(gentle music) - The World Health Organization declared COVID-19 a global pandemic on March 11th, 2020.

And since then, it's been two long years of uncertainty and grief, trauma, and in many cases, resiliency.

Now experts are cautiously planning for a future in which we live with and manage the coronavirus for the long term.

But the normal of tomorrow will look different than the normal of the past as we consider all the innovations that have come from the pandemic.

Tonight we'll talk to researchers and health providers about how COVID-19 has shaped the future of scientific advancement and healthcare delivery.

We'll also hear from those who've worked on the front lines in Connecticut hospitals and how that experience has changed their career paths and outlooks on the profession.

And finally, we've asked everyday business owners and residents, "What does living beyond the pandemic look like to you?"

For Connecticut Public, I'm Nicole Leonard, and this is "Cutline".

(gentle music) When COVID-19 became a threat in Connecticut, state officials issued orders, asking all non-essential workers to stay home.

But this presented a challenge for healthcare providers and their patients.

How would they get health services to people safely and effectively?

The answer came in the form of telehealth.

Access to virtual and over the phone medical appointments dramatically grew, particularly during the first year of the pandemic.

Some saw this as a temporary solution while COVID-19 transmission was at its highest, but new polling shows that many providers and patients want to keep telehealth as a permanent treatment option.

We spent time with members of a Simsbury family, who hope that telehealth is here to stay.

- Okay.

I found it.

- Ooh, perfect.

- Going back two years ago to the start of the pandemic, we were in the same mindset with the rest of Connecticut of, oh, this is gonna be two weeks.

And then that moment where it clicked where this might be a little longer, we rallied and really just drew upon the strengths of our colleagues and our teammates and our clinicians to be able to figure out we can do this.

You know, we have an important job to do.

We have clients to reach and we need to make these services accessible.

And how are we gonna do that?

- What did he draw?

- A firetruck.

- [Therapist] That was really nice talking.

It's a red fire truck.

- My name is Sarah White and my wife, Jen Lano, and I own Speakology and we also have a five-year-old named Maeve.

We started Speakology probably 10 years ago.

And at the start of the pandemic, we converted everything to telehealth.

And not only have we done that for our clients, but also for our daughter.

So Maeve is five and she has an articulation disorder, ironically.

She either goes in person or participates in telehealth now on a weekly basis, twice per week for speech therapy sessions.

- Smoke.

- Perfect.

- [Caretaker] Wow.

Good job.

She has been thriving and making progress through the telehealth platform.

- You know, I remember the very first sessions of, okay, we're all home, we're all in our pajamas and our casual wear and we're trying to make this work.

And to hear a little child's voice pipe up and say their clinician's name was so exciting because that's when we really knew, that moment, that this is going to work.

They're going to buy into what we're doing, and it's going to make a difference.

- Ready?

Let's hold our tongue tip behind our teeth for three seconds.

- Once implementing telehealth, we saw some children that we serviced really come out of their shells.

We saw family members and caregivers being able to understand what it is on a daily basis of us working with their children.

And then to see the smile on the caregiver's face, to watch their child say a sound that they had been practicing or say a dog's name that was tricky to say, it really brought everything full circle, and everyone was really receptive to it.

- I actually didn't think that she was gonna succeed with telehealth and I've seen all of our clients succeed or most of our clients succeed and I just thought she's not gonna talk on the screen or she's not gonna interact.

And she so does great and interacts with the screen and participates and even kind of gets through problems with the therapist that maybe she wouldn't in person even.

But it's definitely changed my perspective in realizing what our kids can do.

And if we provide the tools and the experiences and give them the tools to participate, they can actually really be successful.

- There was a special magic that happened.

Even though it happened accidentally and it happened through tears, and we didn't know what was gonna happen the next day, there is a part of that, that we'll continue to keep with us.

And strategies that we learned over telemedicine, different activities.

We definitely were able to differentiate our instruction and that's something we'll take with us into the future.

- We have several clients who have stayed full-time on telehealth and they continue to this day.

And then we have many clients who opt to do both, depending on the situation, the numbers, the COVID numbers or things like that.

And then we have a couple of clients who had telehealth fatigue, and they're really glad to be on the other side of this and coming back in person.

- As we head into the future and the uncertainty of different variants and what is the future going to be like for all of us in a therapeutic medical facility, we would love to be able to call on teletherapy in the future for when there is a need for it.

Whether a client is ill or a family member is ill, it doesn't mean that the child should not, or the adult should not be able to access services.

We hope to be able to provide those services regardless of what's going on in the world and continue to make everything accessible.

- Now that we're on the other side of everything, we've been closer to our families, so closer to our clients, we've been in their houses and worked with them through everything.

If that was ripped away, I mean, I don't even have that perspective any more.

I would feel so disappointed.

Many of our clients would be lacking services because people are so reliant still on telehealth and for good reason.

