CHICAGO — The patient wasn’t initially worried when she first caught COVID-19.

Fully vaccinated and relatively healthy at the age of 41, Johanna Claudette of the Irving Park neighborhood thought the positive test in February 2022 wouldn’t be a big deal.

But within days, her memory became spotty. Her heart raced and she became fatigued. Today, she said, she’s still grappling with blurry vision, chest pain and brain fog — all symptoms of the chronic condition called long COVID, which can linger for months or even years after an initial infection and which has afflicted millions worldwide.

Five years ago, reports of the new and mysterious virus emanating from China gripped the globe in terror and uncertainty.

As infections spread across continents, humanity raced to better understand the novel coronavirus and prevent its proliferation, with case counts, hospitalizations and deaths climbing rapidly.

On March 11, 2020, the World Health Organization declared COVID-19 a pandemic, the first in over a century. The international agency urged everyone around the globe to work together to alter the course of the virus, which had already touched 114 nations and ended more than 4,000 lives.

“Some countries are struggling with a lack of capacity. Some countries are struggling with a lack of resources. Some countries are struggling with a lack of resolve,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus announced that day. “All countries must strike a fine balance between protecting health, minimizing economic and social disruption, and respecting human rights.”

Days later, President Donald Trump proclaimed the virus a national emergency. Later that month, Gov. JB Pritzker issued a statewide stay-at-home order aimed at limiting viral transmission and protecting the health care system from becoming overwhelmed.

Across Illinois and the nation, school buildings were empty. Normally bustling highways and downtown corridors were barren. Restaurants, shops and entertainment venues went dark, some to never reopen.

And everyone tried to adapt to the “new normal,” as life with COVID-19 became commonly known.

As the five-year anniversary of the pandemic approaches, the threat of the virus has been drastically reduced, with low rates of transmission and hospitalization across much of the nation.

COVID-19 tests — once near impossible to find or take — are now sold at drugstores and shipped via mail. Billions have been vaccinated against the virus, an intervention Trump lauded as “one of the greatest achievements of mankind” during his first term.

Yet local medical experts and scientists caution against letting down the nation’s guard against the ever-evolving virus as well as other health epidemics — and even another potential pandemic — that might emerge in the future.

As the second Trump presidency unfolds, various local leaders and public health experts are sounding the alarm about dramatic shifts in health care policy under the new administration, from threats to cut Medicaid to attempts to slash funding for research to anti-vaccination rhetoric coming from high-level federal officials.

The state’s top health leader recently voiced grave concerns about the president’s January decision to cut ties with the World Health Organization; it was the second time Trump has done so, following his 2020 withdrawal during the height of the pandemic.

“The U.S. may lose internal access to WHO’s global surveillance system, which provides the United States, including Illinois, with early warnings of outbreaks by monitoring disease activity in more than 150 countries,” said Dr. Sameer Vohra, director of the Illinois Department of Public Health, in a January letter. “Without access to this network, Illinois could lose critical time detecting threats like new COVID-19 variants, Ebola, avian influenza and more.”

The five-year battle against COVID showed the strength and ingenuity of American medical professionals and scientists, who worked quickly with others around the world to learn to detect, trace, treat and prevent the virus.

At the same time, COVID also revealed the fragility and numerous weaknesses of the nation’s public health system. Early COVID testing debacles slowed the pace of detecting and learning about the virus. Long-standing health care inequities made it harder to treat and prevent COVID. Supply chain disasters spurred a shortage of critical tests and personal protective equipment.

The pain of the pandemic is ongoing for the loved ones of the millions whose deaths have been attributed to the virus worldwide. In the first year alone, roughly 2.6 million deaths internationally were due to COVID, with more than half a million in the United States and roughly 20,000 in Illinois.

For those suffering from long COVID, the consequences of the pandemic continue today.

Claudette said she never imagined the many ways the virus would transform her life, work and relationships.

“They couldn’t understand what was happening, despite me trying to explain it to them. … It brought me to bouts of depression and frustration,” said Claudette, whose health has improved somewhat due to treatment from various physicians, therapy and rehabilitation at the Chicago-based Shirley Ryan AbilityLab. “My frustration would turn into anger and my sadness would turn into bouts of crying for a while.”

Many medical professionals will never forget how the virus ravaged their patients and threatened to collapse the health care system not so long ago.

They urge the nation to remain vigilant against emerging threats — and to not dismantle the public health strides of the past five years.

Dr. Marc Sala was working in the intensive care unit at Northwestern Memorial Hospital when the pandemic began. Terrified, he and his wife, who is also a doctor, printed off copies of their living wills “in preparation for the fact that we were going to do our jobs at any cost and we wanted to make sure our family was taken care of.”

“We just went through hell,” said Sala, who is now co-director of the Northwestern Medicine Comprehensive COVID-19 Center. “Let’s not forget all the lessons we took from this. This needs to be a learning experience for the next pandemic. If you’re thinking this is a once-in-a-100-years thing, you’re not paying attention.”

Lessons learned

Former Chicago Mayor Lori Lightfoot said she’ll always remember Dec. 15, 2020, the day the first COVID shots went into the arms of Chicago health care professionals. Some were moved to tears, she recalled.

“These health care workers were under extraordinary pressure and were experiencing firsthand trauma of an unprecedented nature,” said Lightfoot, who lost her reelection bid in 2023.

