2020

The year 2020 was one to remember. Adversity and resilience, racial violence and social justice, hope and heartache came in waves upon us all throughout the year.

The coronavirus-2019 (COVID-19) pandemic has taken—and continues to take—a massive toll on states across the United States and on countries around the globe. In December 2020, just as the first vaccine was released by the U.S. Food and Drug Administration, the death toll from the pandemic in the United States alone reached over 300,000 individuals and marked 17 million infected (1). The personal, professional, and financial toll on individuals and institutions surely will have a lasting impact. Our world has changed dramatically, and we continue to face challenges for which no one could have prepared us. Yet, we continue to demonstrate great resilience and strength, which gives us great hope.

Over the past year, the American College of Cardiology (ACC) refocused its institutional energies on helping its members do what they do best—help and heal. To date, we have reached millions of cardiovascular clinicians worldwide with the most recent clinical guidance, latest published research from our JACC Journals, frontline perspectives, operational best practices, patient education, and health policy updates on our COVID-19 Hub. We have collaborated with our U.S. and international cardiovascular societies, federal and state lawmakers and health agencies, industry partners, and other stakeholders to provide critical COVID-19 education on topics related to specific clinical areas, clinician and patient safety, access to care, health care disparities, clinician well-being, and more. Critical stakeholder roundtables addressing clinical research in the COVID-19 era, as well as telemedicine, provided unique opportunities to collaborate on ways to overcome challenges and identify solutions for clinicians and patients alike.

I believe we have learned some important lessons that will carry with us into 2021, and long after the pandemic ends. Specifically, the pandemic has underscored the importance of the following.

Collaboration

The pandemic has reminded us of the global nature of human health and disease and underscored the importance of collaboration and working across borders. The early, educational webinars and reports from our colleagues in China led the way to a better understanding of the nature and treatment of a new disease. Cardiovascular societies rapidly published best practice guidance together—on topics from ST-segment elevation myocardial infarction care, to elective procedures, to hydroxychloroquine—bending the usual rules for thorough guideline reviews and publishing. The voice of science was needed. It is clear again that the ACC’s commitment to improving cardiovascular health can only be achieved through partnerships with cardiovascular organizations here and abroad.

Prevention

As in the treatment of heart disease, the focus on prevention is critical in the battle against COVID-19. Many risk factors for coronary artery disease increase risk of morbidity and mortality from COVID-19 infection, further underscoring the importance of lifestyle modification and prevention. The ACC has developed a number of CardioSmart tools and infographics in multiple languages to help clinicians talk with their patients about healthy lifestyle choices, as well as the importance of preventive measures like social distancing, wearing a mask, handwashing, and getting the influenza vaccine in helping to slow the spread. A separate public-facing campaign also focused on raising awareness about the importance of early treatment for heart attack and stroke symptoms.

Advocacy

From the beginning of the pandemic, the ACC has been a leading voice of advocacy for physicians, nurses, and patients on critical issues like telehealth, availability of personal protective equipment, access to care, provider relief funding, and more. Because of these efforts, we have been instrumental in shaping health policies, programs, and legislation during this period. Key successes include efforts to reduce administrative burden in areas such as prior authorization, optimizing electronic health records for interoperability and streamlining and prioritizing quality measures that are transparent across payers. These efforts are linked to reducing physician burnout.

Clinician Well-Being

Throughout the pandemic, health care workers have been working longer, more physically and mentally demanding hours with less time to decompress at home. Health care workers are not immune from stress, anxiety, and depression—if anything, data show they are at greater risk, especially now (2). There is no single solution to this problem, but we must make sure that clinicians know that they are not alone and provide them with resources to help them through these extraordinary challenges. The ACC Well-Being Task Force has developed webinars, podcasts, and online tools that are available on the College’s Clinician Well-Being Portal. Additionally, the portal includes links to critical resources like the Physician Support Line (1-888-409-0141); Hope4healers, a free service providing brief counseling to help health care workers and first responders manage COVID-related stress; and PeerRxMed, which utilizes a buddy system to help prevent burnout.

Agility and Adaptability

While COVID-19 derailed our ability to travel to meetings and participate in workshops, conferences, and other events, it has not stopped us from finding new ways to engage and interact with one another. Rapid adoption of technology has allowed us to bridge the distances. In March, ACC’s 2020 Annual Scientific Session was the first major medical meeting to go entirely virtual. In just 2 short weeks, we put on an incredible event attended by a record number of more than 60,000 attendees from over 150 countries and established an effective virtual model for future meetings. Since then, the ACC’s Quality Summit, 2020 Legislative Conference, and Medaxiom’s Fall TransForum each had record numbers of virtual attendees. Most recently, the New York Cardiovascular Symposium in December reached almost 3,000 members in 75 countries. Agility allowed us to employ new methods of knowledge dissemination and created new audience and opportunities.

Health Care Disparities

Diversity, inclusion, and health equity are critical to achieving excellence in care and achieving our mission of transforming cardiovascular care and improving heart health. The inequities in COVID-19 hospitalizations and deaths, coupled with the ongoing racism and violence faced by African American and other minority communities, have highlighted the very real health care disparities that exist in the United States and elsewhere. We can and must act to acknowledge and help dismantle structural racism in our profession and our institutions.

What does this mean? It means putting greater focus on social determinants of health that are involved in developing clinical guidelines, patient education, and shared decision-making tools. It means working with industry, payers, and other stakeholders on drug pricing and access to treatments, as well as developing clinical trials that reflect race, ethnic, and gender diversity. It means continuing to foster a diverse pipeline of cardiovascular clinicians that represent the patient populations they treat. It means each of us taking a hard look at our own biases and educating ourselves, our leaders, and our colleagues on how to be effective allies. Our ACC task forces on diversity, inclusion, and health equity have created actionable plans and online resources.

COVID-19, if nothing else, has underscored the importance of—and the power in—the global community coming together in a time of change and uncertainty to continue to deliver science and education so critical to our profession and our patients. We have been able to pivot quickly to provide cardiovascular clinicians with the tools and information they need to provide the best care to their patients. I have never been prouder of the ACC and our members. I am sure that we will emerge from this time in history stronger and more united around our shared mission than ever before.