Dean's Notes

For the moment, the COVID-19 pandemic is waning in Colorado while protests continue in Colorado and elsewhere over systemic racism. This week, I focus on public health bills at the closing of the Colorado General Assembly 2020 session. Public Health Day at the Capitol was on February 12 and was the topic of my March commentary, during a very different pre-COVID-19 time. In the ensuing months, the 2020 legislative session has been delayed and truncated. Nonetheless, several bills with key public health implications passed and will move on to the Governor for signature. 

One of the most effective tobacco control measures is increasing the price of tobacco products, generally accomplished through increased taxation. At $5.65 per pack in Colorado, including only $0.84 of state tax, cigarettes in Colorado are inexpensive and the more highly addicting electronic systems are untaxed. HB20-1427, Cigarette Tobacco and Nicotine Products Tax, is a first step towards increasing taxation of all tobacco products by referring this increase to the November ballot. A ballot measure, Amendment 72, failed in 2016. At the time, Dean David Goff, my predecessor, said: “By defeating Amendment 72 we have taken a step backwards in improving our health, and more tragically, we have let our kids down.” Such measures have failed elsewhere, most notably in California in 2012 when the tobacco industry spent almost $50 million in opposition to Proposition 29. A tax increase was passed in 2016 by the California’s voters. Undoubtedly this Colorado ballot initiative will be opposed by the “usual suspects.” Our faculty, staff and students should be prepared to provide and disseminate the substantial evidence on the public health benefits of increasing taxes on tobacco products. 

Senate Bill 163, School Entry Immunization, was also sent to the Governor. This bill is a needed measure to address Colorado’s exceptionally low childhood immunization rates. This contested bill brings formalism to the definition of a “non-medical exemption.” For entering school, it will require “either a certificate of immunization, a certificate of medical exemption, or a statement of nonmedical exemption for an immunization for a religious or personal belief.” Procedures are described for obtaining a nonmedical exemption and a standard of 95% vaccination coverage is required for schools, which will assure herd immunity. Voting was split along party lines, further indication of the unfortunate politicization of public health. 

“Vaccine hesitancy” continues to threaten public health and may pose an obstacle when efficacious vaccines for the SARS-CoV-2 virus are ready for the public. Admittedly, safety problems have arisen with vaccines: perhaps most notably the Cutter incident in 1955 with a polio vaccine made by Cutter Laboratories, and the outbreak of Guillain-Barré syndrome following the swine-flu vaccination in 1976. But, when we do have efficacious and safe vaccines for the SARS-CoV-2 virus, it would be unfortunate if those opposed to vaccination clouded and delayed their use. 

Colorado did respond quickly to policing issues raised by the death of George Floyd. Senate Bill 217 brings a number of reforms to policing in the state, responding to some long-recognized issues with urgency to address racism and policing. Nationwide, there is a push to remove names and monuments linked to the Confederacy. Here in Colorado, the neighborhood association for Stapleton has voted to change the name because of namesake Mayor Stapleton’s ties to the Ku Klux Klan. We are at a pivotal time of societal change. 

The Sunday New York Times magazine has some great COVID-19 relevant reads: an article by Steven Johnson, author of The Ghost Map about John Snow and cholera, on William Farr and vital statistics, and a panel discussion on vaccine development led by Siddahartha Mukherjee, author of The Emperor of All Maladies: A Biography of Cancer. 

Remember that Colorado’s primary election is June 30. Vote! 

Until next week,   




Jonathan Samet, MD, MS
Dean, Colorado School of Public Health