Annual Reflections at the End of 2021

William Hersh, MD, Professor and Chair, OHSU
Blog: Informatics Professor
Twitter: @williamhersh

As is the tradition with this blog, I end each year with a reflective look at the year past and what the future may hold. The year 2021 is not ending quite like I anticipated. At the beginning of the year, there were stirrings of optimism. The new COVID-19 vaccines had been released, and a new approach to political leadership had just been elected in Washington, DC. On January 2nd, I received my first dose of the Pfizer vaccine, followed by a second one three weeks later.

By the spring, the pandemic was seeming to wane. In late June, Oregon lifted all pandemic restrictions, and life seemed to be returning to relative normal. At work, my department began making plans for returning to the office, aiming to slowly transition over the summer and then return to a new state of normal when the regular academic year started in the fall.

Alas, it was not to be. By August, the Delta wave was surging and plans for returning to the office were postponed. Things became more optimistic into the fall, with my getting my booster vaccine in early October, but then, just when it seemed that the Delta wave was on the decline, the new Omicron variant emerged.

Nonetheless, there is some reason for optimism in the long run for the pandemic. The vaccines are having an impact, even if mostly among the vaccinated. Clearly the vaccines are not completely protective against infections, but they do appear to blunt the worst complications of the disease. In addition, there are new COVID-19 treatments becoming available in pill form, such as Paxlovid, which may provide a means to further prevent the worst impacts of infection. With my three doses of Pfizer vaccine on board, I feel relatively well protected, and feel confident that if I were to have a breakthrough infection, the course would be mild. (Though I am not taking any excessive chances.)

Although I look forward to getting back to working in person, I have managed to maintain my own productivity by working mostly from my home office. One thing that the pandemic has taught the informatics field, and certainly the work of my own department, is that we can pretty much function virtually. I still enjoy interacting in person with colleagues, but clearly most of the research and educational work we do can be carried out in a virtual manner.

I am sad that this pandemic has been so politicized. Every happening, often having nothing to do with the action of politicians, seems to require being viewed through a political lens. While there is, as with all science, some room for debate on translating scientific findings into public policy, it is unfortunate that many, especially those on the right, have chosen to frame everything in that context and make decisions that defy sound public health practice. I don’t enjoy wearing masks or avoiding large gatherings more than anyone, but I recognize these as a small price to pay to protect public health. And it is sad to me that new vaccine technology, one of the greatest public health advances in human history, has also become a political Rorschach test.

The ability to function virtually would not be possible without the maturing of computing and network technology. It is still far from perfect, but we almost take for granted now that we can have a synchronous video call with almost any location on the planet. Social media has played a valuable role too, especially in my case, Facebook. While I am no big fan of Facebook’s business model, and I would happily pay a modest subscription fee to get the benefits of it that I like, it has been invaluable in keeping up personally and professionally with friends and colleagues around the world.

In terms of the informatics field, I am optimistic that we will continue the contributions we make to health and larger society. While the pandemic has caused a detour in our priorities, we are still moving forward in core advances, particularly turning the potential of machine learning and artificial intelligence into reality and advancing standards to make data more interoperable. The pandemic has exposed the limits of our current health information systems and processes, and even if too late to provide optimal value for this pandemic, will hopefully put us in a position to benefit the next public health crises.

This blog itself continues to be successful. This is the 361st post, and it is closing in on 768,000 page views over its nearly 13 years. This blog has provided me an opportunity to provide commentary on many topics, mainly professionally but also personally, and is easily accessible from the Internet. My frequency of posting has decreased some over the years, but I still appreciate the opportunity to weigh in on important topics and not feel the need to post at any specific level of frequency.

I head into 2022 with the optimism that things will get better, yet also with the realism that unforeseen events will happen and set us back. The key, as always, is to live life in a way that one has no major regrets for paths not taken, and living in a way that is just and equitable for the rest of society.

This article post first appeared on The Informatics Professor. Dr. Hersh is a frequent contributing expert to HealthIT Answers.