While the vaccine marked a turning point in the fight against the virus, Lightfoot recalled in an interview that its rollout was difficult, with local and national leaders trying to get initial doses to the most vulnerable populations as soon as possible while also combatting vaccine hesitancy.

In recent years, public health experts have been increasingly troubled by low uptake for both the COVID shot and the seasonal flu vaccine locally as well as across the country.

Lightfoot believes this problem will worsen under the new presidential administration, which includes “a bunch of vaccine skeptics and deniers in charge of public health.”

Prominent vaccine skeptic Robert F. Kennedy Jr. was sworn in last month as the nation’s health secretary; FBI Director Kash Patel has used anti-vaccine rhetoric in promoting a supplement line on social media, encouraging followers to “Mrna detox, reverse the vaxx n get healthy.”

“They devalue the truth,” Lightfoot said. “So I can’t sound this alarm any louder than what I am: We have a potential to have an unmitigated disaster on our hands as a result of decisions that are being made already.”

Vohra, the state health department director, said Illinois has increased its preparedness to handle public health emergencies, in part due to knowledge gained during the pandemic.

In May, the state released a 33-page playbook chronicling measures to be taken in the event of a future health crisis, informed by lessons learned from COVID. The plan covers various health emergencies including infectious disease outbreaks and natural disasters, as well as chemical, biological or nuclear calamities such as accidents or acts of terrorism.

“Following a once-in-a-century event like the COVID-19 pandemic it is critical that we take the time to thoroughly study how our state responded to the emergency and seek to learn lessons that will put us in a stronger position the next time such an all-of-government response is required,” Pritzker said at the time.

But Vohra also worries about Trump administration decisions affecting public health, from severing ties with WHO to moves toward mass firings of federal employees, including those in public health.

“The public health workforce was already reeling before COVID,” he said. “Losing even more individuals is a concern.”

‘Catastrophic effects’

In March 2021, the Chicago Department of Public Health and Rush University Medical Center launched the Regional Innovative Public Health Laboratory, which focused on genome sequencing to track and trace COVID variants in Chicago.

“The vaccine strains have changed every year, and that’s informed by the sequencing data and which variants they are. That’s sort of on a population scale,” said Hannah Barbian, a virologist with the lab. “It can help on…. a finer scale too if you’re investigating an outbreak.”

The lab’s work has since expanded to analyze other pathogens, including Mpox and Candida auris, a fungus that can spread in hospitals. In 2022, the lab began a pilot project testing air samples to detect viruses, including COVID and other respiratory illnesses; the scientists also found some skin infections and gastrointestinal illnesses, Barbian said.

The partnership with the city health department means funding for the lab will likely be stable for a while, said Stefan Green, director of core lab services.

But he’s concerned about broader threats to public health funding.

“The time to maintain public health investment is when you don’t have an obvious epidemic. You want to use your resources in a way that you can detect as early as possible the next pandemic or the next epidemic,” he said. “It’s like if you have a soldier guarding a base and he’s there all day. And you’re like, well nobody invaded.… But you need somebody there all the time. Because when you do get attacked, you need someone there.”

The Trump administration has attempted to drastically slash federal funding for medical and scientific research; Rush University President Dr. Robert Higgins warned during a news conference last month that these cuts would have “catastrophic effects on research studies nationwide.”

A federal judge Wednesday blocked the cuts; lawsuits filed by a group of 22 states — including Illinois — and organizations representing universities, hospitals and research institutions across the country have argued that stripping the funding would cause “irreparable harm.”

Dr. Emily Landon, an infectious disease specialist at University of Chicago Medicine, said she is “terrified” about the nation’s ability to handle another pandemic.

She became a prominent voice in Illinois in the early days of the COVID crisis, speaking alongside the governor during a March 20, 2020 press conference when he announced the stay-at-home order for Illinois.

The nation made mistakes in the months leading up to that order, Landon said. One of the biggest, she thinks, was that U.S. leaders didn’t take big enough steps to address COVID-19 early enough; they were reactive rather than proactive.

Now Landon says she hears echoes of that same attitude, citing reactions to the ongoing measles outbreak in Texas.

Last month, Kennedy Jr. commented that measles outbreaks are “not unusual,” despite the recent death of an unvaccinated child from measles — the first U.S. measles death in a decade. His stance on vaccines, however, might have softened: In a recent Fox News opinion piece, Kennedy Jr. hailed vaccination to protect children from measles.

“They need to be able to say: ‘This is a real threat to children and immunocompromised adults. You need to take action now, and here is the action you can take,’” Landon said. “I see some evidence that we maybe haven’t learned that lesson.”

Landon first realized the potential magnitude of COVID-19 a couple months before the Illinois stay-at-home order. University of Chicago has a relationship with Wuhan University’s medical school, in ground-zero of the outbreak, and Landon saw photos sent by doctors there in which they were wearing full-body protective suits. She knew then that Chinese doctors were worried about person-to-person transmission.

But she’s concerned about the nation’s ability to understand the nature of illness outbreaks in other parts of the world going forward.

The Trump administration’s recent cuts to the U.S. Agency for International Development, which delivers humanitarian funding overseas, threatens America’s understanding of what’s happening on the ground internationally, Landon said.

“We don’t have the same information that we usually have about what’s going on elsewhere in the world,” she said. “If we can keep outbreaks contained where they start, instead of letting them spread unfettered in places where they just don’t have the resources to contain these things, that protects Americans.”

The Associated Press contributed.

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