The COVID-19 Pandemic: Juneteenth and Pride Month, and the Delta variant is winning the raceJun 21, 2021
Two days ago, June 19, was the first celebration of Juneteenth as a federal holiday, after President Biden signed the enabling legislation on June 17. Like many, I was aware of Juneteenth, but without deep understanding of its historical origins. In fact, a recent Gallup poll found that a majority of Americans know “nothing at all” or only “a little” about Juneteenth. Specifically, it is the date when Union General Gordon Granger delivered the news in Galveston, Texas, that slavery had ended—over two years after the Emancipation Proclamation was issued by President Lincoln. We should remember the end of slavery while not forgetting its legacy and move forward to reduce the lasting impact of structural racism. I was touched by learning about Opal Lee, whose family was driven from their Fort Worth home on June 19, 1939, by white rioters. At age 89, she walked from her home in Fort Worth to Washington, DC, to advocate for the designation of Juneteenth as a federal holiday. She attended last Thursday’s signing ceremony.
June is also Pride Month, commemorating the 1969 Stonewall Uprising in Manhattan. The Library of Congress has documented that story, one that I remember well. The event exposed the ongoing attacks by the police on the LGBTQ+ community. This year’s presidential proclamation on Pride Month highlights progress since the Stonewall Uprising, but the LGBTQ+ community is now threatened by the “culture war” driven by conservatives. This threat makes Pride Month particularly meaningful as a celebration of our diversity.
Heard of “the horse-racing effect”? This term was coined by Richard Peto in reference to analyses of longitudinal data on change of lung function over time. It is described in the appendix to a 1976 book describing a pioneering study of workers in London. The horse-racing effect is common sense; at any point in a race, the horse in the lead has run the fastest. Now switch from horses to mutant strains of SARS-CoV-2. If there is a mix of strains circulating, the most transmissible will eventually become the most prevalent, i.e., “it runs the fastest.” At the moment in Colorado, the Delta variant (the renamed B.1627.2 strain first identified in India) is about to surge ahead, replacing the Alpha variant (the renamed B.1.1.7 strain) as the most common. It was first identified in Mesa County in early May and has been rising in frequency ever since statewide. Beyond its greater transmissibility versus the Alpha strain, there is also concern about somewhat lower vaccine effectiveness with the current vaccines. Unfortunately, the prevalence of vaccination in Mesa County is among the lowest in the state, giving the Delta variant the opportunity to out-strip the other strains. It is doing so just as the four-day Country Jam approaches, bringing thousands of attendees to Mesa County. The Colorado Department of Public Health and Environment will be watching closely. Unfortunately, superspreading events can still happen.
Last week, I commented on the CDC and the challenges facing its new director. The New York Times published a lengthy article this week: “Can the C.D.C. be fixed?” The question is not answered but the need to do so is made clear.
As we start the first week of summer, Colorado’s epidemic curve continues to decline, but very slowly, and at the moment it is again at a plateau of around 320 hospitalized. Vaccination remains critical, but is also stalled.
Jonathan Samet, MD, MS
Dean, Colorado School of Public Health