Five years after the COVID-19 pandemic began, experts reflect on health care shortcomings revealed by the public health crisis and emphasize the need for future preparedness. Key challenges include personal protective equipment (PPE) shortages, misinformation, and widespread health care workforce burnout.

Featured experts include Jason Bellet, cofounder and chief business officer of Eko Health; Geoffrey Rutledge, MD, PhD, cofounder and chief medical officer of HealthTap; and Dan Nardi, MS, CEO of Reimagine Care.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

What were the biggest weaknesses in the health care system exposed by the COVID-19 pandemic? What steps are necessary to build resilience moving forward?

Bellet: I think one of the biggest weaknesses that was exposed, not only within a hospital and health system, but overall, was PPE and ensuring that we had access to technologies that would keep providers safe in really complex medical situations.

One of the things that Eko [Health] did very early on was release a feature within our product that allowed providers to listen through Bluetooth headsets. A provider could put on an entire protective PPE gown, getting ready to go into a complete isolation room, but what you didn’t want to have happen was the provider needing to put stethoscopes into their ears and then have a tube connecting them to the patient.

[That was] a use case that, at scale, we really hadn’t thought through. I mean, there were infection control rooms within hospitals, but we never really planned for the large-scale need for infection control in the case of a pandemic. We were able to quickly iterate and develop a solution that allowed providers to put headphones under their protective gear and then, via Bluetooth, stream to those headphones.

I think one of the things that it exposed is the need for preparedness in the event of a pandemic, or in the event of a need for large-scale infection control, to have alternative solutions to perform some of the most critical parts of the exam, ie, listening to heart and lung sounds.

I think, in general, they need to stockpile PPE. We were, as an overall world, and certainly as a health system, dramatically underprepared in terms of masks and protective equipment needed. I know that the federal government had a stockpile of PPE that was largely outdated and expired. This was a good crash course on keeping that up to date and making sure that the safety net is in place.

Rutledge: Certainly, [we] should be drawing lessons. People are pointing fingers after the fact at some of the decisions that were made. For example, there’s been great criticism of the lockdowns, which I think, at the outset, were absolutely essential. Then the discussion really is, how should we decide and define how to unravel or roll back the lockdowns? I think such discussions in the future will be important.

I guess the other issue is understanding the power of misinformation. Early on, in particular, as these events [pandemics] occur, there is uncertainty, and how we manage that uncertainty, how we focus the discussion to be based on the facts at hand, ends up being important. There is this thing called the “fog of war,” which I think applies to what happens early on when pandemics occur, where, in the midst of a crisis, information can be uncertain, and it can be challenging to make good decisions. Looking at how we made those decisions, I think it’s important for us to consider how we would respond the next time around.

Nardi: I think there was a handful of weaknesses that were really brought to light. I mean, I think the workforce strain is one of them. I’m going to say that, combined with our over-reliance on a facility-based care, right? For decades, we expected patients to come in to receive their care, and we didn’t really have as much, or at least not at scale, the ability to support patients at home, on the go, and virtually. I think that puts a lot of strain on the workforce.

I think you ended up having this already borderline burnt-out workforce, and then we had a pandemic that just asked even more of these caregivers. I think that put a lot of these nurses, frontline healthcare workers, providers, clinicians, it asked so much more of them because we expected patients to come in. I think that’s one where we really have an opportunity to continue to build and make sure we’re having the right support systems around that.

Also, I think equity and gaps in access in rural areas. Again, same type of thing, right? How are we supporting patients who don’t live within a handful of miles of a hospital or their health care provider? Being able to ensure the right access to care is going to be extremely important as we move forward for patients in all locations, no matter their diagnosis, no matter what treatment they need to have.

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Older adults and other groups at risk for severe complications from influenza infections often do not receive flu antiviral prescriptions in urgent care (UC) and emergency department (ED) settings, according to a recent study in Clinical Infectious Diseases.

The study was based on findings from 10,700 patient encounters for acute respiratory illness at urgent cares or emergency departments and with positive influenza virus test results during the 2023-24 flu season at four large US healthcare systems.

All patients were considered higher risk for severe influenza, the median age was 65 years, with 59% female, 36% Hispanic, 37% non-Hispanic White, and 16% Medicaid recipients.

