Dean's Notes

The epidemic curve continues upward in Colorado with 270 people hospitalized on June 7 and test positivity reaching over 12 percent. My degrees of separation from someone with COVID-19 have dwindled to one. Close friends, colleagues, and family members have become ill over recent weeks, although all have been vaccinated and received at least one booster. Most have been strict in following public health recommendations over the last two years, but "COVID fatigue" and hope for normalcy have perhaps displaced caution.
 
Looking to New York, Massachusetts, and some other East Coast states, if Colorado were to follow their recent course, optimistically, our epidemic curve may peak within a few weeks. The most recent surge began on the East Coast several weeks before the bend upward in Colorado. The epidemic curve has already peaked and is now falling in New York and Massachusetts. Omicron variants BA.4 and BA.5 have reached Colorado, but represented only a few percent of isolates as of mid-May. The implications for the course of the pandemic are uncertain as they are not yet well characterized. The rapidity at which new variants and subvariants are appearing is concerning, as inevitably some will have the threatening characteristics of greater transmissibility, virulence, and immune escape. To model the trajectory of the pandemic, the Colorado Modeling Group needs to make assumptions about these aspects of new variants before the needed information is in hand. We learn more and more about the characteristics of each new variant as we watch its course. 
 
Over its first year, the burden of the pandemic fell mostly on people of color, people with lower incomes, and people in the service industry. Some of those disparities have now narrowed. Provisional death rates from COVID-19 for 2020 and 2021 showed substantial reductions in these disparities across the pandemic’s second year. In fact, a recent analysis in The New York Times shows that COVID-19 mortality is now higher among white Americans than other groups. The article attributes this change to the success of vaccination campaigns in Black and Latino communities and the impact of political views on white people. “Only about 60 percent of Republican adults are vaccinated, compared with about 75 percent of independents and more than 90 percent of Democrats, according to Kaiser. And Republicans are both disproportionately white and older.” These data are yet another example of the unfortunate consequences of the politicization of the pandemic.
 
Speaking of politicization, Governor DeSantis did nothing notably outrageous last week. Florida’s auditor general did release a report last week describing the notable deficiencies of the state’s COVID-19 data collection and reporting during the pandemic’s first months. You may recall that a data scientist, later turned whistleblower, was fired for calling out the problems, which decreased the apparent scope of the state’s epidemic. Public health data need to be protected against meddling.
 
Even in fiction, the pandemic has left its mark. I have long enjoyed noir mysteries set in Los Angeles. There are too many classics to name—The Postman Always Rings Twice by James M. Cain—for example. Michael Connelly is one of the most successful authors in this genre at present. I just read his most recent book, The Dark Hours. The pandemic is part of the background and threads through the story. Characters wear (or don’t wear) masks and the protagonist, Harry Bosch, begins the book unvaccinated but is by its end. The pandemic’s appearance in the book is one more example of its imprint—everywhere.
 
While the pandemic may feel all-consuming at times, there are many other public health challenges that also need our attention. In this next chapter of my career, I hope to turn my attention to some of those issues. I announced last week that I will step away from my position as dean of the Colorado School of Public Health when a successor is found. I am not retiring, but once replaced after a national search, I will turn to many long set-aside projects. The school is in great shape and I am confident that the search will find an outstanding next dean. I will leave as the school’s longest-tenured dean and, without doubt, its oldest!
 
For now, these weekly commentaries will continue. There is too much to say as the challenges to public health continue.



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