COVID-19: Is the pandemic over, and have we learned from our experiences?
Disparities in Care
COVID-19 highlighted the disparities within the healthcare system, with elderly, low-income, marginalized and vulnerable populations facing the worst health outcomes. Over the course of this pandemic, infection and mortality rates have been highest among nursing home residents as well as black, indigenous, and latinx communities.
Black Americans make up 13.4% of the US population, but in July 2020, accounted for 23% of deaths from COVID-19. Black counties had a mortality rate 6 times higher than white ones. In New Mexico, Native Americans accounted for 32% of COVID-19 cases, although they only make up 11% of the population.
Transmission rates were also higher among essential workers: health care, food service, and public transportation. Nursing homes, prisons, meatpacking plants, homeless shelters, and psychiatric or developmental care facilities saw significantly higher rates of infection. In 2020, more than 400,000 residents and employees had been infected in nursing and long-term care facilities, leading to more than 68,000 fatalities—more than 40 % of the total deaths from the virus in the USA.
Poor Coordination and Rampant Misinformation
COVID-19 highlighted the general disorganization in public health offices. As the outbreak began to escalate, it was evident to see how badly fragmented the pandemic response was among different states and localities. Some fought against the various restrictions that were supported by the CDC, while others battled against each other for diagnostic tests, medicine and medical supplies.
The Commonwealth Fund released a scorecard ranking states responses to the pandemic. Hawaii and Massachusetts got the top scores, based on the measures they took to improve healthcare access and quality, service use and cost, as well as addressing health disparities. Meanwhile, the states with the worst scores included Mississippi and Oklahoma. The outcomes are significant: Hawaii had an excess death rate of fewer than 200 deaths per 100,000 people, while Mississippi experienced a rate of 500 deaths per 100,000 people.
This difference is based on a wide-range of factors but it is clear that access to affordable care was a dominant factor: states with lowest scores included those that had not yet expanded Medicaid eligibility under the Affordable Care Act as of 2020: Texas, Oklahoma, and Mississippi. Meanwhile, Massachusetts reported the nation’s lowest adult uninsured rate, 3.6%.
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