Overall, 58% were prescribed antivirals during their UC or ED visit, with 67% of prescribing occurring on the encounter date. Among those prescribed antivirals, 3,050 (80%) had them dispensed, with 65% of dispensing occurring on the prescription date.

Those 50 to 64 had more antivirals dispensed

Among the 7,138 eligible encounters with an antiviral medication prescription, 7,135 (99.96%) were prescribed oseltamivir (Tamiflu).

Older age (65 and older) was associated with lower odds of same-day prescribing (0.57; 95% confidence interval [CI], 0.42 to 0.78). For same-day dispensing, the odds were 0.58 (95% CI, 0.36 to 0.94), compared to those 18 to 49 years.

Those aged 50–64 years had the highest proportion dispensed antivirals (85%) among those prescribed,

“Patient encounters aged ≥65 years had the highest proportion prescribed antivirals (63%); however, those aged 50–64 years had the highest proportion dispensed antivirals (85%) among those prescribed,” the authors said.

The authors said their study points to gaps in the antiviral prescription timeline.

“Strategies to improve earlier initiation of influenza antivirals for older, chronically ill patients along with expanded use of rapid and highly sensitive point-of-care testing in ED and UC settings could improve treatment initiation among patients with influenza,” the authors concluded.

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Europe’s progress on health is “stagnating” and in certain areas, even backsliding, according to an overarching new report that covers everything from infections and chronic disease to life expectancy across the continent and parts of Central Asia.

The new 2024 European Health Report found, for instance, that gaps in vaccination coverage have worsened in some countries in the region, leading to a resurgence in diseases such as measles and pertussis (whooping cough).

There were more than 58,000 measles cases in 2023 across 41 countries, according to the new report as well as 87,000 pertussis cases – the highest number in the last decade.

Just seven countries in the region – Hungary, Kazakhstan, Malta, Portugal, Slovakia, Turkmenistan, and Uzbekistan – have greater than 95 per cent coverage of three key vaccines for diphtheria, tetanus, and pertussis; measles; and pneumococcal infections.

The newly published report is released every three years by the World Health Organization (WHO)’s European regional office and comes as countries face several challenges, such as ageing populations and climate change.

“Whilst progress was happening, it has stagnated, and of course, we know that the COVID pandemic has had an impact, but we can’t just sit back and be complacent,” Dr Natasha Azzopardi-Muscat, WHO Europe’s Director of Country Health Policies and Systems, told Euronews Health at a press conference.

She added that “progress cannot be taken for granted”.

Region must ‘confront root causes of chronic diseases’

There were also signs of improvement in the region. The new report found that diseases such as cardiovascular diseases, cancer, diabetes, and chronic respiratory illnesses are declining.

Ten countries – Belgium, Denmark, Estonia, Israel, Kazakhstan, Luxembourg, the Netherlands, Norway, Sweden, and Switzerland – have reached the target of reducing premature mortality from the main chronic illnesses by 25 per cent.

Yet these diseases are still linked to the deaths of one in six people under the age of 70 in the region.

The leading cause of premature death is cardiovascular disease, which is especially the case in Eastern European countries and Central Asia.

While northern and western European countries have higher numbers of new cancer cases, mortality is decreasing. Eastern European countries, meanwhile, have lower numbers of cancer but higher mortality.

“The entire region must confront the root causes of chronic disease; from tobacco and alcohol use to poor access to healthy and nutritious food, to air pollution, to a lack of physical activity,” Dr Hans Kluge, WHO’s regional director for Europe, said in a statement.

Europeans consume the most alcohol globally with an average of 8.8 litres per adult per year – roughly 733 to 880 standard drinks in a year. Alcohol consumption is highest in EU countries and lowest in Central Asia.

It is responsible for one in every 11 deaths in the region, the report said.

Dr Gauden Galea, a strategic adviser to WHO Europe’s regional director, explained that many European countries “are producing a very large amount of the world’s alcohol” and that there is low awareness of the “strong link” between alcohol and cancer among the population.

There is also a high level of tobacco smoking at around 25 per cent, with the region not on track to meet the goal of reducing that by 30 per cent this year, WHO said.

Meanwhile, obesity, which can lead to an increased risk of diabetes and heart disease, is rising in the region with nearly a quarter of adults living with it.

