information." What happened during those early weeks and months of the COVID pandemic changed the face of health care both in terms of the people working within it and the way that health care is delivered. Vaccines entered the health care system in ways that they hadn't before, from cameras following a UPS van bringing the first doses of the COVID-19 vaccine into Western Pennsylvania to a carefully orchestrated hierarchy of who was eligible to receive vaccines by age and health conditions to vaccine contrarianism and distrust of the health care system. Masking also arrived suddenly, with statewide recommendations in April 2020 and mandates that June, followed by pushback from some segments of the public. The state and county health departments issued public health orders such as closing schools, restaurants and other businesses that affected all Pennsylvanians.

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"Clearly a lot of things have changed," said Donald Whiting, who is now chair of neuroscience at Allegheny Health Network but was the health system's chief medical officer from 2019 until earlier this year. "The most rapidly developed during COVID and most long-lasting single thing is telehealth. It was remarkable how quickly it rolled out truly, within a matter of weeks - and how it was accepted by patients." Before COVID, telemedicine was often seen as an inferior option, or one to be used only in special circumstances. But as it became commonplace out of necessity early in the pandemic, a surprising thing happened. "People started liking it," said Dr. Whiting. "They started seeing it as a reasonable alternative to in-person visits, and there's a whole younger generation that that's their preference in a lot of cases." Kristen Walker, a therapist and clinical director at the Counseling & Wellness Center of Pittsburgh, now sees about 50% of her patients online. Prior to COVID, "it was very rare," she said. "You may have done one or two here and there." The switch to online has not just opened up the ease of access for her local patient base, but has also allowed patients across Pennsylvania to access therapy even in rural areas with limited in-person options.