Over 1,000 days ago, the world was first alerted to the threat of COVID-19, sparking dramatic change for health care providers and patients.
In the three years since, a recorded 2.7 million people have come down with the virus in Kansas and Missouri, and more than 31,000 people have died.
The average life expectancy in the United States dropped to 76.4 in 2021, the lowest since 1996.
Beyond the numbers, Kansas City health officials saw changed approaches to health matters, deteriorating trust in public health agencies, and a burgeoning capacity crisis in area hospitals. The politicization of the pandemic has, at times, hindered their mission to minimize its spread.
Overall, case numbers have leveled off from the worst periods of the pandemic. But with the rise at-home tests, which are not automatically publicly recorded, experts believe the actual case totals may be anywhere from two to five times higher.
"What we can count on is hospitalizations and hospitalizations nationwide are up 6%," says Steven Stites, chief medical officer for the University of Kansas Health System. "We also know that there's a concern because there's such a high community rate of transmission and many counties are back into the red zone."
As of Jan. 5, all Kansas City metro counties are at least at a medium level of community transmission. At this level, the Centers for Disease Control and Prevention recommends those at high risk of getting sick wear a high-quality mask or respirator when indoors in public.
Leavenworth and Wyandotte counties have high levels of community transmission, at which the CDC recommends everyone wear a mask in public.
Despite these recommendations, masking is still rare in public. Health officials are seeing similar drop-offs in vaccine and booster uptake.
Thus far, the Kansas Department of Health and Environment reports about 57.3% of residents have been fully vaccinated, meaning they received the initial dose of a single-shot vaccine or both doses of a two-shot sequence. For bivalent boosters approved last year, there is a steep drop to just 11.5%.
There is a similar disparity in Missouri, with about 59% of the population fully vaccinated but just 14% boosted.
Richard Watson, the co-founder of Motient, a health care technology company, attributed the change in public response partly to divisive political approaches.
"A lot of times we were pitted one against the other for what seemed to be political gain by one side or another," Watson said. "It changed who the experts are and I think it humbled us in a lot of ways."
Marvia Jones, director of the Kansas City, Missouri, health department, said there is a sense of fatigue in the community from the constant whirlwind of new strains, vaccines and research.
People's priorities have also shifted. The pandemic was a significant concern at its peak, but now Jones hears people primarily concerned with child care, safe drinking water, housing and more.
"It is a fine line that we walk of empathizing and understanding why people aren't prioritizing something like COVID-19 but also doing our jobs to let them know that they are at risk," Jones said.
Changes in approach
Jones believes some people's perception of public health agencies has also shifted from that of a service provider to that of an an overbearing authority figure.
When people don't see their priorities reflected in public health messaging, it can make them think the agencies are not concerned about their needs. This reality was humbling, Jones said, but it helped them find new methods of encouraging best practices during the pandemic.
"People don't want to hear from us on this. They want to hear from their neighbor," she said. "They want to hear from the person they see every day, who gets them their mail. That person has more influence on them than I do."
Beyond public perception, the pandemic has exposed infrastructure issues within public health. Jones said the primary problem is the people in this field are underpaid and undertrained.
She said that is due in part to an exodus of highly-skilled, very experienced workers retiring or shifting to other fields amid the pressures of the pandemic.
"You have great people with great potential, but because they had not been skilled up and exposed to the types of opportunities that maybe that retiring class had, you are at a deficit as to what you can do with them," Jones said.
Jones said with some of the chaos of the pandemic subsiding,now is the time to make sure those who stuck around are adequately trained and compensated.
A chronic capacity issue
Staffing also caused issues within area hospitals during the pandemic, leaving them packed to the brim with patients. Even now, hospital leaders report they are consistently at or near capacity, with many of the beds reserved for those with severe COVID-19 cases.
"There was the time when people thought we're way over-bedded in our metropolitan area," Stites said. "We are no longer over-bedded and we are certainly not overstaffed for the beds."
An early spike in the respiratory syncytial virus, or RSV, and flu season have made things more difficult for area hospitals. Edward Kammerer, chief medical officer at Mosaic Life Care in St. Joseph, doesn't think this problem is going away anytime soon.
"With COVID, it's not seasonal," Kammerer said. "It's chronic for us. It's is a chronic smolder."
COVID is not done with us
As the pandemic continues, hospitals and health agencies are trying to rebuild community trust.
"Usually a great crisis brings people together," Stites said. "For some reason, we've allowed COVID to split us apart, which just made it harder to take care of every patient with a heart attack, a stroke with cancer or anything else."
He said it's a long, but necessary, process.
"In the next 10 years, our big goal has to be to pull ourselves back together," he said. "To do that, we have to believe in reliable, honest sources of information from people who really work in a field and do things every day to try and make it better. If we can do that, we can heal a lot of wounds, not just COVID."
With a new strain of the omicron variant now becoming the chief concern in the United States, Gene Olinger, a virologist and the chief science advisor for MRI Global, is hopeful people can turn some of these concerning trends around.
"I heard a comedian say that the public's done with COVID. But you know, COVID is not done with us," Olinger said Monday on KCUR's Up to Date. "We have to kind of realize that we do have to sometimes stay home when we're not feeling well, we have to wear a mask. Hopefully never have to see a shutdown again but we can definitely do things to protect ourselves and our loved ones."