Young people ‘lonelier’ than before

One in five adolescents in the region are struggling with mental health with suicide a leading cause of death among 15 to 29-year-olds, according to the report.

“In our online and interconnected world, our young people are ironically feeling lonelier than ever before, with many struggling with their weight and self-confidence, setting them up for poor health as adults,” Kluge said in a statement.

He added that protecting children’s health can help them to grow into healthier adolescents and in turn, healthier adults.

The report addressed a host of other health issues in Europe, noting that while the region has relatively low maternal mortality rates, they have also stagnated since 2015.

It called for closing a wide gap between countries on preventable child deaths and noted that Europe is the fastest-warming region globally, with an estimated 175,000 heat-related deaths per year.

Kluge added at a press conference that while people are living longer lives, they are not necessarily healthier and warned that Europe’s health systems “are no better prepared for emergencies today than they were before the COVID-19 pandemic”.

He said that viruses such as avian influenza, mpox, and Marburg do not have borders and that “keeping health high on the agenda means working together to build a safer and more resilient world”.

Several years ago, a little-known drug named Ozempic – previously used only to treat diabetes – emerged as a promising new drug for weight management.

The Food and Drug Administration’s approval of Ozempic in 2021 for weight loss treatment ushered in a new era for the class of drugs called glucagon-like peptide-1 agonists, or GLP-1.

Today, GLP-1 drugs, including Wegovy, Mounjaro and Zepbound, have become household names and key tools in the fight against obesity: 1 in 8 American adults say they have used a GLP-1 drug, and forecasts show that by 2030, 1 in 10 Americans will likely be using these medications.

Now, research from my lab and others suggests that GLP-1 drugs could help treat dozens of other ailments as well, including cognitive issues and addiction problems. However, my colleagues and I also found previously unidentified risks.

I am a physician-scientist and I direct a clinical epidemiology center focused on addressing public health’s most urgent questions. My team works to address critical knowledge gaps about COVID-19, long COVID, influenza, vaccines, effectiveness and risks of commonly used drugs, and more.

On Jan. 20, 2025, my team published a study of more than 2.4 million people that evaluated the risks and benefits of GLP-1 drugs across 175 possible health outcomes. We found that these drugs lowered risks of 42 health outcomes, nearly a quarter of the total that we analyzed. These include neurocognitive disorders such as Alzheimer’s disease and dementia, substance use and addiction disorders, clotting disorders and several other conditions.

Unfortunately, we also found that GLP-1 drugs come with significant side effects and increase the risk of 19 health conditions we studied, such as gastrointestinal issues, kidney stones and acute pancreatitis, in which the pancreas becomes inflamed and dysfunctional.

Cognitive benefits

One of the most important health benefits we found was that the GLP-1 drugs lowered the risk of neurodegenerative disorders, including Alzheimer’s disease and dementia. These findings align with other research, including evidence from preclinical studies showing that these drugs may reduce inflammation in the brain and enhance the brain’s ability to form and strengthen connections between its cells, improving how they communicate with one another. These effects contribute to mitigating cognitive decline.

Two other key studies have shown that patients treated with a GLP-1 drug for diabetes had a lower risk of dementia.

All of these studies strongly point to a potential therapeutic use of GLP-1 drugs in treatment of the cognitive decline. Ongoing randomized trials – the gold standard for evaluating new uses of drugs – are looking at the effects of GLP-1 drugs in early Alzheimer’s disease, with results expected later in 2025.

Curbing addiction and suicidal ideation

GLP-1 drugs have also demonstrated potential in reducing risks of several substance use disorders such as those involving alcohol, tobacco, cannabis, opioids and stimulants. This may be due to the ability of these drugs to modulate reward pathways, impulse control and inflammatory processes in the brain.

The effectiveness of GLP-1 drugs in curbing addictive behavior may explain their spectacular success in treating obesity, a chronic disease state that many have suggested is indeed a food addiction disorder.

Our study demonstrated a reduced risk of suicidal thoughts and self-harm among people using GLP-1 drugs. This finding is particularly significant given earlier reports of suicidal thoughts and self-injury in people using GLP-1 drugs. In response to those reports, the European Medicines Agency conducted a review of all available data and concluded that there was no evidence of increased risk of suicidality in people using GLP-1 drugs.

