A break in the clouds
After weathering the COVID-19 storm for more than a year, University of Minnesota and M Health Fairview experts reflect on the pandemic’s silver linings
There will come a day when the COVID-19 pandemic is a thing of the past.
Restaurants will buzz with hungry eaters, stadiums will fill with raucous crowds, classrooms will thrum with curious learners, and so much of pandemic life will be happily left behind.
But the impact of COVID-19 won’t soon be forgotten. Hundreds of thousands of lives have been lost to the disease and countless more forever changed. And yet, despite a year of unimaginable challenges, the pandemic’s long shadow can’t cover some of the bright spots it’s revealed about people and their potential.
Timothy Schacker, M.D., vice dean for research at the University of Minnesota Medical School, has seen some of those bright spots firsthand. Schacker has spent much of his 30-year career at the vanguard of HIV and AIDS research, helping turn a once-untreatable disease into the manageable condition it is today. Even with that perspective, he’s never seen anything like the U’s response to COVID-19.
In the days, weeks, and months following the pandemic’s arrival, laboratory scientists, clinical researchers, frontline care providers, and others from across the U stepped forward to pursue nearly 200 COVID-19-related initiatives. From a rapid rollout of virtual visits and in-home care through M Health Fairview to the unprecedented pace of clinical discoveries in Medical School labs, the pandemic’s unexpected upshots have already changed medicine for the better, Schacker says.
“The work that we have done in this last year has been breathtaking,” he says. “The experiences we’ve had with COVID-19 have tested our limits and proven that we have the capability to go well beyond what we thought was originally possible.”
Here are a few examples of the pandemic’s silver linings.
Making house calls
Dean Friesen used to drive to the M Health Fairview Masonic Cancer Clinic twice a month for chemotherapy infusions to treat his multiple myeloma. The appointments took up much of his day. He wanted a more convenient care option and was intrigued when he heard about a new M Health Fairview Home Infusion program.
Then COVID-19 arrived. In addition to the time commitment, visiting a care facility during the pandemic put Friesen—whose immune system is weakened because of his treatments—at greater risk for catching the virus. So in March 2020, he became the first patient to enroll in the Home Infusion program. Now, he receives his chemotherapy in the comfort—and safety—of his own home.
“[It allows the clinic] to focus on people who need the in-clinic time more than I do,” Friesen says of his home care. “If it helps other patients get better, deeper care, it’s a good outcome for everyone.”
M Health Fairview physician John E. Wagner, M.D., is an international expert in the development and use of cell therapies to treat life-threatening diseases.
He’s pursued numerous clinical trials in his career, but never as urgently as he did last March.
Within a matter of weeks, Wagner, the Hageboeck Family/Children’s Cancer Research Fund Chair in Childhood Cancer Research and McKnight Presidential Chair in Hematology and Oncology in the U’s Medical School, and colleagues had devised a clinical trial that uses a type of stem cell to thwart the body’s overreaction to the COVID-19 virus—the so-called cytokine storm, which causes lung damage and often death.
Wagner’s clinical trial, which calls for three doses of mesenchymal stem cells, was approved by the U.S. Food and Drug Administration in just three months—a breakneck pace for a process that can sometimes take a year or more.
And now, because of the pandemic, he and his team know what’s possible for the future.
“This is what we can do,” he says, “when we have a collective sense of hope and purpose.”
Reimagining medical education
When their regular in-person clinical rotations were paused last spring, Medical School students still craved an opportunity to lend a hand during the COVID-19 crisis.
The Department of Medicine’s Karyn Baum, M.D., and Brian Hilliard, M.D., launched a new curriculum for third- and fourth-year medical students designed to remotely equip them to help clinical staff at M Health Fairview hospitals throughout the COVID-19 patient surge. Students helped remotely with patient placement, transfers, and flow, and also reviewed charts and crafted detailed summaries for providers to review and approve.
“We learned a lot about what students really can do when you give them the chance,” Baum says. “This wasn’t busywork. It allowed them to contribute in a meaningful way and learn right alongside the providers as we all figured out how to take care of a large population of patients.”
Understanding our mental health
Kaz Nelson, M.D., is hopeful that our postpandemic future is filled with something she calls “shared empathy”—a greater understanding and appreciation of our own mental health and that of others, too.
“There’s this universality to what we’ve experienced,” says Nelson, an M Health Fairview psychiatrist and associate professor in the Medical School’s Department of Psychiatry and Behavioral Sciences. “I think we realize now that we have this responsibility to understand how stress, adversity, and other vulnerabilities impact our health and the health of our communities.”
From forced isolation to financial stress to concern about the health of loved ones, the pandemic wrought a level of collective mental toil unlike anything most of us have experienced before, Nelson says. But it also made the conversation around mental health more accessible.
Already, she hears more people openly talking about visiting a therapist. And the rapid implementation of virtual visits has allowed psychiatrists like Nelson to see patients more regularly. She’s hopeful that as these conversations continue beyond the pandemic, more people will prioritize mental well-being as a normal part of staying healthy.
“Things are changing for the better,” she says.
Providing care anywhere
Back in 2017, Wayne Adkisson, M.D., and his fellow M Health Fairview cardiologists launched a pilot program to explore telehealth’s potential.
The program—funded in part by the Richard M. Schulze Family Foundation—allowed doctors to meet virtually with heart failure patients from outstate Minnesota. Patients didn’t have to drive to an office in the Twin Cities, and providers were able to monitor patients’ conditions from afar while recommending in-person appointments only when necessary.
“We saw the potential,” Adkisson says.
Fast forward to 2020, when so many M Health Fairview providers were forced to tap into that potential on a massive scale almost overnight. In January 2020, M Health Fairview patients checked in to about 3,500 virtual care visits. By April, that number had grown to 120,000 visits. In the year since, the health system has logged more than 1 million virtual visits.
In addition to the flexibility and convenience telehealth affords, perhaps its biggest benefit is that it brings down the walls of the clinic, allowing patients and providers to connect as people first, says Susan Pleasants, M.D., chief medical informatics officer for M Health Fairview.
“For the first time, we see patients in their home, we see their families, and we see what their life is like,” she says. “It gives us a lens into people’s lives that can tell us more about how they’re really doing.”