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This time a year ago, Joanna Wilson and her husband, Dennis, were preparing for their anniversary.
June 27, 2020, would have marked their 50th year of marriage, and Joana Wilson says they wanted to celebrate with some kind of party.
But that didn’t happen.
Not only were large events inconceivable amid the summer surge of new COVID-19 cases, but Dennis had lost his fight to the novel coronavirus in late March.
At the time, Joanna said she felt helpless. After 51 years of being a nurse herself, there was nothing she could do to help her husband.
Dennis Wilson was a retired educator and avid magician. His was the first known death from COVID-19 in Johnson County, and that total has since grown to 640. Each death, a person that left behind others to grieve and contemplate what the last year has meant.
“It’s just been very lonely,” Joanna Wilson said recently. “When a spouse passes away, normally you’re surrounded by other people. During that time, and when he passed away, I had to come home to an empty house.”
Wilson’s story is one of thousands to be told as Johnson County surpasses the one-year mark of the pandemic. On top of the deaths, nearly 43,500 people in the county have been infected with COVID-19.
The full extent of the pandemic and its long-term impact on the community has yet to be determined.
The cost to community health
Beyond the local case statistics, the pandemic could have long-lasting consequences on the overall health and wellness of Johnson County.
Though dealing with infectious diseases and outbreaks is one component of the Johnson County Department of Health and Environment’s role in the community, it’s normally just a small part of it, local health officials say. And other priorities have been put on hold to deal with the pandemic.
“We very much miss public health in the way that we used to do it, and the projects we got to work on and the partners we were involved in,” Elizabeth Holzschuh, director of epidemiology, said.
In normal years, the health department would have been addressing issues with housing and equitable access to health care. It would have carried out numerous community health initiatives targeted at supporting homeless populations and dealing with mental health. All of that fell by the wayside when COVID-19 came.
“Responding to the infectious disease outbreak is a part of what we do in public health, it just doesn’t take over everything like it’s done the past one year,” said county health director Sanmi Areola, Ph.D.
Putting those other efforts on the back burner for the last year will most certainly have consequences, Holzschuh said.
“We will have ground to makeup, there will be delays in implementing programs and initiatives because of this year that we’ve lost,” she said. “We’re looking forward to being able to hopefully start taking some steps back into that world, because it is important work.”
Every day a bad day
On top of that, the pandemic has taken a toll on the health care field, said Casey Pickering, nurse manager of the University of Kansas Health System’s intensive care unit and director of its COVID-19 rapid response team.
“This is not anything that we were prepared for in terms of the emotional heaviness of this work,” Pickering said. “A textbook and training and none of that is going to prepare folks emotionally for what we are going to see and encounter during this.”
Usually, bad days in the ICU are infrequent and broken up by days filled with positive patient outcomes and recoveries, said Pickering, who uses they/them pronouns. With the pandemic, every day has been a bad day.
“It’s hard when I can’t say to [my team], tomorrow is going to be better,” they said. “There’s only so much you can put on people and expect that they can carry.”
When this is over, Pickering expects some frontline health care workers to seek less demanding posts or leave the field altogether.
Those who stay in intensive care nursing may not ever get the opportunity to fully recover from the trauma they have experienced every day during the pandemic.
“The reality is there are still very, very sick patients to be cared for, and we’ve chosen to do this work — for most of us, this is our calling,” Pickering said. “I think people can’t forget what frontline health care workers have been through — the mental, emotional, almost PTSD piece that is going to come at the end of this.”
Lessons for the next pandemic
Though it’s not the primary function of a public health department, Areola said they’re always preparing for the next threat to the community’s health.
“For us, it’s not a question of the pandemic happening, it’s a question of when it will happen,” he said. “It really underscores the need to build on what we have, because there will be another.”
Holzschuh, whose background is in emerging infectious diseases and microbiology in addition to public health, says humankind’s behavior brings the population closer and closer to new climates and new species that could be the source of the next major health crisis or illness.
“I pray that there’s not another pandemic like this for another 100 years,” Holzschuh said. “But the likelihood is ever-increasing that we’ll see another one of these sooner than 100 years from now.”
But now that the community has seen how vital public health is, Areola said he hopes there will be more support for better funding for departments and initiatives that support community health and emergency preparedness.
“The challenges that we have are consequences of the policy decisions we made decades ago. Where we’ll be 10 years, 20 years would be consequences of the policy decisions that we made today,” he said. “When you invest in public health, you will reap the benefits.”
After crises, there tends to be a lot of public support for increasing public health spending, Holzschuh says, but as the fervor and the fear die down, money can dry up. When that happens, she says “we can’t keep the public health workforce, public health infrastructure funded at a level that will allow us to really respond to these sorts of events.”
Think of it like you would other public safety and critical infrastructure workforces.
“Sort of like the idea of a fire department, right, you don’t only fund them once the fires happen, they have to be prepared, they have to have the staff, they have to have the equipment,” she said. “I think what we’ve seen here is that public health, as a whole, didn’t have that equipment that we really needed when the pandemic hit.”
As bad as it was, Areola said, the COVID-19 pandemic could have been worse.
“Public health is always tough to measure when the key metric is what did not happen,” Areola said.
In Johnson County and across much of the state of Kansas, the state of the COVID-19 outbreak has been improving. For several weeks, new cases, the rate of hospitalizations and deaths have trended downward.
Johnson County’s current percent positivity is at its lowest point since last summer.
Vaccination efforts have also ramped up. In Johnson County, nearly 89,000 first doses have been administered and the county’s weekly allotment of vaccines is expected to grow in coming weeks.
As for Joanna Wilson, she’s excited to get back to traveling — even if it’s without Dennis. Mostly, she says, she’s just trying to find a way forward in her new normal.
“I still have a great deal of sadness, of course, this was my life partner, he was my soulmate,” she said. “Of course, I’ll never get over it — I’m just hoping to get through it.”
For now, as COVID-19 continues to affect the community, Wilson hopes people who doubted will see how serious this public health crisis has been.
“I hate the fact that if you haven’t been affected by it in a personal way, then you really just go about life like usual, and I’m very concerned about that,” Wilson said. “One life is important, much less all these lives. … It’s just not worth taking the chance.”