Now at least two studies, including our own, show that GLP-1 drugs actually reduce the risk of suicidality.

Other benefits

In addition to the well-documented effects of GLP-1 drugs in reducing risks of adverse cardiovascular and kidney outcomes, our study shows a significant effect in reducing risk of blood clotting as well as deep vein thrombosis and pulmonary embolism.

One puzzling finding in our study is the reduced risk of infectious diseases such as pneumonia and sepsis. Our data complements another recent study that came to a similar conclusion showing that GLP-1 drugs reduced risk of cardiovascular death and death due to infectious causes, primarily COVID-19.

This is especially important since COVID-19 is regarded as a significant cardiovascular risk factor. Whether GLP-1 drugs completely offset the increased risk of cardiovascular disease associated with COVID-19 needs to be thoroughly evaluated.

GLP-1 drugs may also be useful in treating fatty liver disease and conditions ranging from asthma to chronic obstructive pulmonary disease, sleep apnea, osteoarthritis, depression and eye disorders.

Risks and challenges

Despite their broad therapeutic potential, GLP-1 drugs are not without risks.

Gastrointestinal issues, such as nausea, vomiting, constipation and gastroesophageal reflux disease are among the most common adverse effects associated with GLP-1 drugs.

Our study also identified other risks, including low blood pressure, sleep problems, headaches, formation of kidney stones, and gall bladder disease and diseases associated with the bile ducts. We also saw increased risks of drug-induced inflammation of the kidneys and pancreas – both serious conditions that can result in long-term health problems. These findings underscore the importance of careful monitoring in people who are taking GLP-1 medications.

A significant challenge with using GLP-1 drugs is the high rates at which patients stop using them, often driven by their exorbitant cost or the emergence of adverse effects. Discontinuation can lead to rapid weight gain.

That’s a problem, because obesity is a chronic disease. GLP-1 drugs provide effective treatment but do not address the underlying causes of obesity and metabolic dysfunction. As a result, GLP-1 drugs need to be taken long term to sustain their effectiveness and prevent rebound weight gain.

In addition, many questions remain about the long-term effectiveness and risks of these drugs as well as whether there are differences between GLP-1 formulations. Addressing these questions is critical to guide clinical practice.

Yahoo is using AI to generate takeaways from this article. This means the info may not always match what’s in the article. Reporting mistakes helps us improve the experience.

Yahoo is using AI to generate takeaways from this article. This means the info may not always match what’s in the article. Reporting mistakes helps us improve the experience.

Yahoo is using AI to generate takeaways from this article. This means the info may not always match what’s in the article. Reporting mistakes helps us improve the experience. Generate Key Takeaways

People are living longer than ever before — but they’re not actually healthier. And the number of years spent sick is only growing, according to a massive new study just published in JAMA Network Open. While researchers found that this is a global phenomenon, the so-called health span-lifespan gap is wider in the U.S. than anywhere else in the world. In America, the gap between how long people live and how long they live in good health is over 12 years.

Experts say it begs the question: We’ve gained more years, but at what cost? Here’s what the landmark research tells us, and how we might close the gap between years lived and years lived well.

What is the difference between health span and lifespan?

Lifespan is simply a measure of how long someone lives or, collectively, how long we live on average at the population level. It’s cold hard math, and doesn’t tell us much about what living is like. In recent years, experts have looked to the notion of health span to measure quality of life. Health span refers to how long someone lives in, well, good health.

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“There are these big debates, as we increase lifespan: Those extra years gained … are they going to be healthy years or miserable years?” Michael Gurven, a professor of anthropology at the University of California, Santa Barbara Center for Aging and Longevity Studies, who was not involved in the study, tells Yahoo Life. “Of course, no one wants the latter, and this is why health span has been the big buzzword recently.”

For the new study, researchers gathered data on the average lifespans of people in the 183 member-nations of the World Health Organization (WHO). Then, to assess the average health span of each country, they assigned a score to each disease or ailment that might cause disability or a generally poorer quality of life. These included chronic conditions like heart disease and arthritis, as well as health problems such as mental health disorders and dependency on drugs or alcohol. Researchers then created an estimate of how many years of healthy life a country’s population lost due to the burden of each of these factors. The answer? In most countries, many years. The difference between the average lifespan, minus the number of unhealthy years, estimated what the researchers call the health span-lifespan gap.

