Q&A: Hendrickson discusses how COVID-19 is weighing on the health care system and the community
Nearly two years into the COVID-19 pandemic, a surge triggered by the omicron variant continues to produce more cases and strain health care systems.
Peoria City/County Health Department administrator Monica Hendrickson says the county has averaged more than 300 new cases per day over the past few weeks.
In an interview with WCBU reporter Joe Deacon, Hendrickson talks about how the extended pandemic continues to impact the Tri-County and the toll it's taking on health care workers.
This conversation has been edited for clarity and brevity.
Joe Deacon: We're coming up on two years into the COVID-19 pandemic, and the latest surge is producing more cases than ever. We've heard a lot about how this is straining hospitals and creating staff shortages. What have you heard about medical workers and how they're coping with stress during the surge?
Monica Hendrickson: It's really hard to kind of fathom what they are going through, partly because these are individuals that are mission-driven. They've made a career in helping others, and to be continuously placed on these various levels of stressors – early on, it was making sure we had the right PPE (personal protective equipment), getting enough ventilators, getting tangible resources. Then it became about getting them properly trained, being able to kind of move your systems through different entities. Then it was getting them vaccinated as quickly as possible. So I think we're sitting in a situation that's a little bit different, more so than any other (previous) steps.
Dr. (Samer) Sader, who is the Chief Medical Officer for UnityPoint, said, “If you had told me two years ago that we would have a medical intervention, we would’ve all signed up and then we could be done with this immediately.” But now we're two years in, and the difficulty of it is that you have a solution, a viable way to get our health care system out of this, and it’s not being fully utilized. I think that's the frustration that is coupled … so, people that have been dedicating over two years of their lives in response are seeing unvaccinated individuals requiring the highest level of care. It can be very frustrating and demoralizing for them.
Similarly, to what extent has the spike in cases and the high volume now been weighing on health departments and your staff? How is that increased burden affecting contact tracing efforts?
Hendrickson: Our staff does a variety of work around this response. We have our Emergency Management Agency and our preparedness program that have been working on getting resources and testing and staffing availability increased. So for them to see the surge and the need for even more, it's pushed them. But I think our contact tracers feel it the most, our disease investigators.
We've had a robust system, and we've had a great team here. But to ask a person to start now averaging almost 48 cases a day, versus five or six, is a lot to put into them. And they've been trained to want to take care, again, of everyone (providing) that high level of care. The fact that we're asking them, “OK, now it's time to prioritize: Which of these cases are going to have a severe outcome? Which of these cases can lead to a large scale outbreak? Those are going to be on the top of your list,” coupled with the public's understanding of what we had been able to do for them has now changed because we can't get ahead of this.
Contact tracing is a great resource that public health has used for a variety of illnesses and (we) continue to use it. But in a situation where you have so much uncontrolled transmission, it doesn't become valuable anymore, except in those like really high cases where it can lead to – like in a long-term care facility or an uncontrolled outbreak – a lot of death, a lot of illness. So for our staff, they already had to deal with a lot of case investigation, and now to have a surge of cases, it's just it's a lot on their plate.
How much do you think pandemic fatigue is factoring in people being less diligent with mitigation recommendations, like masking and distancing and avoiding large gatherings?
Hendrickson: I think definitely COVID fatigue is there. But I also think there is the additional fatigue for individuals that have been continuously doing everything correctly, including getting their vaccine (and) getting their booster, coupled with individuals, watching those individuals have taken on those interventions and kind of changing their behavior to match it, without recognizing that they have not participated in that medical intervention.
So when does the pandemic become endemic? What needs to happen for us to get to that point?
Hendrickson: I think when we move to endemic phase, it’s going to be a couple of things. I think even with the most recent variant that was identified in South Africa, we have to recognize that this is still a global pandemic. So what happens on the African continent, in Asia, in Europe, in South America, it impacts us here locally. So first and foremost, for this to really become out of a pandemic into an endemic, globally we need to get a better handle on it with vaccinations, accessibility to treatment courses, all of those things.
I think locally, where you can see maybe as a country where we start getting some breathing room, is when we're not putting this much strain on a hospital system. We had both of our leadership from OSF Saint Francis Medical Center and UnityPoint Health – Central Illinois at our press conference, and I think what was really key in their commentary was: You may not directly be impacted by COVID. But when you need our services, because of what we are going through dealing with COVID, you can't necessarily be guaranteed the same level of care. I think that's something that we have to recognize is that it impacts all of us.
How surprised or distraught or frustrated are you with where the pandemic currently stands and appears to be heading after almost two years now?
Hendrickson: I think after two years, I've also gained a lot of maybe reflection, self-reflection. The challenge I have is, I recognize this as a pandemic and that we are fighting it on a global level. But I think what really may be the most difficult to process is when there is a solution, and yet only 56% of your community has stepped up to take on that solution, to fight the good fight.
