Looking at COVID-19, five years later

On Jan. 21, 2020, the state of Washington reported its first confirmed case of COVID-19. On March 13 of that year, Idaho would do the same.

By the time the World Health Organization announced the end of the global Public Health Emergency to COVID-19 in May of 2023, the world, for many, felt fundamentally changed.

Public demonstrators had stormed Idaho’s Capitol building and shut down school board meetings by refusing to mask. Health care workers reported record levels of burnout, and the industry saw an exodus of professionals.

Political activism in the middle of it all galvanized some, and revealed fault lines within American communities. And across the United States, more than a million people died from COVID-19.

Two years after the official end of the pandemic, The Tribune caught up with local residents and doctors to talk about moving forward, how the experience changed them, and wisdom they’ve gleaned along the way. These are their reflections.

Dr. Pete Mikkelsen

Dr. Pete Mikkelsen is the chief medical officer for Pullman Regional Hospital, an emergency physician, and medical director for the hospital’s emergency department.

In his work, he juggles health care administrative tasks with caring for patients. When the pandemic began, he said, health care workers dealt with a lot of fear for their patients, and for themselves.

“There were stories of young, otherwise healthy, physicians who died of COVID early on,” he said. “That hit home for a lot of us. There were a lot of unknowns.”

Mikkelsen said in many ways, the pandemic brought out the best in providers as they worked together to take care of their community. But that focus also meant health care workers couldn’t work toward other goals. That’s something they’re still catching up on, he said.

“I think a lot of people felt like they had all these things on their agenda that they wanted to achieve that we had to put on the back burner,” Mikkelsen said. “A lot of organizations went through this, where they had to start becoming more strategic because you can’t do everything.”

Post-pandemic, doctors are seeing more patients than ever, Mikkelsen said. He estimates at his emergency department, there is a 20%-25% higher patient volume than before the pandemic.

At Pullman Regional, where administrators are preparing for an expansion, patients in the emergency department are often treated on gurneys in the hallway as rooms fill up. That expansion is still about two years away, he said.

“We have six patients in the hallway and eight in rooms, and a few more in the waiting room,” Mikkelsen said during his early March interview. “That’s the reality right now. We have one nurse who’s taking care of three patients with acute behavioral health crises.”

Health care providers, especially in emergency care, are also increasingly concerned with workplace violence post-pandemic, he said. Some research suggests the pandemic may have contributed to an increase in violence against health care workers.

Some proposed legislation would establish federal criminal penalties for attacking health care workers. Many efforts within hospitals focus on de-escalation and response plans.

“A lot of it has to do with predicting and preventing (violence),” Mikkelsen said. “De-escalation efforts, having an organized response when we have a patient who is agitated.”

Providers also faced a general increase in mental health challenges during the pandemic, Mikkelsen said. Today, he thinks medical professionals are better equipped to seek help when they need it.

“Physicians are certainly talking more about their own mental health care. They’re getting treatment for depression and anxiety and other mental health things,” he said. “So, I think that’s probably a positive to come out of this,” he said.

Dr. Jacques Bouchard

Dr. Jacques Bouchard is a family medicine doctor and the owner of Link Family Medicine, which is a direct primary care clinic in Moscow.

When the pandemic started, Bouchard was working in a local fee-for-service clinic. He said normal health services ground to a halt.

“We essentially combed through our schedules and whoever was not urgent, we called those patients and said, ‘Hey, we’re gonna reschedule you,’” Bouchard said.

One of the most stressful experiences for him, Bouchard said, was when a patient needed surgery in the middle of the pandemic but couldn’t find a hospital with the resources to take him.

“Three or four of his vessels were blocked and he needed the intervention of a bypass graft,” Bouchard said. “He went up to Kootenai (Health). And was all ready. And they’re like, yep, you need the surgery. You probably needed the surgery yesterday.”

But because no ICU beds were available to transfer someone after his surgery, Bouchard said, his patient had to wait at least a month. All the other hospitals had the same problem, Bouchard said.

“They had the ready space to do the operation. They had the manpower to do it. They had the resources, but they didn’t have the hospital space to take care of him.