The global lifespan is nearly a decade longer than the average health span

The study found that an average global citizen lives 9.6 fewer healthy years than they live altogether — so, for example, someone who lived to 80 might have spent the last decade of their life in poor health. That disparity is even more stark for women, for whom that gap is 2.4 years wider compared to men.

Researchers say the global gap is also widening. Over the past 20 years — between 2000 and 2019; the study doesn’t include data from 2020 through the present — the average lifespan worldwide has extended by 6.5 years. But the number of healthy years one can expect to live has only increased by 5.4 years. Our health span is not keeping pace with our longevity. Keep in mind that these estimates are for an entire population, so this doesn’t necessarily mean that everyone, everywhere, can expect the last 10 years of their lives to be spent debilitatingly ill. Some people live relatively long, healthy lives, even with chronic disease, the study authors noted. And others may experience their most unhealthy period of life somewhere in the middle due to addiction or cancer.

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According to the findings, the majority of the health span deficit can be attributed to non-infectious diseases, which include heart disease and diabetes — and which have cumulative effects that typically come to a head in old age. “Aging itself is a very important factor in the development of chronic diseases, so that’s an unintended consequence of people living longer,” Armin Garmany, an MD-PhD candidate at the Mayo Clinic and study co-author, tells Yahoo Life.

His co-author, Dr. Andre Terzic, who pioneered regenerative medicine at the Mayo Clinic, says they are now looking into why this gap exists and is widening. “But suffice to say that clearly there is an association [with] … chronic diseases that the world, in general, is more and more afflicted with, such as cardiovascular disease, but also cancer, diabetes and neurological disease, etc.,” he adds.

The U.S. has the widest health span-lifespan gap

The average life expectancy in the U.S. is 77.5 years, according to the Centers for Disease Control and Prevention. But Americans outlive their health spans by 12.4 years, the study found. It’s closely followed by Australia (which has a gap of 12.1 years), New Zealand (11.8 years), the U.K. (11.3 years) and Norway (11.2 years). Several countries in Africa fall at the bottom of the health span-lifespan gap rankings, but this is less due to longer health spans than to the fact that lifespans are relatively short, as there have been fewer advancements to prevent deaths from infections or to allow people to live with chronic diseases.

Just as in other countries, chronic conditions like heart disease are major factors in how many years Americans remain alive but in poor health. But, the authors add, a high burden of mental health and behavioral conditions — which the WHO groups together, and include depression, anxiety and addictions to alcohol and drugs — are also weighing heavily on our health span, as well as curtailing life expectancy in the U.S.

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Underpinning both chronic diseases and what are sometimes called deaths or diseases of “despair,” such as addiction, is the prevalence of loneliness, stress and inequality in the U.S., Gurven says. “It’s hard to avoid that living in a highly unequal society is stressful and that takes a toll on our health in so many ways,” he says. That inequality affects not only access to health care, but can also be seen in how little opportunity there is for Americans in many parts of the country to get physical activity or healthy meals in their busy days, helping to fuel the obesity epidemic, which, in turn, curtails health span.

Why it matters — and what to do

The main takeaway, Gurven says, is that “yes, lifespan has been increasing over the past two decades, but a lot of those years are not being spent in a healthy state.” Not only does that inflate health care costs to individuals and their countries, it’s simply not what most people want. Older people and aging experts often value quality of life over quantity.

If more people lived healthy lifestyles — eating a balanced, heart-healthy diet, exercising, maintaining a healthy weight and so on — that gap would likely narrow, but we can’t rely on individual “willpower” alone, says Gurven. He, Terzic and Garmany all agree that both behavioral changes and more effective health care practices will be crucial to closing the health span-lifespan gap. Terzic hopes that technologies like AI will soon help usher in an era of “interceptive medicine,” allowing doctors to identify people at risk of shorter health spans, and intervene before a chronic disease takes hold.

But some changes that could make a difference are far more low-tech. These include easier access to fruits and vegetables and more sidewalks and protected bike lanes, says Gurven. “A lot of this relies on the structured environment,” he says. “When everything relies on our [individual choices], everything works against us.”