Change and Challenge: CHI Reflects on a Year of the Pandemic

The participants (clockwise from top left): Karam Ahmad, Policy Analyst; Alex Caldwell, Director; Joe Hanel, Director of Communications; Michele Lueck, President and CEO; Nicole Steffens, Program Manager and CHI’s Co-Facilitator of the Metro Denver Partnership for Health.

To mark a somber one-year anniversary of the arrival of COVID-19 in Colorado, the Colorado Health Institute brought together five team members to reflect on how the past year has changed our work and our lives.

When did COVID-19 become real to you?

Alex Caldwell: My husband works at Denver Health, and we all thought he was totally nuts. He was like, don’t take the bus. No Lyfts. We’re going to Sprouts, and we’re going to buy $300 worth of canned goods. We thought he was nuts, and then a week later we all shut down.

Karam Ahmad: Every week I go to this place called the District with my friends to watch the Nuggets and eat messy wings. In the middle of the game they made an announcement that the NBA was shutting down. This was on March 11. I remember seeing (Dallas Mavericks owner) Mark Cuban’s reaction on TV. He was looking at his phone, and he had no idea what was happening. It felt very surreal.

Michele Lueck: I was sitting in a nail salon with my daughter getting pedicures on March 15 of last year, and on that Friday – Friday the 13th – I had said goodbye to everyone in the office because I was going to Mexico for spring break. The only other person getting a pedicure was a doctor who was taking calls from her chair. I struck up a conversation with her and she said, “Do not go to Mexico.” I feel like it was divine intervention because there was no one else there. So, we came home with painted toenails and cancelled our trip, and that’s when I knew.

Nicole Steffens: I had a very similar experience to Alex and Michele. My fiancé’s brother is an ER doc, and we would work out together in the local parks. And then the parks started getting caution tape placed around them. He said, You know what, I’m going to see you guys in a couple weeks. And we thought, what? We see you every other day. What are you talking about? And I would have conversations with family members and friends and I’d say, you’re fine. It’s gonna be fine.

And then I ate my words two weeks later. I look back, and I think in public health we tried to downplay some things. That was my gut reaction. I’m glad a lot of these doctors were more upfront about it. They said, Pay attention. This is going to be bigger than you think.

Alex: And now here you are running the show with MDPH.

Nicole: Exactly. The irony is just hilarious.

Karam: Do you guys remember I had a cough in early March? We were in one of our last large-group meetings, and I was sitting there trying not to cough, and then I couldn’t hold it and I coughed and everyone looked at me. I said, it’s just allergies!

How did the focus of your work change?

Nicole: My work and my career did a 180. It completely changed. One year ago, I was not a coronavirus expert. Now I am 100% fully involved in COVID. The biggest pivot was the amount of work that was launched in such a short amount of time. In the beginning part of the pandemic, I was working with Sara (Schmitt, Managing Director, Research, Evaluation, and Consulting). We established four different workgroups for MDPH that met every single week, if not twice a week. We were getting buy-in, getting all these players at the table, and it was just chaos.

My mental health suffered – it was bad. It was exhausting. I was on Zoom calls 10 hours a day straight. And it was exhausting to think about COVID 100% of the time, especially in the early part of the pandemic. My mental health has been better now because I’ve been able to decompress and work through it. But when you’re working on a topic 10 hours a day and that’s the only thing people wanted to talk about at night, with your friends with your family. It was 24/7 COVID.

Joe Hanel: Nicole, you were in a different position than most of us at CHI because there were only a few people working with local public health like you were, and then a few other people working kind of behind the scenes to support the governor’s team. And in those first few days the rest of us were thinking, where do we fit in? That’s when we decided that we needed to have rapid commentary on fast-changing situations. We activated what we call the Strike Team to write blogs and do quick research projects around the COVID response in Colorado. And we’re still at it today.

Karam: I worked with Joe and Chrissy (Esposito, Policy Analyst) to put together a timeline, so every day I was tracking every single thing happening, to the extent that I could, at the federal, state, and local level. It felt like I had to know everything that was happening about COVID all the time. At the beginning it was overwhelming to have to think about it and then talk about it afterwards with family and friends. You become that go-to person in peoples’ lives for questions like … should we wear masks? Should we be doing this sort of thing or that?

Michele: I spent April and May so worried about our whole team and how we were going to make it. And all the plans that we had laid, and they’re suddenly out the window. 

What new areas of work did the pandemic response bring to CHI?

Michele: Telehealth.

Alex: We got real smart about that real fast.

Joe: I was impressed by what CHIers were able to do with that. We were one of the first big studies at a state level on telehealth adoption during the pandemic. 

Michele: (Former HCPF Executive Director) Sue Birch used to tell me the way she leads is she moves toward the white space. So, you take a look at the things that are really crowded, and you just don’t worry about them. And at CHI, that’s what we did. We moved to where there was white space. We did it on MDPH, we did it on telehealth, we did it on climate and health, and with the Strike Team. We just found the places where we could make an impact and a difference and that weren’t really crowded. That’s what saved us in 2020.

Joe: I think there is a huge white space now in trying to figure out what we do as we’re coming back from the pandemic and not losing this moment to prepare ourselves for the next emergency.