There are certain insurance plans right now that won't cover telehealth any more.

Self-funded plans, many plans have exclusions now for telehealth just based on the type of plan it is, but I would hope that it continues to be an option.

- Joining us today is Dr. Ramindra Walia.

He is the Chief Medical Officer at United Community Family Services.

Also with us is Dr. Corinne Seville.

She is a psychologist and Program Director of the adult outpatient behavioral health program at Cornell Scott Hill Health Center.

We've been so focused on the changes and innovations within healthcare, and one of the biggest ones has been telehealth and the access to telehealth and the way people use it nowadays, as opposed to before the pandemic.

So now we're two years in, but if you could imagine, remember what it was like prior, March, 2020, Dr. Walia, how often was telehealth used before the COVID-19 pandemic and in what ways was it used before we entered this phase?

- Before the pandemic, I mean, Connecticut never, it was not reimbursable visit.

So we never used telehealth in primary care services per se for primary care medical patients, except very rarely for our Medicare patients who lived in extremely rural areas.

Those were the only people we were able to connect, but we didn't, UCFS didn't have those.

Some other providers might have utilized it for their Medicare patients.

There's some years, I feel, I remember around four years back UCFS, along with some other federally qualified health centers had participated in a pilot project that was launched by our association CSC Act to access specialty care via telehealth for patients who have difficulty getting to the specialists.

So different specialists, dermatology was a big one.

So we actually got a small grant, CSC Act did, and we participated in that.

It was clunky at best in my knowledge.

We continued with the grant until the grant was over.

And then the overheads and the cost of actually continuing the service was prohibitive.

So we gave up on that.

It was outside that, electronic health records, so then the providers had double work, first to look into the other portal, then come back.

So it just wasn't the right fit for us.

So that's the extent of our telehealth experience before the pandemic hit.

- And Dr. Seville, what did telehealth look like in the behavioral health field?

How was it used or was it used very frequently at all for patients seeking mental healthcare?

- So for my agency and most other agencies, I don't believe that telehealth was being used for the same reasons that Dr. Walia explained.

Insurance wasn't reimbursing for that.

And as most of our clients prefer to use their insurance, unfortunately, telehealth wasn't a covered modality of treatment service delivery.

I know that there are some other smaller, maybe for-profit private practices or group practices that did offer some telehealth, but on an agency level, that wasn't something that you used.

- And so you both mentioned some of the challenges and barriers that existed prior to the pandemic even starting, that made it, it sounded like made it hard to implement telehealth and to bring it to your patients.

Now, Dr. Walia, what changed during the COVID-19 pandemic specifically that perhaps opened the door to offering telehealth in more ways to people seeking physical healthcare?

- Well, the legislation changed, so they allowed Medicaid to be, telehealth to be a billable visit in Medicaid.

This was around March, April when they started.

That was around the time when the first lockdown was announced.

The volumes in most of our health centers, why just the health centers, even in private practices was down to under 20%.

So access to care was limited.

So this was a much needed, it's unfortunate that we had to use the pandemic to bring this into legislature, but I think that's what changed, making it reimbursable, making it accessible was a different challenge altogether.

Now it's become almost second nature.

Things are not where they should be, but it's become much easier to use, our providers have got much more, in the last two years they've got really used to the use of.

- And Dr. Seville, was it a similar experience?

Did you have a similar experience at Cornell-Scott Hill, especially with patients seeking behavioral health, what sort of access, how did access change after the COVID-19 pandemic and how did you all pivot to providing telehealth services perhaps more than in person for quite a time during the pandemic?

- Well, frankly, it was a necessity.

I mean, we were trying to respond to this crisis and reduce risk exposure as fast as possible.

Luckily, I mean, my agency acted very swiftly, so we never stopped providing services for clients, not one day.

So as we had seen that it was approaching, we rapidly got the equipment so that all of the providers had what they needed in order to offer services.

We identified reliable HIPAA compliant platforms to use in order to provide those services.

And then it was a lot of educating our clients to make sure that they were able to get the access to technology that they needed in order to continue to receive their care with us.

- And speaking about patients, Dr. Seville, what kind of feedback have you gotten from your patients after, helping educate them about how to use telehealth?

I'm imagining that you had patients who maybe have had a little bit experience with telehealth, but a lot of patients who had never used telehealth before to get their mental health care.

- So the response has been overwhelmingly positive.

Of course, there are several, there are clients who prefer in person appointments.

And so we try to provide that where it's possible to do so safely.

But the response has been pretty incredible.

I think that, our clients were able to adjust fairly quickly with support and with education and training on how to use the various platforms we have, whether it be via video or telephonic telemedicine, they've been able to adapt.

And I think that for our population, you know, we serve the underserved.

So we serve a lot of clients who don't have the resources maybe that they need in order to get access to care.

So one of the barriers to accessing services historically has been transportation to get to their appointments.

