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Q+A with Dr. Nancy Messonnier

December 2021

If you watched TOTALLY UNDER CONTROL, you may remember Rick Bright describing the moment when Dr. Nancy Messonnier, formerly the Director of the National Center for Immunization and Respiratory Diseases at the CDC, sounded the alarm for the first time in late February 2020 about how COVID-19 was about to cause severe disruption to our lives. Now as the Skoll Foundation’s Executive Director for Pandemic Prevention and Health Systems, we had the chance to ask her some of our most pressing questions.

Q. How long will the pandemic last? Are you hopeful for the future?

It’s a mistake to try to predict the trajectory of this pandemic. Almost universally, the predictions made by many scientists have been incorrect. It’s also a mistake to think that one day it will all just be over. Omicron, Delta, and other variants are cases in point and a reality that we must be prepared to address. We need to learn to live with this virus and accept the fact that the risk will not go down to zero—much like with many other common respiratory viruses. However, I do believe that we can manage to live alongside it and find ways to modify our behaviors, when necessary, to keep the risk low. As frustrating and depressing as this pandemic has been, I think we are learning from it and that it will have lasting positive impacts on certain aspects of our lives. I hope that once the dust settles a bit, we will be able to think objectively about how to leverage advances in science and biotechnology and how we can better prepare for future events, including preparing and equipping healthcare and public health workforces. I hope that we will be able to better understand how interconnected the entire world and we all are and the deep need for basic scientific literacy. In the meantime, especially during this holiday season, I’ve been thinking a lot about the people in my life and their safety and how thankful I am for my family, my friends, and my community.

Q. What kind of impact has the pandemic had on frontline healthcare workers?

Frontline healthcare workers have been in the trenches of this pandemic from the beginning. In the early days of the pandemic, they were treating the sickest patients without being sure of their own safety and, sometimes, without having the advantage of personal protective equipment. It is a tremendous responsibility and so difficult to watch patients you’re responsible for suffer and sometimes die. Healthcare workers have carried a huge weight and burden that they just can’t put down—and they have been doing it for almost two years. To make matters worse, they carry that burden with them when they come home, concerned about transmitting the virus to their families and friends. In recent months in the U.S., the availability of vaccines has made the situation better for many healthcare workers because they are better protected and the number of new cases have trended downward nationally. But, in some parts of the country, case rates are rising quickly and healthcare workers are frustrated because most of the hospitalized patients are unvaccinated. After nearly two years of fighting a pandemic, the healthcare work force is decimated and hospitals are short-staffed. I’ve talked to friends who practice clinical medicine who agonize over the fact that they know that they are not able to provide optimal patient care. Many colleagues also talk about how hard it is to have to dig deep to find compassion for patients who could have prevented their illness had they gotten vaccinated and followed masking and social distancing guidelines. The situation is even worse in many countries around the world that don’t have access to vaccines, protective equipment, supplies, and healthcare staff and infrastructure. Community health workers play an even more critical role in these contexts, in many cases despite lacking the resources and systems needed to fight a pandemic.

Q. What is one thing about mental health and healthcare workers that you wish more people knew?

It might seem simplistic to say this but healthcare workers are human and suffer the same stresses and mental health challenges, like depression and anxiety, as we all do. The important difference that people need to understand is that the stresses that healthcare workers experience are magnified by their responsibilities for the lives of others. Unfortunately, the healthcare sector does not have comprehensive systems in place to support healthcare workers’ mental health. To make matters worse, healthcare workers frequently do not feel they can report their mental health challenges for fear of impacting their careers and peers’ perceptions of them. Healthcare workers choose to go into healthcare because they want to care for others and, generally, they are incredibly resilient, but they are not superhuman. The impact of the pandemic on some healthcare workers has been unbearably devastating.

Q. What are some of the unforeseen consequences the pandemic has had on the healthcare sector

The pandemic has had a tremendous impact on all aspects of the healthcare sector. Too many providers are walking away or choosing to take jobs that are less stressful, less busy, less consuming. Healthcare workers closer to retirement are thinking of retiring early. We will suffer immeasurably as a society if we lose their caring capacity and many years of experience. This is even more pronounced in the Global South where healthcare workers have less access to personal protective equipment and vaccines and where there are fewer of them caring for growing numbers of patients.

Q. What are your hopes for the future of our healthcare system?

I hope we will take this opportunity to think more systematically about our healthcare system, both in the U.S. and globally, and enact reforms that improve resilience in the system and treat healthcare workers as the life-saving heroes that they are. This pandemic should also remind us how important the bonds are between a patient and their primary care providers, who are trusted by their patients to help them make healthcare decisions like getting vaccinated. The U.S. health care system should do more to ensure that primary care providers are well-equipped and -treated and adequately compensated–and that primary healthcare is available to everyone.

Q. What can we do as individuals to support our frontline healthcare workers moving forward?

I hope that we can also remember to be patient and compassionate with our healthcare workers. This is true with healthcare workers who care for us as patients but also healthcare workers who are our friends and neighbors. They have been traumatized disproportionately by this pandemic compared to other sectors of society. More generally, the most important thing we can do is to prevent people from getting COVID so that we decrease the burden on healthcare workers and the sector at large. That is yet another reason everyone should be getting fully vaccinated and taking appropriate precautions to decrease the spread of COVID.