Alex: And I know that we’re talking about COVID, but of course at the same time is the total upheaval about how we think about racial equity in our work and in our partners’ work. That’s a shift that’s been happening for years but with the death of George Floyd and the increased visibility of violence against people of color, I think there is a crossing of the pandemic and its impact on people of color that’s really forced us to do some thinking.

Nicole: I think we’d be remiss if we didn’t talk about that. We are intentional with our COVID response now because of the things that have happened over the course of the past year.

Michele: I think that shows up in two things. First, the work that Joe and I did on the New Better project supported by The Denver Foundation. The concept that I’ve taken from that is that the pandemic has not so much defined us as it has revealed us. And second, the inequities that have been laid bare by the pandemic. There is an opportunity to operationalize on equity that moves it out of the rhetoric. Like for CHI, I feel like we’ve spent five years thinking about the equity journey and what we should be doing and what could we be doing better and everything is in this type of conditional tense. And now we’ve had the opportunity to really be a part of the vaccine equity fund, to actually prioritize populations, not talk about how we should prioritize populations. Nicole can say, “Here are the priority populations. Here’s where they live. This is where we need to put vaccine sites.”

Nicole: And then do it.

Michele: Yes, and then do it. That has provided this opportunity for CHI but really Colorado writ large to be in this operationalization of equity. Take it out of the rhetoric.

What other challenges has the past year brought?

Karam: We also had the wildfires in 2020. There was a period of time when you couldn’t go outside and even breathe easily. It was just a reminder to me that everything touches health and health touches everything, and it touches everyone.

Michele: It’s almost like the pandemic is so long that we have phases now. Personally, I’ve had the sourdough phase, the yoga phase, and the running phase. Yoga was so mid-pandemic!

Karam: I had a Rollerblading phase.

Michele: You think you’re going to do these things for the whole pandemic. It turns out my family doesn’t eat a lot of bread.

Joe: For me there are only two phases: The remote learning phase and the in-person school phase. It’s all the difference in the world. Last year my son, Charlie, was in preschool five days a week, and then one day in March, it’s just gone. It was a tough summer. For a 4-year-old, this has been a quarter of his life. It’s been hard on the little ones in ways that they can’t express.

Alex: I’ll add to what Joe said about phases. For me and four of our CHI colleagues, the phases have been pre-baby pandemic and post-baby pandemic (Editor’s note: the CHI family welcomed five babies in late 2020 and early 2021). And, yeah, a quarter of Charlie’s life and 100% of these new babies’ lives. They’ve never been held by our friends.

Michele: By me!

Alex: Yes, by our colleagues. So that’s just a super emotional point for me and our other new moms.

Nicole: Personally, I got engaged a year ago this week …

Michele: Happy anniversary!

Nicole: Thank you. I’m just waiting for a wedding. We’re planning September, but I don’t know. Becoming a homeowner, getting engaged, moving forward with these big life events at the same time as navigating this new professional career. It was a lot.

Michele: That’s one of the considerations we have when we return to the office. Whoever is coming back to the office is not the same person who left the office. I think that really has to inform our thinking about how we come back.

Joe: And like so many others, we’ve lost people; 500,000 Americans, a few million people around the world. My wife lost her father to COVID and 10 days later lost her stepdad to cancer. They both lived in the Czech Republic. Her dad was in a nursing home in a little town. Somebody had a wedding there over the summer, and it was a super-spreader event. They had an outbreak in the nursing home a few months later and that was that. There’s no ability to grieve and mourn properly.

And it’s not just how many people died, it’s the way they died. Alone. Her dad was an author. He was a dissident journalist during the Prague Spring. He was persecuted by the Communist government. He fled the country by escaping over the Slovenian Alps, sneaking under machine gun nests. And there are so many people who were heroes in their own way that aren’t here anymore.

Karam: My father lost his brother, so I lost an uncle, to COVID. He was a pharmacist. This was a guy who survived the invasion of Iraq. He survived ISIS. My dad went through mourning for his brother, who was his hero for his entire life, disconnected and virtually.

Nicole: I have an uncle on a ventilator right now. I don’t know if he’ll survive. I think everyone is going through these emotions of loss and grief and isolation. Whether someone lives or not, you’re scared, you’re nervous … you go through all these things, and we don’t have the community to go through it together.

I’m grateful that we could make an impact at CHI on just a little piece of the puzzle here in Colorado and try to help move the needle and prevent another 500,000 deaths.

Joe: On a much happier note, both my 76-year-old parents are fully vaccinated and by tomorrow my 68-year-old mother in-law will be. This has just been a historic achievement in science. It’s incredible to be alive at this moment.

What has COVID taught you about CHI?

Michele: We step up. We stepped up to a lot of challenges and delivered on a lot of things that are really important to the health and policy community. I think MDPH is the leader, and the state is more likely to adopt what Nicole and the MDPH group come up with. We’ve led in terms of our telehealth research. We were out in front with the governor’s innovation response team. We said yes to that work before we knew how it was going to get funded. I think we’ve got a lot of grit.

Karam: We typically make sense of things that don’t have clear answers, and 2020 was the biggest example of that.

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