And this has been unbelievable in terms of providing access to care to clients who couldn't afford to necessarily get to us as frequently as maybe we felt that they needed to get to us, or that maybe had other factors to consider, like maybe medical complications or they were home bound or childcare issues so that they couldn't be gone for several hours in order to get care.

Now, if they can just find a quiet space for, you know, just the time of their appointment, it's allowed them to access treatment in a way that they never could before.

So the response has been overwhelmingly positive.

- And so now we're two years into the pandemic.

We're entering a third, although there's a lot of discussion of whether COVID-19 will, at some point, possibly this year become endemic, something that we all live with and manage as time goes by.

And so looking forward, Dr. Walia, you pointed out some of the limitations that telehealth still has, right?

Even though it's a tool that has been utilized a lot during the pandemic, a lot more than before, what sort of circumstances might you still, if somebody had the choice between both a telehealth appointment and an in person appointment, what are some circumstances that might still benefit somebody for you to see them in person rather using telehealth?

- Right.

In medical, I think you can't do away, it can't all go virtual.

You do need that direct face to face patient interaction, the listening to, the use of the stethoscope, the use of the palpation, even though technology works wonders and has come a long way, even in the last 20 years that I've been in this country, we have a long way to go to switch out of direct patient care.

So, but we now have a tool that can add to the benefits of direct patient care.

So we are in a process like all other organizations, I'm sure, on developing the telehealth tool kit, how do we use this important tool, addressing some of the needs that our patients couldn't meet 'cause of various social factors.

So that is definitely going to, it's going to be a challenge initially, but I think technology is strong enough to overcome that, and in interfacing and integrating certain services will optimize the use of telehealth even more.

- And I think it's fair to say, right, that healthcare is, a lot of it is individualized, but perhaps even more so in behavioral healthcare.

So I know Dr. Seville, this might vary on a case by case basis very much, but what could you see sort of telehealth working really well in, but also those instances where somebody may be best served if they still do come in, right?

Do you see telehealth completely replacing in person appointments?

- I think that's a great question.

I think that for our agency, replacing it 100%, I'm not sure about that.

We do still see people in person, because as Dr. Walia said, a lot of people don't have the resources, they don't have the technology, whether they don't have the phone, the computer, the iPad, or they, it's just not something that they're comfortable with in order to be able to access telemedicine, telehealth.

We also have clients who maybe are struggling more, or maybe their symptoms are more acute.

We need to do safety assessments in person.

Sometimes, you know, behavioral health is so much about the connection with the client.

It's not just about listening to them and giving them advice.

It's much more than that.

And the connection between the provider and the client is paramount to the success of any kind of treatment plan that we put in place.

So I think that sometimes that engagement and that can connection, while telemedicine is definitely a very valuable and effective tool for providing access to care, in some cases that in person, person to person face to face contact is still important.

So like I said, if we're doing safety assessments, or if we're trying to improve engagement, sometimes clients, if they don't have the technology or they don't have access to a private space, depending on what their home situation or their living situation is, they may need to come into the office and so that we can create that private and safe space for them here, on-site.

- Well, thank you both very much for joining me today to talk about telehealth and the future of where we go out of this pandemic.

We all appreciate the work that you do.

- Thank you very much.

- Thank you very much.

A pleasure being here.

- COVID-19 has impacted healthcare workers most acutely, as they care for the sick and vulnerable.

Many say this has been extraordinarily burdensome, both professionally and personally, they've logged countless overtime hours, said goodbye to patients and have become exposed to the virus themselves.

And all of this while dealing with workplace issues like staffing shortages, wage disputes, and safety concerns, longstanding problems that have only become exacerbated during the pandemic.

The experience has inspired some workers to make changes in their careers, while others leave the profession altogether.

And for those who are members of healthcare unions, they say the pandemic has shown them just how powerful advocacy can be for their colleagues and patients.

Joining us in studio today is Sherri Dayton.

She is a registered nurse of 16 years, and she's currently working in an emergency department.

And our other guest is Brittany Manley, who's also a registered nurse.

She's been working for seven years and just recently became a travel nurse.

Welcome.

Thanks for joining me today.

- Thanks for having us.

- Thanks for having us.

- Now, I know we're two years into the pandemic already, so it it's really hard to believe, we're entering the third year, since this was declared a pandemic in March of 2020.

Now, if you can think back to the Sherri and Brittany of March of 2020, Sherri, how did you feel about your job and your role as a registered nurse before the pandemic began?

- Honestly, being a registered nurse has always been a challenging position.

It's always been understaffed.

It's always, but for me, it's what I did.

It's what I wanted to do since I was in kindergarten, and literally, kindergarten, drew a picture, of what you want to be when you grow up?

I drew a nurse.

I found it very rewarding.

And oftentimes the jobs that are the most rewarding are the most difficult, both physically and mentally.

- And Brittany, where were you at?