Bouchard was also a first step for many people seeking mental health care, he said. In a small town with only a few psychiatrists, he said, family medicine doctors are often the first point of contact for people with mental health problems.

“I encountered a lot more anxiety and depression that I treated,” he said.

Looking back, Bouchard said, the lessons from the pandemic reinforced his understanding of how people make their medical decisions, about things like vaccinations, and how he can help them make those decisions.

Bouchard can’t change what people believe, he said. But what he can do is share what choices he makes for his own health and his family.

“When I tell patients about COVID and how it can be prevented by a vaccine, I tell them in the same breath, ‘I get the vaccine. My wife gets the vaccine. All our kids get the vaccine,’” he said. “By telling them personally that you’re invested in this, most studies (show), as well as anecdotally with my patients, that goes a long way.”

Melyssa Andrews

Two years ago, Melyssa Andrews, 47, spoke with the Tribune about her time during the pandemic.

A health care worker, Andrews also suffered her own losses during the pandemic, including the deaths of several grandparents and friends.

Five years later, Andrews said, her family is still recovering from the pandemic. Andrews is still a working mother, supporting her own mother, and now-17-year-old daughter.

One of the hardest things has been helping her daughter move on and cope with negativity in online spaces, Andrews said.

“It’s hard on our kids. They don’t have the ability to cope and adapt, because it’s all they know,” she said. “Even adults got locked into the electronic age.”

Andrews has been trying to pull herself and her daughter away from electronics, she said. She goes on trips with her family to places like the Wallowa mountain ranges, boat rides on the Snake River, and stops at Lake Coeur d’Alene and Palouse Falls.

In her work in health care, Andrews said, she saw a shift where more people seemed willing to act aggressively toward workers even after the pandemic ended.

“We’re in a new normal where there’s less accountability for actions and people are finding it acceptable to be rude in public,” she said. “It’s hard working in any field that you deal with customer service because people do find that it’s OK to treat people badly.”

Andrews said she’s also seen hostility toward people who still wear masks. But often, those who mask up are doing so because they’re more susceptible to disease.

“There’s a reason that people are still wearing masks. It’s not because they’re one political party or another, it’s because they have medical ailments,” she said. “I just think that people need to be kinder to others.”

Jared Edmonds

In 2022, Jared Edmonds spoke with the Tribune for the first time about his experience after contracting COVID-19 in July 2020, and the ordeal that followed. About a week after getting sick, Edmonds woke up with a racing heart rate and couldn’t feel his arms or legs.

Two years after getting sick, Edmonds had shared he still struggled with fatigue and a racing heart rate from mild exertion. That’s still the case today, he said.

Now 33, Edmonds has struggled being someone who often felt sick, but didn’t look sick. Since his last interview, Edmonds was diagnosed with chronic fatigue syndrome, which affects some people experiencing long-term side effects from COVID-19.

He said the biggest thing that helped him was working on acceptance, and grace for medical professionals.

“Being ready to accept the unknown and the ‘I don’t know’ (is important),” he said. “Those are a part of life.”

Edmonds said going to therapy helped him accept how his life changed from the pandemic.

“Tackling the mental side of things helped me the most,” he said. “There was no avenue for me to go down that was going to wave a magic wand and make life go back to the way it was.”

Since 2022, Edmonds has taken on a less physically strenuous job. He said leaning on his faith, friends and family has helped him find acceptance for his new life.

“I also found out I have a family friend who has chronic fatigue and fibromyalgia. So we’ve grown closer through our illness,” he said.

Oluwaseyi Arogudade

Oluwaseyi Arogudade is a sophomore at the University of Idaho from Lewiston. She spoke with the Tribune two years ago about her experience during the pandemic, which started when she was just 14 years old.

She said the changes she underwent during the pandemic were closely tied to the political movements of the time.

Arogudade recalled being shocked and confused as she watched the people around her react to the murder of George Floyd, a Black man killed by police, and the Black Lives Matter movement.

“It’s hard when you really just want people to understand you as like, who you are as a human being, and they’ve just been so ingrained with ‘it’s me versus you’ and that type of mentality,” she said.