I think that's really what's challenging is: we have a vaccine. It's scientifically supported, it is safe, it is effective. There is over millions of individuals that have received it, no side effects what have you, and yet there is still uncertainty about taking what is a life-saving intervention. I think for me, that's really challenging because I can continue to do testing 24 hours a day, seven days a week; we can continue to treat in a hospital systems to a brink of capacity. But at the end of the day, as an individual you have to recognize that your actions are having an impact. There is a reason why unvaccinated are taking up that many beds in our hospital systems. So to have a solution and not use it, it's really hard for me to kind of digest.
At this time last year, or even six months ago, did you even consider that we'd be battling COVID to this extent and cases would be skyrocketing the way they are?
Hendrickson: No, I didn't. You know, I really felt that in April, when we started seeing the opening on expansion of vaccination, I remember I took a vacation in June. I finally took a family vacation and I was like, “this is it; this is a time for us to sit back and reflect.” Now looking back, I'm glad my family did get away for that time period, because that's not something we'll be able to do right now.
Where do you think we're heading with this current surge? Are we cresting to a point yet? Are we going to start seeing this surge start to decline?
Hendrickson: I think with the surge, we are still not on the decline yet. In fact, I think Peoria County, we are (averaging) just about 300 cases each day now (and) we're getting close to that 400 average. It does eventually have to even out, and that partly has to do with the fact that there's (only) so many people from a population standpoint, right? We can't just keep on going forever.
Now having said that, the issue that's going to make it the biggest play is, again, going to be that level of vaccination that we have in a community. We need to have more people get vaccinated, get boosted so that even if cases are high, the severity is low enough that those resources that we rely on as a community – our EMS, our hospital systems – that they can care for other emergent issues. I think that's what we have to recognize, is if we had a million cases a day in the United States and it was mild symptoms, and no one was hospitalized, that would look a lot different than what it is today.
I spoke with regional Superintendent of Schools Beth Crider just recently, and she said that coming out of this pandemic, things are never going to be normal the way we knew them before and there might not even be a normal to go back to – that we're just going to have to know that this is permanently changing things. Do you feel the same way?
Hendrickson: I do. I think that is a really good recognition of what we've gone through for the past two years. I think we've learned lessons in terms of infection control and where there are health priorities. I think we learned a lot about health equity and why different populations are impacted differently, that may change how we provide services and how we look at the social determinants of health in the support networks, whether it's looking at the economics of it or the education. So I think we're going to have a lot of lessons learned and be adapting in the future.
I also think that this is a traumatic experience, and people have different levels of resilience. So I think, as we see with any traumatic experience, you're going to come out of it a different individual, and how you respond is going to look a lot different. And so I think Beth Crider was right on in terms of that assessment.
You mention that this is such a traumatic experience for everyone. Aside from just the COVID illness itself, what type of mental health situations could we see arising out of this from this point?
Hendrickson: I think when we started this pandemic, we saw a lot of anxiety and depression, especially with stay at home (orders). I think moving through this and even coming out of it, whether it's endemic, I think you’re going to see a lot of depression, you're going to see a lot of anxiety. I think you're going to also, at the same time, see a lot more awareness.
If there is a silver lining in this pandemic, it’s the fact that we now talk openly – I like to say, at the dining table because I know it happens in my own household – about mental health, about social determinants, health equity. We talk about it in a much more conversational way, where before these to be stigmatized; mental health was not something that we necessarily bring up, right? But how often were you told now, in an office setting or amongst friends, to do a wellness check on each other – when you appear on a Zoom call and be like, “So Joe, how are you today?” You know, not just how your work is, but “how are you doing?” Right? I think we're going to see a lot of that come through as well.
With how these last two years have played out, what are your biggest concerns for the next year or two then?
Hendrickson: I think my biggest concern for the next two years, is a little bit still similar. As we move to this endemic phase, whatever it's going to look like, it's going to be taking away layers, and I think every time we take away a layer, you're going to see surges of cases maybe, and then some kind of stabilization. But also we are trying to retrain ourselves after two years. I'm very confident that we're going to see a lot of anxiety in our community.
I have friends that have done everything correctly, right? They have socially distanced, vaccinated, boosted, their families have, and they've been a breakthrough case – which is OK; again, the vaccine is meant to prevent that severe hospitalization and death. But their gut reaction when they told me at times, is just the anxiety of how it happened to them, what they did wrong. It's not about them doing anything wrong; the virus is smart, this is how it works.
Now take that and magnify it at a larger level in terms of the anxiety of “OK, I'm now able to start maybe doing different activities again.” I keep thinking of coming out slowly into, like, a bright room, right? You kind of are adjusting, and definitely there going to be some shocks. But also, I think, (it’s) recognizing that a lot of people are not going to get to that normal point at the same pace.