Where was your head space at two years ago, when you were in your role, you were working in a hospital at that point?

- Yep.

I was on a med surgeon unit that they were converting to take the COVID patients.

So we were the one unit outside of like ICU progressive care that was gonna take the COVID patients.

And knowing it was coming, the anticipation was pretty hard, but at the same time, like, I knew, I was like, we can handle this, we got this, we're a phenomenal team.

I loved my job.

I loved being a nurse.

It was what I was meant to do, much like Sherri, and I, if I could go back and talk to her, I'd probably, I don't even know what advice I would give her, just be like, keep moving forward, basically.

- And now we're two years into this pandemic.

We are entering another year.

There's discussions that this COVID-19 may become endemic, and so there's maybe a light at the end of the tunnel as to the official end of this pandemic, but this virus is going to be around for quite a while.

And we know that this pandemic hasn't been more acutely felt probably by anyone, you know, other than healthcare workers, especially.

So when you think about where you are now and how you look at your role and how you feel about the work that you do, what kind of experiences in the pandemic have changed the way you feel now?

And I wanna ask Sherri first.

- Two years ago, I pretty much felt that healthcare was gonna be my life forever.

And that I loved what I did, and I was gonna do this till I retired.

After doing this for two and a half years, I decided that I need to find, not that I would leave healthcare per se, but being an emergency room nurse until I retire at 65 or older, like, it just doesn't seem like it's a possibility at this point.

You really, there's just so much a human body can endure mentally and physically.

And there's just, you know, I'm more than willing to advocate and fight for my patients and my coworkers and colleagues and profession.

But at some point you need to just try to step, take a step back.

So I've taken a lot of different steps in that direction.

I'm currently going to school for my master's because leaving bedside nursing without a higher degree is difficult to do, though more and more jobs are coming available and more, and more nurses are being very creative in finding a way to step away from the bedside, which is very unfortunate.

- And two years in, Brittany, I know that there have been some significant changes to your career, but right now, if you remember how you felt about your job and where your career trajectory was gonna go before the pandemic versus how you look at it now, what are some of the things that have happened in the last two years that have led up to some of those decisions that you've recently made?

- Probably my biggest factor was the emotion toll it took on me, watching what my patients had to go through.

Knowing that I couldn't give patients the care that they deserved.

That's not the kind of nurse I am.

That's not the kind of nurse I wanna be.

I feel like I was almost encouraged to step away from my current role as a bedside nurse.

I stepped away because it is imperative that I give the care that I would wanna give to my family members.

And when I am stopped from doing that, I had no choice.

So I chose to start travel nursing because it gives me a little bit more control of what environment I'm in.

And if I'm being able to give people what they deserve, 'cause I couldn't live with myself any more, to be honest.

And it, I look forward to the opportunities in having a little bit more say in what I can do for my patients.

- Now, speaking of travel nursing, that something that we saw throughout the pandemic skyrocket, we saw a record number of registered nurses and other people in healthcare join travel nursing, which is when you can travel, even within the state to different hospitals, you can travel out of state depending on where your license and where your license is accepted.

So we've seen this in record numbers.

What was your perception of travel nursing prior to the pandemic?

Did you ever think this was going to be part of your career?

- No, I never, I always... Travel nursing had an interesting stigma in that the nurses almost couldn't stay in one spot or they were money hungry or something like that.

And then the pandemic, nurses stopped caring about those stereotypes so much.

You can either treat me like not well, or I'm gonna go find someone who values my time and who will treat me with respect, as a nurse and a caregiver.

It was a huge step for me to be able to admit to myself that it's okay to do that.

But I would've never, if I had told myself two years ago that this where I was gonna be, I would've been shocked, 'cause I loved my job.

- So speaking of doing what is in your best interest and what may be in the best interest of your colleagues, Sherri, you have been on the front lines, you and your colleagues advocating for yourselves a lot during this pandemic, we saw healthcare unions get together in numbers and in strength to advocate for themselves.

How significant were those moments for you as a registered nurse advocating on behalf of yourself and your colleagues?

How significant were those moments to actually help move the profession forward?

- More importantly than what it did for myself and my colleagues, it's what it's gonna do for the patients in the community.

What people don't understand is there's a direct relation to safe patient limits and staffing and to the care that the community is getting.

My motivation and goal that lets me wake up every morning, continually advocate and come do interviews and be a union president and to advocate is to give the patients in the community the best care that they can get.

Unfortunately, it's been more and more difficult to do that.

When we were a state full of small community hospitals, where the organizations, families, and friends went to the hospital that we gave care to, there was more of a motivation to focus on that care.

Now it seems that there's more of a motivation to focus on the profits that occur.

Unfortunately.

And the hospital that I work at, unfortunately, was one of the least paid hospitals in the state, but my families and friends went to this hospital.

