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  WINDY CITY TIMES

Howard Brown president/CEO reflects on COVID's impact
by Matt Simonette
2022-08-31

This article shared 713 times since Wed Aug 31, 2022
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According to Howard Brown Health President and CEO David Munar, the early days of the COVID-19 pandemic seemed eerily similar to the AIDS crisis of the '80s.

"We saw all the same patterns at the dawning of COVID—a lot of skepticism, mistrust, medical misinformation, confusion—and then poor response systems," Munar said. "…There was a really strong recognition that mobilizing through public health was a core capacity, and a unique capacity, that we need to share."

Now, well over two years after the pandemic took its hold both across the city and across the globe, Howard Brown Health has been transformed by it. Some of those changes, among them the extensive application of telehealth appointments, have been positive, Munar noted, while other changes, such as increased waits for in-person visits, less so. In recent months, the facility has taken part in efforts to control and treat for transmissions of the monkeypox virus (MPV) as well.

Another challenge has been the Great Resignation, which has also taken its toll on Howard Brown Health. Non-nursing Howard Brown employees, citing burnout, understaffing and what employees told Block Club Chicago was a "toxic" work culture voted to unionize in August. Nursing employees already unionized in 2019. (In response, Munar said in a statement, "I'd like to extend a heartfelt congratulations to the organizers, everyone who voted, and all staff who push Howard Brown to be the best it can possibly be. As we take the next steps in the process, we will move forward together in support of our patients and clients, seeking at all times to improve the workplace experience for our valued employees.")

Munar said that, at the height of the pandemic, turnover was about 2-5% a month, a figure he said was steep. A huge surge in demand for in-person appointments at Howard Brown further began in 2021.

"A lot of that [that demand] is great," Munar said. "People weren't going in 2020 and people thought that in 2021 it was safe. It all spiked last summer. We saw a lot of people having health complications, not from COVID but from chronic conditions that had not been managed the last few years. We see more viral-suppression [issues], substance abuse, depression and anxiety. There was a real spike in health care needs in that period."

The federal government awarded relief funding to meet the surge in demand for medical services, but those funds are tapped out, Munar said, adding, "We're having to rework our new cost centers with our old cost structure—that's a challenge that all health centers are facing."

Telehealth capabilities provided some relief for capacity for patients with chronic health conditions such as HIV/AIDS. Patients generally got lab tests on-site and then discussed their results with providers via telehealth. That worked well for patients with online access and the means for privacy, but others who could not get online faced barriers staying on a continuum of care.

"We saw a whole lot of health issues got worse in the first two years," Munar said. "In the hierarchy of needs, maintenance visits took a back seat—the crisis du jour takes precedence over everything else. We saw that."

Telehealth is here to stay, he added, but Howard Brown is using it much less. "Some of the providers were wanting to do more comprehensive examination of patients. Some providers are doing a half-day of telehealth for their patients and it [takes the place of] visits where there weren't going to be labs or physical exams—to talk about treatments only. The model is physical visits supplemented by telehealth."

Howard Brown has developed several plans should more insidious variants of COVID appear and require massive precautions, and rely on Centers for Disease Control and Prevention (CDC) guidelines. "Recommendations have changed and they probably will continue to."

Munar admitted that the entire cost model of healthcare will "continue to be a big issue" going forward.

He added, "It's become more complicated to deliver healthcare, and it's slower. Then there's the telehealth issue—what are the right uses and who pays for it? And the feds discontinued paying for COVID testing for people who are uninsured. Things like that sound like obscure, arcane issues, but over the next period of time, we're going to see fewer of these pop-up COVID testing sites and less access for people who aren't insured. Those are all big issues I've been hearing about."


This article shared 713 times since Wed Aug 31, 2022
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