The experience spurred Arogudade to be heavily involved in student government and organizations. Two years since her first interview, she’s chief of staff for the Associated Students of University of Idaho, and vice president of the Black Student Union.

“I think that the pandemic, in and of itself, wouldn’t have been as impactful for me if all of those other social issues didn’t happen at the same time,” she said.

In the years following the pandemic, she said, Arogudade would learn more about how to sustain herself and others in her community through emotional ups and downs.

“Providing spaces for us not to have to be strong for us not to have to have to get over it, spaces where we can be angry and upset without worrying like how we’re perceived is a luxury we’re trying to afford to each other,” she said. “Because it’s not a luxury that we are given in day-to-day life.”

That lesson was tested this winter when the Black Student Union lost its meeting spot after UI closed its Black and African American Cultural Center ahead of policies targeting diversity, equity and inclusion programs on university campuses in Idaho.

Arogudade said to her, it felt like taking a step back. That’s where another post-pandemic lesson for her younger self comes in, she said.

“Change isn’t gonna happen overnight,” she said. “It’s OK to feel joy and feel happiness. … Finding joy and finding happiness in everything you do is the motivation for you to keep going.”

Chris Skidmore

Chris Skidmore is the director of Whitman County Public Health. When the pandemic started, Skidmore had been serving as deputy director of the organization.

But after his predecessor left at the end of 2020, Skidmore said, he found himself learning how to direct a public health agency in the middle of a pandemic.

“I was just kind of drinking from a fire hose,” he said.

Skidmore became director about a month before COVID-19 vaccinations became available. He’d never managed a mass vaccination. The pandemic necessitated a public health response at a scale no one had been prepared for.

Skidmore and his staff managed to distribute the vaccine with help from community partners, he said, but shortly thereafter many of the county’s public health workers, facing burnout, left their job.

“I lost about 60% of my staff during that time,” Skidmore said. “I was making lots of mistakes. I was learning, a lot of times the hard way.”

That period put a heavy strain on public health workers, Skidmore said, and was hard on his own mental health.

“I’ll never be the same person I was before the pandemic,” he said. “It has put some scars on us that you’re not going to erase. They’re going to be with you for the rest of your life. But you can’t go back. You got to look forward.”

Five years later, looking forward means catching up on community health programs that fell to the wayside during the COVID-19 response. Skidmore said his biggest priorities are childhood immunization programs.

During the last check that measured data from 2019 to 2021, children 0-3 years old in Whitman county saw a roughly 17% decline in childhood immunizations, Skidmore said, while the rest of the state as a whole declined by about 5%.

That’s especially significant as communicable diseases such as RSV, pertussis and measles have risen. Skidmore said during the pandemic, the public was bombarded with false and misleading information. That’s still something he still has to combat today.

“Trying to arm our residents with the tools so they can filter through that and get what the real, is, I think, important,” Skidmore said.

He hopes the information from state and federal agencies stays consistent with evidence-based medicine, Skidmore said, but acknowledged there can be discrepancies.

Just this past week, Secretary of Health Robert F. Kennedy Jr. touted unproven treatments for measles, and suggested negative side effects from the measles, mumps and rubella vaccines were more common than they are.

When it comes to public health information, including vaccines, building trust within the community is important, Skidmore said. He feels his team has done that.

“I will tell you that the majority of the residents have a lot more trust in their local health departments more so than they do in their state and federal folks,” he said.

Skidmore said he doesn’t think things will ever be the same. But working in public health during the pandemic left him and his team better prepared for the challenges ahead.

Even with the recent measles outbreak in Texas, everything feels more doable than before the COVID-19 response, he said.

“We did things during the pandemic we never thought we would be able to do,” he said. “Prior to the pandemic, a measles outbreak … we would be freaking out. But COVID is just as virulent as measles. And we’ve dealt with that at a much higher level.”

Sun may be contacted at rsun@lmtribune.com or on Twitter at @Rachel_M_Sun. This report is made in partnership with Northwest Public Broadcasting, the Lewiston Tribune and the Moscow-Pullman Daily News.