So my motivation was to get it to par, to be equal and fair pay in that hospital so we could retain great nurses and great healthcare professionals across the board, so that my friends and family who went to this hospital and my community that I grew up in would get better care.

So I'm glad that the conversations are being had, that we're here, that we're talking about it, but now we need to move past those conversations to actions, to make things better, to have safe patient limits, to stop mandates, to make this profession more appealing to the next generation, so they would come in and they won't work 16 hours straight against their will, they're not going to work for 8, 10, 12 hours without being able to have a break or being able to pee even, you know?

We need to start making some real big changes to make this profession more appealing because ultimately all of us become a patient someday, whether it's our friends or families or us, and in order to make sure that good outcomes are occurring and that good healthcare is being performed, we need to do this.

And as my coworker here says it's very, very important that we also do some wellness checks on ourselves, because what's been happening during this pandemic is that nurses are getting PTSD, call it more injury, call it compassion fatigue, call it whatever you want, the bottom line is the mental health of healthcare professionals, not just nurses, respiratory therapists, doctors, PCTs, all of it, is going downhill and we are losing them in droves.

The great resignation is occurring in healthcare, and we need to make changes to fix that.

- My last question that I wanted to post to both of you was that as tragic and for many traumatic as this experience was, this COVID-19 pandemic, many people died, many people got sick, many people are dealing with their changed circumstances because of this pandemic.

And especially the healthcare workforce are dealing, going to be dealing with the fallout, do you, in some ways though feel that it has taken the pandemic for people to realize how important nurses and healthcare workers are in the work that they do and made help some people who weren't thinking about it before, say, oh, we need to do something to make this better going forward?

- Definitely.

- I think that'd be the silver lining of a pandemic.

- Yeah.

- I think that would.

- It's a hard price to pay.

It really is because we watched so many people die.

It gave me a drive to move forward and try to make it better.

Yes, it's a silver lining, but the price is hard to think about.

It really is.

- Thank you both for joining me today in studio to talk about your experiences, what you went through in the pandemic and to shed a little light on what we are thinking about as we head out of this pandemic.

Nurses have been an integral part of managing COVID-19 and taking care of people and their families.

So thank you for what you do.

- Thank you for having us.

- Thank you for having us and talking about it.

- I'm here today joined by Brian Williams, who is a certified addictions counselor at Connecticut Valley Hospital, a state run facility for people who need treatment for behavioral and mental health.

Thanks for joining us this morning, Brian.

- Thank you.

- Brian is also a member of SEIU 1199 New England.

He's been with the union for the last 10 years.

In your work as a certified addictions counselor, when you go back two years ago, before the pandemic, what was your work environment like and how did that change very quickly once the pandemic did hit, especially in Connecticut?

- Before the pandemic, we had this incredible epidemic that we're dealing with, the opioid epidemic.

And in the area of Connecticut Valley Hospital that I work, we spent our focus on working with people who are struggling with addictions.

We were already short staffed, we were challenged, but we were full all the time.

We were at capacity.

Since the pandemic, what we've had to do is shut down, almost completely shut down services to the population that's addicted, because we had to redeploy the staff members to actually go and address the concerns of COVID.

That has been awful.

It has almost been like as if you knew you were sacrificing one child to take care of the other.

It's been extremely, extremely difficult.

I can tell you that what the pandemic did was to expose the fact that when you have underfunded, short staffed environments, when a crisis occurs, it is virtually impossible for you to be able to respond.

So the crisis actually pushed us to a place where we had to make these awful choices of actually shutting down one service to go address another.

- And I know you just mentioned some of the concerns that you had, both with existing problems being exacerbated by the pandemic, when you realized that this was a deadly virus that was affecting both your patients and could affect your colleagues, you guys were still on the front lines, working with people in a healthcare setting, what were some of your top concerns either to yourselves physically or to your patients?

What have been those top concerns these last two years?

- We have been concerned with our own mortality, right?

In the beginning, we were fearful.

We were all horrified.

We didn't know what was happening.

We had colleagues who loved the work that they did, who were committed, who probably were 5, 10 years away from retirement who chose to actually leave because they have family members with multiple illnesses at home that they were fearful of taking these illnesses back to.

I can tell you that while many of us were probably not diagnosed formally, but we were definite exhibiting symptoms of clinical depression.

It's a very, very difficult time.

We lost patients, we lost family members, we lost coworkers and we couldn't even grieve in the normal ways that we could, you know, that we normally grieve.

And then in the midst of this, while we're dealing with this horrifying condition, we did not have adequate equipment.

So we did not have adequate PPEs.

We did not have adequate staff members to actually respond to it.

So it was an incredible, sorry, it was an incredible stressful time for us.

- I'm glad you brought up the stress component, because not only has this been physically demanding, both before and during the pandemic, but it's also had an intense emotional burden.

And like you had mentioned, it takes a toll on your mental health.

