Dean's Notes

Transition from “stay at home” to “safer at home” continues. For the City of Denver and some surrounding counties, stay-at-home orders will end this week. This will not be an abrupt transition, if we are to avoid a resurgence of the epidemic. Every model predicts the possibility of a fall surge absent successful control measures. A thoughtful analysis, drawing on analogy to major influenza epidemics over the last 100 years offers three scenarios; the two considered most plausible forecast several more years for the COVID-19 epidemic. For this long-run phase of the epidemic, models also make clear that every modality in the public health armamentarium is needed. Adherence to all public health recommendations by everyone is critical and necessary for maintaining the needed social distancing and for masks to be effective. For those protesting public health measures, there appears to be insufficient understanding that cooperation of everyone is required if they are to work. 

The use of masks is visible evidence of compliance and it appears to vary widely. Walking the streets in Boulder, most people are masked by my observation, even many runners and cyclists. And, Boulder County requires masks for staff and customers in stores; I saw the requirement enforced at the neighborhood Safeway, leaving three customers unhappy. In Denver, use of masks seems less common than in Boulder and on Saturday morning, many customers entered the downtown Whole Foods without masks. Mayor Hancock has now required universal mask use beginning May 8th. The Mayor is correctly calling for use by all, since the impact of masks depends on the proportion of people using them and their effectiveness. Remember that you are wearing a mask to protect others from the infectious droplets you might produce if ill. Lee Newman described the role of masks on The Ingraham Angle on Fox News last week, in part to address a new conspiracy theory claim about them. As part of the “new normal,” some airlines are now requiring that passengers wear masks. 

For those who can, working at home is also part of the new normal. For those of us with “Zoom fatigue,” we have a new understanding of why we enjoy coming to work, even if we can do much of our work remotely. I miss the spontaneous exchanges with colleagues in hallways and some meetings are best held face-to-face. But a return to work life as it was is likely many months away. Hang in; I have discovered “mini-walks”—taking a periodic quick break away from the monitor. Try my approach for maintaining well-being, especially with such inviting Spring weather, at last! 

The flood of information about the SARS-CoV-2 virus and the COVID-19 epidemic continues. Papers are being published rapidly and largely without peer review, making it difficult to find and evaluate them. Last week’s batch included the disturbing finding that viral RNA had been found in the small particle size range in two Wuhan hospitals. The finding implies the potential for transmission in the air of buildings. A report on the seroprevalence of antibodies in northern California remains controversial— a controversy reflecting release of papers that are not peer-reviewed but carry policy implications. Even with the need for information to be in hand as quickly as possible, the quality of the evidence conveyed to decision-makers cannot be compromised. 

I also recommend this weekend’s New York Times interview with Laurie Garrett, author of the 1994 book, The Coming Plague, which provided one of the first warnings of pandemics to come. The interview speaks to her role as a Cassandra, following the prophetess of Greek mythology who was cursed to give true, but unheeded warnings. In 1994, The Coming Plague was a gripping read and probably still is. Add it to the stack.

Until next week,   




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