A year into the COVID-19 pandemic, we’ve settled into a change of place: Elementary school classes take place remotely from dozens of kitchen tables, while work meetings once held in conference rooms now convene from spare bedrooms and that little corner tucked away by the stairs. Most of our social lives have shifted to happen exclusively outdoors, and as the fall progressed to winter we’ve huddled (not too close) around our new patio heaters. Quite simply, a lot of activities have moved to new places thanks to COVID-19. These pandemic-induced changes in venue may seem so familiar as to be prosaic at this point. But the places we inhabit are a detail worth noting, in particular for this issue of the magazine, which ventures into ways these places matter both more and less than we might have thought.
In planning our feature story about medical education, Suzanne Rose, MD, MSEd, the senior vice dean for medical education in the Perelman School of Medicine, told me that students miss being able to meet in person and en masse in the Jordan Medical Education Center (JMEC) — and she misses them, too. Yet the story shows that the physical spaces where people learn and connect sometimes matter less than the quality and frequency of that connection. The essential parts of the medical student experience that had to endure during the pandemic, did endure, and will outlast this disease. For a brief period as the first wave of COVID-19 hit, students’ clinical clerkships converted to virtual learning electives that were closely shaped by students’ input into the developing the curriculum. While clinical trainees are now back in the hospital — an instance where the place remains foundational — the learner-centered approach to shaping the curriculum is here to stay.
But sometimes a physical place has everything to do with health and disease. Unsafe or unstable housing conditions, poverty, and related social inequities are deeply linked with well-being. The nature of such connections are what you will find once you dig beneath the creepy-crawly surface of our cover story. What begins as an exploration of vector-borne diseases, and a tale of two cities with distinct pest control concerns, ultimately yields lessons about the intimate connections between housing and public health. “Policy matters,” as the story’s central expert, epidemiologist Michael Z. Levy, PhD, says. A change in zoning policy affecting settlement patterns in Arequipa, Peru, made the difference in sparking a once-mysterious outbreak of Chagas disease there, as his team’s research helped show. Since then, in Philadelphia, Levy has used his research to advocate for housing policies that can mitigate bedbug infestations in the city — and more recently for moratoria on evictions to reduce the spread of COVID-19.
So many of us are experiencing places differently during the pandemic, or have experienced some form of displacement, whether from workplaces, schools, jobs, routines, or celebrations. But there is some comfort in knowing that the most valued places we’ve lost, may yet be places we’ll return to. And vaccines are the reason (see our coverage in Vital Signs and in a perspective by Abike James, MD, MPH). The arrival of vaccines to Penn Medicine in mid-December brought not only pride in the achievements of our own scientists in helping to make this possible, but also a new energy and relief among faculty and staff who have worked so hard all year to care for our community. Though there remain uncertainties as this issue goes to press about the supply and procedures for more widespread vaccination, it is time to celebrate that a remarkable feat of science is giving us a path toward a different place.