So going through this very uncertain and stressful time, how did being a member of a union, a union that represents healthcare workers, how did that help you and your colleagues get through what you were going through throughout this pandemic?

- Well, I cannot imagine what it would've been like without having a union, right?

Because here we were, with inadequate tools to do our work, here we were, with insufficient numbers of people to do our work, and yet expected to go to work and to provide care.

And we wanted to go to work.

We wanted to provide care for the patients that we were serving.

Being a member of the union, allowed us to organize ourselves in a way where we could confront the governor, in a way where we could go publicly without fear of losing our jobs and expose these inadequacies and advocate and fight.

And there was some accountability and also some change.

- And so what are some of the top things that either you yourself or the people you work with every day, what are some of the things that you would like to see or that you think is important to be addressed in the immediate future?

- This pandemic has reinforced for us what we knew already.

And that is that if we're going to have healthy, thriving communities, that working people need to be organized in a way where they can advocate and fight for themselves.

One of the popular terms that have come out of this experience has been 'essential workers', right?

So we have a group of people that are now being referred to as essential workers.

We actually discovered during this incredible, stressful time, there are a group of people, mostly who make, who are on the lower part of the socioeconomic spectrum, and we have discovered that they're essential.

What I would say is, we need to do more than giving them the trinket of a label called essential.

We need to treat them as such.

This needs to be reflected in how they're paid.

It needs to be reflected in the benefits that they receive.

How could we label a home care worker as essential and yet not provide them with sick benefits, not provide them with health insurance benefits?

So I think one of the things that we should commit to moving forward is to improving the sort of health infrastructure across our state, maybe even across the country, and with particular focus to improving the mental health and behavioral health infrastructure, because one of the things that this pandemic has revealed is is that health is really, if you're gonna look at it in a holistic sense, it's not just about what my blood pressure is.

You know, it's important.

My emotional wellbeing is also important.

That the only way to experience health in a way that's whole includes, yes, my biological wellbeing, but also my psychological and emotional wellbeing.

And I would even add my social connections.

So I think we need to begin to think about healthcare in a way that's more creative and also places value in the people who provide that care.

- For the past two years, scientists and researchers have been studying the SARS-CoV-2 virus that has caused hundreds of thousands of Connecticut residents to become sick with COVID-19.

They've used their collective expertise to try and find to best identify cases, treat illness and prevent infections.

Some of the most significant outcomes of these efforts have been vaccines.

Epidemiologists, public health experts, and immunologists have taken the lead in developing vaccinations that enable the body to defend itself from future exposures to the coronavirus and hopefully prevent serious illness.

In addition to creating tools to help manage COVID-19 in the future, scientists say these efforts have also driven scientific advancements in other parts of medicine that may benefit patients going forward.

Joining me now is Dr. Akiko Iwasaki.

She is an immunologist at the Yale School of Medicine.

Thank you so much for joining me today.

You know, as we talk about innovation and scientific advancements within the COVID-19 pandemic, we can cover a lot, but today I wanted to focus on vaccines, which has really been a main topic during this pandemic.

So if we could go back prior to the COVID-19 pandemic, what was sort of the pace that vaccines were developed or even modified before the pandemic even hit?

- Thank you for having me, Nicole.

Yes.

Vaccine development prior to COVID pandemic took about 10 to 15 years, on average.

The reason it took so long is because things were done in sequence.

For instance, the preclinical animal models took about two to four years to complete.

And then after that, you would apply for a clinical trial, and phase one, phase two, phase three were done in sequence, each taking two or two to three years.

That's why it adds up.

And then after that, you would apply for the FDA approval.

So every step took a long time and in sequence, whereas during the COVID pandemic, things were sped up very quickly, without compromising the safety and efficacy measurements.

Things were done in parallel instead of in sequence, phases one, two and three were staggered and stacked up on top of each other, as well as the production of vaccines were done at risk, which meaning that, assuming that things would work, the production already started before the approval.

- Did it factor in at all that it seems like obviously the COVID-19 pandemic was a global pandemic?

And so you had scientists from all sorts of countries and institutions looking at the virus that causes COVID-19 and possible solutions to it, including vaccines.

Did it factor in that a large portion of scientists around the world were working on the same vaccine, which as I understand it, that's not the normal circumstances.

- That is absolutely correct.

So scientists, immunologists, virologists, public health officials, everyone was focused on one goal, that definitely contributed to the speed and the success of the vaccine development.

However, also decades of research preceding the development of mRNA vaccines was instrumental.

It kind of set up the stage for success for the vaccine to be developed for COVID with all the attention that was being paid.

- And I'm glad that you brought up decades of research, right?

Because these vaccines were not developed in a vacuum.

They were built upon many, many years of research and data of what we know.

And so that leads me to ask about mRNA vaccines.

They have really sort of become spotlighted in this COVID-19 pandemic.

