Lessons from COVID-19 paved a ‘roadmap’ for future disease responses, officials say

Tonii Gedin concedes that there were some growing pains when the state began to grapple with the then-emerging COVID-19 pandemic five years ago, including how it spread and how to best combat it.

“We were learning. We were trying things and making the best decisions we could with the information that we had at the time,” said Gedin, the Anne Arundel County Health Officer who served as the deputy health officer during most of the COVID pandemic.

The pandemic sparked debates about the appropriate level of response, and not all actions were successful, most famously the 5,000 COVID-19 test kits from South Korea that were procured to great fanfare early in the crisis by then-Gov. Larry Hogan, only to be found later to be flawed.

But the pandemic, stumbles and all, gave health officials lessons in effective public health communication and outreach that have stuck around five years later, putting the state on better footing for the next public health crisis to hit the state.

“We have more data available to us to understand what’s happening,” said Sean O’Donnell, deputy chief of Public Health Services at the Montgomery County Department of Health and Human Services. “Going through the pandemic, and the unprecedented challenges associated with that, we definitely had lessons and a roadmap so that we are now better prepared to handle future public health emergencies.”

O’Donnell said that one of the most important lessons from the pandemic is that COVID-19 highlighted how access to health care varies across communities.

“Before COVID, we had seen many of the same disparities across populations — who’s coming out to get a flu vaccine, who’s coming out to access medical resources, doing preventative health,” he said. “We see disparities. We see our residents with less resources access health care less.”

O’Donnell said that in Montgomery County, bridging the gap in health care access during the pandemic meant the health department needed to meet community members “where they’re at” – testing sites and vaccination campaigns were targeted to communities with less access, such as in low-income communities.

“We had data telling us where people were vaccinating and where they weren’t and we could send in resources into geographic communities or into the populations that had lower vaccination rates.

Gedin said that Anne Arundel County saw that same pattern and created an “ambassador” program that recruited community members to help push communications about the pandemic.

Anne Arundel has continued the program to this day due to the success of the ambassadors, particularly for the county’s Korean residents, Spanish-speaking communities and “different populations that are more vulnerable or have more issues with access to health care.”

“We’ve been able to find a number of health topics … outside of COVID that they’re tackling,” she said. “They’re tackling mental health, weather preparedness. They’re looking at things like overdose prevention and making sure that communities have naloxone [a drug to reverse opioid overdoses].”

Meanwhile, the shift to social distancing during the pandemic meant that Maryland’s public health system needed to adapt the technology needed to track the virus and help get messaging out to community members.

Kristy Frashure, deputy director of disease, prevention and management for the Anne Arundel County Health Department, said that surveillance methodology such as wastewater testing for COVID-19 and other viruses were improved over the course of the pandemic.

The county continues to test wastewater to track transmission of COVID-19 now that testing is less widespread than in the early years – and it uses the technology to track other viruses such as the flu.

“We’re still using that, not just for COVID but for other various infectious diseases,” Frashure said.

She added that the knowledge and acceptance of “telehealth” services have gained popularity since the pandemic.

“We’ve had some of these things before COVID, telehealth and whatnot, but certainly during the height of COVID, that really accelerated the adoptions of … these digital health solutions, which increased access to care for individuals and reduced the risk of infection,” Frashure said.

A 2024 report from the Maryland Health Care Commission said that while “telehealth visits have declined in recent years both nationally and in Maryland, they remain significantly higher than pre-pandemic levels.”

“Embracing these technologies have really proved effective and we’re still using them today,” Frashure said, noting that mental health issues have particularly benefited from increased awareness of telehealth services since the pandemic.

“With the pandemic and quarantine and lockdown and individuals working from home … I think the pandemic really set a light on mental health,” she said. “Certainly post-pandemic we really need to prioritize mental health and the well-being of all the communities.”

O’Donnell noted that there were some costs that came with social distancing protocols and remote life.

“None of this was done lightly, and there was a cost to all of it. Not just the economic costs. I can talk about how successful social distancing is, but it comes at a behavioral health cost. It has an educational costs,” he said. “All of these things have to be balanced. We have to balance the successes we’ve seen in the past with what these costs are.”

The Montgomery and Anne Arundel health officials agreed that a lot of the public health infrastructure built through COVID-19 remains to help battle future severe diseases – assuming federal resources are available for additional support.

“We’ve learned that when we have those resources, we can do amazing things,” O’Donnell said. “I do think we could do it again – public health has the knowledge and the will to do it. But that’s not a standing resource that we all have.”

As for the lessons learned during the pandemic, he said that the experiences of battling the worst of COVID-19’s impact will have a long-lasting impression on those on the frontlines.

“I don’t think we’re going to easily forget those because of the lasting impressions they’ve had on us,” O’Donnell said. “Our health care workers who watched tens of thousands of people die – they’re not going to be forgotten.”

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