Updates from HSR&D Central Office
April 5, 2021
By David Atkins, MD, MPH, Director of HSR&D
David Atkins, MD, MPH, Director, HSR&D
When the first day of spring arrived last month, it felt that we had just endured a year-long winter, one without trips to the office, visits with family, or children heading off to school. Far grimmer has been the toll on patients with COVID, the families mourning loved ones, and the clinicians bearing the weight of it all. The initiation of this monthly “Updates from HSR&D Central Office” is a recognition that one the of major casualties of the past year has been communication with the field as my usual venues to connect with you have all been put on hold – field visits, national conferences, and our national HSR&D/QUERI meeting.
The good news is that it seems permissible to be hopeful this spring – hospitalizations and deaths continue to decline in most parts of the country as the numbers vaccinated climb steadily. With the hope that an even brighter summer lies ahead, here are some reflections on what I learned the past year:
- Given a challenge, our researchers respond with amazing creativity. A March survey of our COINs identified over 200 COVID publications in the past year, many without dedicated research funding.
- VA is an ideal system to study COVID due to the quality of our data, depth of our research community, and the consistency of our clinical response. Unlike in many other systems, COVID outcomes in VA aren’t confounded by lack of access or overwhelmed hospitals. Teams from VA were some of the first to publish results within a large FDA collaboration of different health care systems using EHR data to assess new COVID treatments.
- Our HSR&D staff and our researchers can work very effectively in a remote environment. We are unlikely to go back to a world requiring 100% office work, especially in areas where commuting can waste more than 2 hours a day.
- It’s hard to manage a national public health crisis with a hodgepodge of Federal, state and county responsibilities. Nothing made clearer the value of a national, integrated system than VA’s success in vaccinating staff and patients.
- I miss the office and even my commute – Zoom makes casual interaction much harder, and it’s difficult maintaining the continuous informal connections that make a team work well. And Zoom coffees or birthdays without the pastries and cakes are for the birds.
- Even setting aside new variants, we still have so much to learn about COVID. A new effort in HSR&D will bring national data to bear to study the long-term outcomes of the 250,000 Veterans who recovered from COVID, including those who seem to suffer from what is now known as PASC – post-acute symptoms of COVID. A separate set of initiatives is examining the effects of pandemic disruptions to work and healthcare on non-COVID outcomes such as suicide, substance use and other mental health outcomes, the care of acute conditions and the management of chronic diseases. VA has experienced far more excess deaths in 2020 than are officially attributed to COVID, but we don’t know the relative contribution of social disruption, delayed or suboptimal health care, or undetected COVID.
I truly hope and believe we will be able to put the worst of COVID behind us over the coming year, but I also know the process of fully understanding COVID will take years of work from dedicated and creative researchers. I am so proud that so many of them work in VA.