And while a lot of people in the general public have never heard of mRNA vaccines before, people in the scientific community though did know about them, there's research about them.

So I'm curious as to why did it take until the COVID-19 pandemic for these vaccines to really become, to have their moment to shine?

- So several things I think contributed to the fact that the mRNA vaccines really took off during the pandemic.

First is, as I mentioned, decades of research leading to the optimization of the mRNA itself, as well as the lipid nanoparticle that codes the mRNA, these two technologies were being optimized and developed over the years.

And it was just the right time for them to shine.

The other issue is that the mRNA is very quick to produce.

Once you know the sequence of the spike protein, you can basically enter that code of mRNA and make that mRNA very quickly, which is not the same as if you had to produce proteins or recombinate viruses or other methods.

So it was the very quick way to achieve we needed to achieve during the pandemic, as well as the technology being ripe for testing.

- And you touched on it already a little bit, not only have we seen advancements in the scientific community, but the general public has been very much engaged in not only the trial process, but also the federal regulation process for vaccines.

And by way of that, they're paying attention to other innovations that are happening in science and in the medical field.

How have you seen that the learning and education grow amongst either patients or people who may have never before been that engaged in medical science before?

- Yeah, absolutely.

That's been transformational during the COVID pandemic.

Of course, people were aware of the immune system before the pandemic, but now lay people are aware of antibodies and T-cells and waning immunity and vaccines and boosters, and just pretty amazing how much recognition and knowledge that the public has now gained over the pandemic.

And I've been personally contributing to some of the immunology 101 type of education to the public, because I think it's an opportunity for people to learn about this wonderful and beautiful immune system.

And it's really important to understand how the body fights against all these infections.

- So now we're two years in, we are entering a third year of the pandemic though.

There are discussions about whether the COVID-19 virus is going to become endemic, something that we manage going forward similar to other respiratory diseases, but for you and your colleagues in the scientific community, what are you most looking forward to in the immediate future or in the long term, are there certain developments that have kick started during this pandemic or things that you really see a lot of potential for going forward in the coming years in the field of immunology and science innovation?

- There are many areas of immunology that are kind of raising a lot of awareness and being developed currently.

Personally, what I'm very interested in going forward is to understand the link between an infection like SARS-CoV-2 and long COVID, the long term consequences of such infections.

So many millions of people are suffering from long COVID.

And this is an opportunity to understand how an acute viral infection could lead to long term consequences, which may also be reflected in other diseases like ME/CFS.

So I think that this is an opportunity for our field to try to link between what happens during an acute infection and what happens in the long term in these, people who are suffering long term consequences.

- Dr. Iwasaki, finally, if you don't mind me asking, when we talk about this field of study and people who are paying attention to immunology and epidemiology, maybe they hadn't before, do you think that this COVID-19 pandemic has encouraged anybody to actually go into this field, professionally, you know, going forward they may have been inspired by what's happened to actually make a career in immunology?

- I believe so.

A lot of talented young people are now looking into this, because they've experienced it firsthand.

And looking into a study, such as immunology, virology, infectious diseases and epidemiology, so I would absolutely welcome more people to join the study of these things, because it will be important in the future as we will face another pandemic sometime soon.

- Especially as we come out of this pandemic, I think people are looking, certainly looking forward to the end of such a heightened crisis and they are looking in a forward direction.

So is there anything you thought was important for people to know heading into the immediate future?

- I think one thing to mention is that the speed at which the science is advancing is just phenomenal.

And we are making effective and safe vaccines against COVID and then potentially other pathogens.

But I think at the same time, what's really needed is public education about the vaccines.

So people are knowledgeable and feel comfortable to take the vaccines.

There's a lot of fear and hesitancy about the vaccines, and that's sort of prevented people from taking the vaccine, and that's also affecting our ability to control the pandemic.

So just as much as science is so important, but science education and public communication is equally important in this regard.

- Well, thank you so much for your expertise, Dr. Iwasaki, and thank you for joining us today.

- Thank you so much, Nicole.

- The pandemic has changed everyday life for people in Connecticut.

Some yearn to return to life as we knew it before March of 2020, but for others, they're eager to build upon the changes they've undergone in the last 24 months, whether it's in the new ways they're running their businesses to how they socialize with family and friends or how they keep a work life balance.

We heard from people across the state about what life beyond the pandemic will look like for them.

- Masking when needed.

I've got filters in my restaurant.

Everybody is vaccinated.

I think that was the key.

You need to be vaccinated 'cause you can't go forward.

And my entire staff is vaccinated, we have two huge filters and we carry on.

- I'm Allie Nicholson-Gauvin and I work at The Next Chapter bookstore.

The Next Chapter is a bookstore that sells books that are donated to us.

It's a bookstore run by the schools.

In this case, it's the post-secondary program.

We had less opportunities last year to learn more hands on than this year.

We couldn't go out to different job areas and we all had to stick in one group.

