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Your Questions Answered: One-​on-​One with Steini

August 6/2020

Last month, Dean Steini Brown and alum Andrea Barrack delved into the COVID-19 response, the inevitable strain on our health system, the disproportionate impact on marginalized groups, the issues around collecting race-based data in the DLSPH’s Advancement Office’s latest webinar.

Not all questions could have been answered. Here’s are some of the unanswered questions:

Do you think that the COVID-19 pandemic has strengthened or weakened the public’s trust in government to respond to pubic health crises?

I think that there are mixed reviews. In many ways, these are unprecedented times, despite having already dealt with SARS. Many saw a delay in local, provincial or national responses. Many also saw systems and practitioners adapt quickly while shifting gears, as more and more information became available. We’ve seen strong leadership from government and health leaders who’ve had to make tough decisions while learning as they go. The availability of information and information-sharing has slowly improved, with social media playing a major role in the dissemination of all types of information. Many of our faculty were also on the forefront of information translation which added to the public’s knowledge about the virus and what each of us can do to stay safe. It’s tough to gauge the public’s trust level during a rapidly-evolving health event. But, leaders within systems, health and otherwise, have learned so much about what is needed going forward. The School expects to be a big part of future planning with the health system and governments overall.

Re-opening the economy will have health-related trade-offs that will impact people and systems. What can we do to minimize the various negative impacts?

The link between a healthy population and a healthy economy is clear. However, the risks are equally evident. Increased focus and frequency of communication regarding physical distancing measures, guidelines regarding group interactions, and safety measures such as face coverings or masks will be critical to mitigate the effects of transmission. If and when a vaccine becomes available, it will be important to adhere to the recommendations and guidelines to keep us all safe and healthy, especially those who are more physically vulnerable due to age or health conditions, those who work with the general public, and those who have living situations where space is a consideration.

How can DLSPH make sure that we don’t have the same situation that after 17 years after SARS and 17 reports, Ontario’s public health system is suboptimal. And, what can we do to make global health even more of a focus of the school with an ambition to become a world-recognized leader.  Is any research being done regarding the impact of the pandemic on children both now and over the next 20 years. They haven’t been infected at the rates of others but been impacted tremendously, from the economic stressors in families, to lack of social and developmental learning at schools to increased anxiety. This impact will be felt over generations likely. Do you see the need for a Child focussed strategy by government as a key part of our recovery?    

There must be additional investment and focus on prevention; surveillance, monitoring, and a global warning system. Investments must also be made to prepare health systems to support and manage testing, treatment, and timely information-sharing. And, as we’ve seen, other systems such as the education system which involve children and young scholars, will bear the brunt of major health events and will have an impact upon families. We do need a child focused strategy, both for the education system as well as other systems where groups of children, who are part of a community congregate setting, are involved. We haven’t seen high rates of infection for children in part because we have closed schools. Understanding those nuances and planning accordingly will be important going forward. The integration of systems is important in implementing a whole-of-society approach which is clearly needed to manage a pandemic. With respect to global health; we’ve recently launched a new Centre for Global Health which will play an increasingly pivotal role in research, education and knowledge translation of key issues. This will include more international partnerships, such as with other post-secondary institutions, global NGOs, and as collaborators on key cross-border and international projects. Many of our faculty are closely involved with the WHO in a variety of ways, including the COVID response. We aim to deepen those relationships and partnerships.

Will the epidemic affect your curriculum at the School?  

We have already begun work on several new courses related to pandemic preparedness and expect to include components of the same into existing curriculum. As well, our students are in a real-life case study where they can understand and extrapolate the issues first-and, and identify needs and possible solutions needed by the health system and beyond. We have had and will continue to have conversations with students about their experiences, what their research will now hold, and the possible outcomes they envision for a safer, healthier world.

Please provide your opinion on the required changes to achieve better patient outcomes while valuing the significant impact of primary care, homecare and public health on the well-being of the public during a pandemic. This is required to keep people safely at home versus being too acute care focused.    

A patient-centered approach puts engagement and communication at the center of health and healthcare. As the pandemic shifts, the ways in which we support patients has and will do the same. We can’t lose sight of incorporating the diverse needs of patients into the new, manageable normal. Personalized care and service remain important tenets as we shift into increased virtual care or adapted face-to-face care. While virtual care isn’t completely new to us, it has been somewhat accelerated with the swift onset of COVID. We’re learning as we go, as we cannot cease care for those in need.  The system and practitioners are adapting and ensuring that patients are not left behind. Things have and will resume its typical pace but with a different face. Now more than ever, we need to assure patients that we understand the importance of their health issues, all while balancing the fact that a pandemic that has changed care; from prioritization issues to format of support.