Dean's COVID-19 Commentary

Today, April 27, marks the start of Colorado’s Safer at Home phase of returning towards normalcy. We will be making decisions as a state and as individuals that will affect public health for the long run. The Governor has chosen April 27 to start this return as the stay-at-home order ends. Some counties and the City of Denver are waiting until May 8 for the transition while some states are delaying weeks more. There is no “right answer” as to when to begin to lessen the restrictions, and there is no clear balance point for the now stereotyped discussion of economics versus the epidemic. Most importantly, all disease control measures possible, including sensitive surveillance, need to be coming into place as workplaces and retail re-open.   

At the University of Colorado Anschutz Medical Campus, planning has been underway for several weeks as to how to begin to open the campus, particularly bench research. For the Colorado School of Public Health, a group is addressing how to resume research with human participants. The discussions point to how all has changed in the “new normal”. Some examples of the issues under consideration: screening for staff who might have COVID-19; protecting staff from contact with research participants who may have COVID-19 and assuring that the staff are not infected; requiring appropriate mask use in the work environment; and maintaining distancing in the office and laboratory environment. Sensibly, those who can work from home will likely do so for months to come. Assuring the safety of all will be the critical driver of how and when we slowly return to this and other campuses.   

Earlier this morning, I delivered the first presentation in a new collaboration and series by the Colorado School of Public Health with the Denver Museum of Nature & Science and the Institute for Science & Policy, "Controlling the COVID-19 Epidemic in Colorado." More than 800 people joined the livestream; a link to the recording will be distributed and posted to our school’s coronavirus website in the next few days. The next installment in the series will be hosted next Monday, May 4, at 8:30 a.m. and will feature Drs. Michelle Barron and Thomas Campbell, both professors of medicine in the Division of Infectious Disease in the CU School of Medicine. The registration and details will be posted this week on the DMNS upcoming events page and will be promoted via email and on our social media channels ahead of time. 

Pivoting, we should begin to anticipate the consequences of the COVID-19 pandemic for public health generally. We were moving into the era of Public Health 3.0,  defined by a broad framework that addressed the societal determinants of health in a multi-sectoral approach. That broader vision is now likely to be replaced by an evolving set of constructs, let’s call them Public Health X.X, as we move from the necessary immediate focus on containment of the SARS-CoV-2 virus to addressing its sweeping legacy of harms to public health. Immediate threats to Public Health 3.0 can be realistically anticipated. State and local budgets will shrink immediately and priorities will be reset. In such circumstances, public health invariably suffers. In Public Health X.1, preserving the resources needed for epidemic management can be anticipated, but with losses for the many priorities of Public Health 3.0.   

Already in Colorado, a budget shortfall of $3.5 billion is anticipated for the next fiscal year and less funding is certain for the state tobacco control programs funded by Amendment 35. These reductions come as terrific progress was made over the last year in public health measures to address tobacco products generally and vaping specifically. And, the challenges of chronic disease control remain while we need to be ready to address a rise of poverty, homelessness, mental health problems, and gaps in health care coverage. It is now time to start planning for Public Health X.X.   

And, I finished my reread of John Barry’s The Great Influenza, and offer a few quotes: “So, the final lesson of 1918, a simple one yet the one most difficult to execute, is that those who occupy positions of authority must lessen the panic that can alienate the members of society.” And, “Those in authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one. Lincoln said that first and best.”

Until next week,   




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