I was wondering when we’d start having retrospective discussions on lessons learned from our bout with Covid 19. My first such invitation came from the Boston Public Health Commission for a program on “Advancing Health Equity in Boston: Building on Lessons Learned from the Covid-19 Pandemic” that was held on April 26.

I was curious to see if the end of the pandemic would be acknowledged. It didn’t need to be. Of the 150 or so attendees at this forum, almost entirely made up of public health professionals, only eight people wore masks, so I’d say that those in the know have determined that it’s over.

I’ve gone to hundreds of health care forums during my 42-year career in the health field. Though much of the information delivered in this forum is widely known, the speakers provided an excellent contextual framework for understanding why Covid had a greater impact among certain groups, what was done (or not) to improve outcomes, and what needs to happen to improve outcomes next time we face a pandemic. It was a good start for a much broader discussion that would include the science of virology and the medical and social impacts of pandemics.

One of the key findings was that public health reductions in the last few decades at both the state and national level left us unprepared. There were thousands fewer staff left in place to fight a public health emergency like Covid, and the national pandemic office was actually eliminated before the pandemic began. It was disclosed that a national lab set up to deal with Covid was staffed with just three people.

Beyond infrastructure, the economic necessities of a country in crisis caused certain individuals to be classified as essential workers. They tended to be lower income people of color who were more likely to get the virus because their jobs required them to work in public locations. The result was a far greater impact on those populations.

The forum had presentations on remarkable community efforts in Chelsea, in Roxbury, and in the Haitian community that worked to alleviate the impact of Covid when it was clear that state actions were not sufficiently helping. Leaders in these communities combined political action with providing basic services and built collaborations with medical programs that allowed their communities to trust the services being provided. Their presentations received a standing ovation.

It was also acknowledged that the impact of Covid went far beyond the virus, that we are dealing with a serious mental health crisis across our country and the world, and that students in low-income communities fell far behind in their education, losses that may take years to overcome, if ever.

Did we learn anything that will enable us to better handle our next pandemic?

Those in health care saluted the resilience of our communities, especially lower income communities, and noted that the pandemic opened a door to figuring out how to collaborate with these communities in improving health outcomes. This becomes especially important as we acknowledge the mental health needs across our communities, something that was largely ignored before the pandemic.

The pandemic also gave great credence to the impact of the social and economic determinants of health and created a greater willingness to talk about race and structural racism, the idea of reparations, and equity in housing and education.

Massachusetts benefitted from having a robust system for recording vaccinations, which made it easier to keep track of vaccination rates for Covid. The state also greatly expanded data capability, such as with measuring disease in wastewater to predict viral surges, an essential component for measuring health.

I was impressed with the forum. The speakers gave a clear overview of what they learned from the pandemic, and the issues we still face. These include maintaining and growing public health infrastructure, building on the partnerships and collaborations that allow for better health care in our communities, providing greater access to behavioral health services, and supporting efforts that decrease income inequality as a path to better health in low-income communities.

But talk is, well, just talk, and America seems to forget its lessons learned rather quickly. In the next few months, 300,000 Massachusetts residents currently getting Medicaid will be removed from this insurance, forcing many of them into much poorer and higher costing insurance via the “Connector.” Other pandemic benefits such as support of families with children have ended, or soon will. The end of the child tax credit payments last year greatly increased child poverty. And this is happening at a time when Massachusetts is flush with cash. Imagine what will happen when Massachusetts finances turn downward.

We don’t have to return to the pre-pandemic status quo. The pandemic taught us that we need a new vision for how health care is delivered if we want better health outcomes. Massachusetts needs to evolve our market-based system focused on disease toward a health-based system focused on prevention and collaboration. Let’s use the trauma of the pandemic as a call to action. Let’s acknowledge that our current system has major problems and begin a process to create a new model of health care focused on community, collaboration, prevention, and equity. I guarantee we’ll be better prepared next time.

Bill Walczak is the former president/CEO of Codman Square Health Center. His column appears regularly in the Reporter.