Dean's Notes

Our state is on the scary uptick of the epidemic curve. Daily, we look at the numbers—new cases, hospitalizations, and deaths—as they inexorably rise. The numbers are presented to us daily: on the news, as alerts, and in conversations. At the time of this posting, in Colorado we are at 2,307 cases, 326 hospitalized, and 47 deaths. We have moved from numbers to the reality of affected people. Colleagues, family, and friends are providing care for infected patients and the degrees of separation are narrowing—we know someone with COVID-19 or we know someone who knows someone with COVID-19.   

But with the epidemic worsening, I can report that last week the Colorado School of Public Health transitioned smoothly to online education and operations.  Together, students and faculty have made this “new normal” work. I feared an internet and Zoom crash on Monday (March 23) as many educational institutions moved to online education adding to the stress on the internet.  Deans hear about problems and few reports reached me with regard to course delivery. Thanks to all who have made this work.   

Last week, I wrote about the modeling team from the Colorado School of Public Health, the CU School of Medicine, and the University of Colorado Boulder. The group tirelessly refined epidemic models and cranked through scenarios, working with the Colorado Department of Public Health and Environment (CDPHE) to provide actionable findings. The work was central to decision-making by Governor Polis in his announcement on Wednesday, March 25 that he was implementing a statewide order limiting activities with the goal of increasing social distancing.   

The Governor was masterful in last Friday’s press conference (on March 27), explaining the COVID-19 epidemic, the model’s findings, and the need for greater social distancing. The press conference should be viewed with attention to how well the Governor communicated, his use of graphics, and his command of the details as he answered questions. You can also view Governor Polis’s slides online.   

We are not the only group in Colorado doing modeling related to the state, as healthcare systems are trying to anticipate load over time. And various institutions are providing estimates for the United States; for example, the Institute for Health Metrics has provided national and state pictures of epidemic curves. Unsurprisingly, different models yield different estimates based on their form, assumptions, and input data. As you peruse the various models, remember the famous quotation from the British statistician George Box: in essence, “all models are wrong but some are useful.” For the moment, all show that we are on the steep upslope.   

Our partnership with the CDPHE will be ongoing as the need for modeling will continue, particularly as we address how to relax restrictions after we have a sufficiently low number of cases in relation to our healthcare capacity. For me, this modeling partnership exemplifies how the Colorado School of Public Health should be engaged with helping to address public health issues in the state. There are more examples. CSU students are working with the Larimer County Public Health Department and Dr. Lisa Miller in our Department of Epidemiology is in the lead on identifying and linking students to volunteer opportunities. As part of the larger effort begun by students on the CU Anschutz Medical Campus, Lisa Miller and Olivia Zarella, a DrPH student, have sent a survey to all ColoradoSPH students and are in the process of connecting students to volunteer opportunities at local public health agencies and other organizations involved in the response. And our faculty are already engaged in research related to some of the most acute needs from the pandemic.   

Already, there is a burgeoning and accessible literature on the SARS CoV-2 virus and COVID-19, the disease it causes. Both scientific journals and some media, e.g., The New York Times and The New Yorker, are offering free access to articles related to the pandemic. The Cochrane Collaboration is also providing access and has rapid reviews in progress.   

Some recent highlights include: 

• In the New England Journal of Medicine, Emanuel and colleagues provide a thoughtful commentary on decisions that may come with regard to care in the setting of scarcity: “Fair Allocation of Scarce Medical Resources in the Time of Covid-19.” 
• A report in Science last week examined the epidemic’s pattern in China in relation to mobility in Hubei Province, finding a close correlation.   
• The Lancet Public Health published another study related to Wuhan; the authors used an SEIR model, the same type of model used by the modeling team here, to explore how to relax restrictions in the city. The approach reflects modeling that will be needed for Colorado.

Until next week,   




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