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The Lessons of COVID

What we learned has made us more prepared for the next pandemic
Animated graphic of a COVID cell dressed as a professor

Miller School experts learned that the most effective planning was collaborative and local.

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xperts agree that it’s not a matter of if, but when the next pandemic will arise. When it does, faculty, staff and students at the Miller School will have plans in place, along with expertise and a history of teamwork from the COVID experience. They know what served the University of Miami and local communities well during that public health emergency.

The most effective planning was collaborative and local, said Bhavarth Shukla, M.D., M.P.H., medical director for infection control at UHealth – University of Miami Health System and associate professor in the Division of Infectious Diseases at the Miller School. “We were very engaged, and I think that really made a big difference,” he said. “Everybody chipped in, and it was great to see everyone at UM come together.” For example, Dr. Shukla conferred with colleagues at the University of Miami College of Engineering to model how the virus driving COVID-19, SARS-CoV-2, behaved early on. “There’s a lot of understanding we have now about how the virus transmits that we didn’t know at the beginning,” he said. For the next pandemic, consulting colleagues across UM campuses will again prove essential.

The collaboration didn’t stop with doctors, other health care workers and scientists. Miller School medical students also proved to be an essential part of the workforce. Dr. Shukla worked closely with Hilit Mechaber, B.S. ’92, M.D. ’95, senior associate dean for student affairs at the Miller School, from the onset of COVID. Shared goals included determining the role students could play during a pandemic while maintaining educational goals and prioritizing student health and safety. Part of the school’s pandemic preparation now includes thinking about what that role might be in a future infectious disease outbreak.

“When the next pandemic emerges, it might be more helpful to communicate risk according to individual factors.”

Looking back, navigating the early months and years of COVID-19 seemed like a tremendous feat, Dr. Mechaber said. “We absolutely learned about the need to be nimble, flexible, innovative and collaborative. We had to drastically modify medical education delivery as we knew it.”

Dr. Mechaber notes the value of guidance from other medical education leaders at the Miller School, because the challenge of navigating the pandemic was compounded by the introduction of a new curriculum called NextGenMD at about the same time. NextGenMD relies, in part, on small group, in-person learning, an antithesis to many recommendations during the pandemic.

Like an Unwanted Guest

Pandemics can arise quickly and disrupt a community with little notice. It’s like answering the door and finding an unwanted guest. Having a plan ready can make it easier to react quickly and effectively. Fortunately, the Miller School had plans in place to address emergence of any dangerous pathogen, reviewed and updated as little as six months before COVID’s emergence.

An unanswered question remains around the timing of the next pandemic. “The key point is really to be prepared, because the next pandemic could be in 100 years or it could be tomorrow,” Dr. Shukla said.

If it seems like pandemics are happening more frequently, you may be right, said José Szapocznik, B.S. ’69, Ph.D. ’77, professor and chair emeritus of the Miller School’s Department of Public Health Sciences. “Pandemics are occurring closer and closer in time. They can move very far and very quickly throughout the entire world because the world today is so interconnected.”

So, it’s unlikely we’ll wait 100 years. “It’s more likely that in 10 years, there will be a virus that moves around the world at some level that’s dangerous,” Dr. Szapocznik said. “And if that virus mutates and transmits through the air, then we could have another pandemic like COVID.”

Plans in Place

The university’s plan for addressing high-consequence pathogens is reviewed and updated every year. And even though state and national governments have similar plans, it “definitely helps to have a plan locally,” Dr. Shukla said.

For example, the national model in early 2020 did not reflect what was happening with SARS-CoV-2 in South Florida. An early surge that saw more than 200,000 laboratory-confirmed cases of COVID in New York City in the first three months of the pandemic did not occur here. “That’s why we built a local model,” Dr. Shukla said.

Another important lesson to apply moving forward is avoiding lockdowns across an entire metropolitan area or state, if possible, Dr. Szapocznik said. “There were public health recommendations that we later decided might have been excessive. Whole states were closed, and everybody was required to be in their homes.” Widespread restrictions “affected the economy and the well-being of a lot of people who needed to work every day to make ends meet.”

Instead, research shows a more targeted approach may be just as effective at curbing the spread of an infectious disease, Dr. Szapocznik said. Limiting restrictive measures to an affected community or even just part of a neighborhood could balance public health protection against individual needs.

Greater Focus on Individual Risk

When the next pandemic emerges, it might be more helpful to communicate risk according to individual factors. This could be modeled similarly to risk calculators that exist for heart attack or stroke. People want to know their personal exposure risk, whether they are a college student or an 80-year-old living in a group setting. “We don’t have that kind of unified model yet, but that is something we could work on,” Dr. Shukla said.

Getting through the COVID public health emergency “involved trusting each other, trusting in our resources and pulling from reserves that I personally didn’t know I had,” Dr. Mechaber said. Enlisting and empowering medical students again will be necessary. “We had a tremendous amount of support from our health care system, which really embraced the medical students as a critical part of the team.” The students not only helped on clinical rotations, but also volunteered to answer the COVID hotline, distributed personal protective equipment, delivered meals to people who were homebound or isolated, and even provided childcare for health care workers who needed to focus more time on helping patients.

Despite the multiple hurdles, COVID demonstrated how resilient the faculty and students can be in the face of a pandemic. That being said, Dr. Mechaber added, “I hope we never experience anything like that again.”

UNIVERSITY OF MIAMI MEDICINE
SPRING 2025