And this year, we hope later on that more authors will come and we could have more people to read to.

Socializing more, going out with friends more, and meeting more people, 'cause we couldn't really do that.

But I'd like to do that again.

- When you practice yoga at home, there are certain distractions that you don't, that you can be free from.

In the yoga studio, you, I mean I frequently have people with their pets, their work phone calls, their babies are crawling on them.

It's actually quite lovely to see, like, to have glimpses into people's homes and people's lives and how they're trying to accommodate a yoga and mindfulness practice, even though they may be in a space that's not entirely ideal.

So we teach from here... We've all collectively gone through two years of Of an experience.

I would describe it as a traumatic experience.

And what we're really hearing from students, teacher trainees, community members is this is the time where people really need yoga.

They need yoga, they need meditation, they need mindfulness.

They need all of those practices that for some people haven't, they haven't had access to for two years.

We decided we needed to continue.

We knew we needed to continue offering yoga in some way, but we didn't have any kind of setup to do that.

When we started all we had was a tablet on a tripod and that's what we were streaming our Facebook Live classes with.

Now we can live stream any class from our large studio.

That's a step that we had always hoped to be able to do and the pandemic really pushed us forward.

So we have felt the pain of the pandemic very, very acutely.

And it's been, frankly, it's been a struggle at times over the last couple years to keep the building open, to keep this space.

So if there's ever a time to support local yoga studios, support local businesses, fitness facilities, this is the time, 'cause we are here, we are ready and we're open and safe and available.

And this is a great community to be a part of.

(light music) - The first decision was, do we close?

Do we close early?

'Cause we're hearing these things coming down the pipeline of it's creeping towards us.

Should we keep our staff safe and not really go forward with business?

So that was the first initial conversations that we were having internally, and with local restaurateurs.

Some decided to not go through that weekend, that last weekend in March.

That was difficult.

And we sort of landed on, let's take the temperature of our clientele and see what happens.

Let's space the tables out a little bit.

Sure enough, we were packed.

We were a little nervous.

So the next day we kind of held back.

That was a Saturday, we held back and Sunday we ended up closing.

And that was the beginning of the mandates.

As the pandemic progressed, it was important to strategize with the team and figure out what, how to proceed, what to do, you know?

And the beginning was, let's make sure we take care of our staff, right?

Because they're not working.

They have no funds coming in.

We've had people here for 22 years that work for us, so it was important for us to continue to pay them, you know?

And I think really everybody understood that we were certainly going you to keep 'em afloat, just like we were trying to stay afloat.

Whatever we could to get revenue going.

And we got quickly started up on to go food, shorten their hours, streamline the menu, streamline the staff, streamline as much as we could.

We kept everyone spaced, kept the staff in masks and then finding other pockets of revenue.

Right?

So, hey, you could do alcohol to-go now thanks to the restaurant associations.

Let's, first of all, turn ourselves into a liquor store so you could buy any bottle or anything off the menu.

And then let's have some mixed cocktails, let's find the right jars, let's get the label designed and all that.

And we go that extent on everything that we do because we want our customers to know that they're getting the Match product, and they're getting it in a way that is gonna make 'em happy, whether they're sitting here or they're sitting at their house.

Progressing forward, it's sure why not?

It opens up your mind to say, well, I couldn't do that before.

Why can't...

I figured out how to do it.

Let's just keep doing it.

You know?

And that's sort of the progression of, okay, let's try it.

If it works, it works.

Let's keep it.

If it doesn't, we'll ditch it.

Now that life is sort of returning to normal, right?

And it's gonna progress forward.

What do we carry with us?

We came up with some great ideas during the pandemic.

The virtual cooking school stays, the little QR codes saving paper on the tables, they stay.

Throughout the pandemic, we made certain decisions with our business of when to run it, how many people to have when we run it.

And it really made us sharpen the pencil, which means just dinner hours, five nights a week for Match.

So I'm okay with you wearing a mask.

If you wanna come in here and wear a mask and sit down, by all means.

The curb side, I'm sort of on the fence with, park, step in, say hi, we'll give you the bag.

I think that's something that needs to fade away.

I think the greatest thing that came out of this in the restaurant business is the communication between other restaurateurs, because we were always too busy to talk or just not interested in what... We had our own problems to deal with.

So let's not pass that on to everybody else.

And the community that we've put together is phenomenal.

And what we're sort of gaining from each other, being able to talk and open up those doors that everybody was hiding behind is priceless.

So that's definitely something that I hope continues.

- We've spent two years living through a pandemic, each of us affected in unique and irrevocable ways.

While COVID-19 continues to present a real danger to people and workers in Connecticut, we can't help but think about what our lives will look like in a future absent of widespread infection.

We may not know the twists and turns that lie ahead of us, but the most important thing is that we keep moving forward together.

I'm Nicole Leonard.

Thanks for watching and goodnight.

(light music)