One year ago, on Feb. 5, 2020, Bob Emery, DrPH, UTHealth vice president of Safety, Health, Environment, and Risk Management, convened and moderated a panel of regional experts on the topic of a dynamic and nascent emergency, the novel coronavirus epidemic.

At that time, the virus had just been declared a global health emergency by the World Health Organization (Jan. 30, 2020) and had not yet been named COVID-19. Throughout the panel discussion, a worldwide coronavirus map managed by Johns Hopkins University displayed the number of total confirmed cases worldwide to date at 24,631 and total deaths 494.The panel at the UTHealth School of Public Health included Dr. David Persse, health authority for the Houston Health Department; Dr. Umair A. Shah, then-executive director of Harris County Public Health and now secretary of health for the State of Washington; and Dr. Philip Keiser, Galveston County local health authority, at the UTHealth School of Public Health; Dr. Luis Ostrosky, professor of internal medicine; and Dr. Cesar Arias, professor of internal medicine.

The experts presented on what was known regarding coronaviruses, spoke about transmission, preparations, testing, and pandemics. They also took questions from a rapt audience. One year later, Emery and Ostrosky give their reflections on where we were and what has been learned since.

Bob Emery, DrPH:
“As we monitored developments in Wuhan, China in late 2019, we became concerned about the possible impacts of this yet-fully understood novel coronavirus on the United States. With the first confirmed case in the United States reported in January 2020, with the support of the UT School of Public Health’s Prevention, Preparedness and Response Consortium, we convened a panel of local public health authorities and UTHealth infectious disease experts at the UT School of Public Health auditorium to discuss what was currently known, what was not known, and what to likely expect regarding this yet-to-be named virus.

“The mere fact that the 2020 panel discussion was held in person, with no masks or social distancing, captures the magnitude of changes that have occurred since that time. As I think back to that panel discussion in February 2020, I think about how hard it is to remember how life was on September 10, 2001. On September 11, 2001 life changed dramatically.

“Throughout this past year we’ve worked through travel restrictions, screening protocols, understanding that the virus could be transmitted by persons not exhibiting symptoms (thus masking recommendations), severe PPE shortages for frontline healthcare workers, school and daycare closures, routine emergency management team conference calls, pivoting to remote learning and working where possible, and addressing community information needs.

“Now in 2021, as we are currently immersed in the nationwide vaccine delivery effort, I am very proud of the way everyone within the UTHealth community has adapted to this challenge and has come together to overcome this hurdle.”

Luis Ostrosky, MD:
“A year ago, we were looking at the prospect of a pandemic under the framework of other pandemics we had experienced over our careers: A relatively contained event of a couple of months duration. Since then, we have been involved in the management of a “once in a generation” event that is not really showing signs of slowing down.

“We have learned a lot over the past year, like how the virus transmits, the role of aerosols in human respiratory virus transmission, the value of rapid/point of care diagnostics, the difference between detecting genetic material of a virus and actually being able to grow it for purposes of assessing infectivity, the value of early treatment with antivirals/passive immune therapy, the value of societal-wide masking, the level of PPE needed to safely take care of these patients, and that we can design and bring vaccines to the market safely in less than a year.

“There are many issues that remain to be studied, chiefly: duration of immunity (both from natural infection and vaccination), genetic, phenotypic, and social determinants of severe disease/mortality, the development of outpatient therapies/more effective inpatient therapies, and the role that genetic mutations and variants will play in the epidemiology of this disease. It’s been a tough year, but as we promised… we’re getting through it together!”

Umair Shah, MD, MPH:
“I guess the biggest thing is that one year ago, we were worried but did not know exactly what we were about to see. There were a lot of uncertainties and unknowns. Yes we knew as a system we had to act and we responded here locally both quickly and aggressively early on, which set up this region for success. I am proud of leading the public health efforts at Harris County Public Health in 2020 and leaning on those of other public health and healthcare leaders alike across Houston and the region around us.

“But a year later, we now reflect on the fact that so much – as a nation – has been learned and unfortunately has been lost. The politicizing of COVID-19, the lack of a national strategy, and so many other factors have led us to where we are today. Vaccines give us the hope for the beginning to the end of this pandemic, but far too many lives have unnecessarily been lost and disrupted over this past year.

“We are hopeful that turning the page on 2020 and moving into 2021 will lift us to a renewed spirit of response and focus that will push all of us to success by seeing COVID-19 in our rearview mirror. Ultimately, the biggest lesson for this past year is that we must invest in public health, support the public health workforce, and remember that public health truly matters.

“COVID-19 has led to so many more health inequities and related issues for our community members. Simply put, we must take these on squarely as this is a transformative movement for all of us. But the transformation doesn’t just stop with health, it gets to the very fabric of how we live our lives – markedly different than a year ago.

“Looking ahead is also about transformation and seeing all of our lives being lived differently. How we see others, our role in community, how our children go to school, how we do business, and the list goes on. It is our responsibility not to forget COVID-19 as a dark time in our history but also to learn from it and be better because of it. The choice is ours.”