Dean's COVID-19 Commentary

The picture in Colorado remains calm with last week’s hospitalization count of 195 representing a slight uptick from 184 the week before. But test positivity continues to decline and case numbers are not clearly rising. If there is an impact of the return to school, it might be evident this week as two to three weeks will have passed since the start of the school year.  

Last week, CDC Director Rochelle Walensky endorsed the recommendation of the Advisory Committee on Immunization Practices (ACIP) for the updated boosters from Pfizer-BioNTech and Moderna. The ACIP presentation materials can be found on CDC's website. The new bivalent vaccines target the BA.4/BA.5 Omicron subvariants along with the “original” or “ancestral” strain. For the Pfizer-BioNTech vaccine, the updated booster recommendation is for those 12-years-old and older, while the Moderna vaccine is for those 18-years-old and older. The positive recommendation is not based on specific clinical trial data, but on the capability of targeting the spike proteins of BA.4/BA.5 with the mRNA technology. Obtaining one of the new boosters is recommended for those who have not had a vaccination (first series or booster) within the last two months, although some argue that a longer interval may be preferable. 

Will the public seek the new booster and a flu shot this fall? A recent University of Michigan poll provides positive news for those who are 50+ with 61.4% of respondents stating that they are very likely to get a COVID-19 vaccination this fall, and 21.2% responding that they are somewhat likely to get one. While the 2022 flu vaccine is now available, statistics on vaccination rates for this year are not yet available. For the 2020-2021 influenza season, about half of U.S. adults were vaccinated—higher than the previous year. Among adults, the rate of vaccination increased with age, reaching 75% for those 65+. We need to achieve high rates of vaccination for both COVID-19 and influenza to avoid surges that could threaten hospital capacity. 

Misinformation remains a barrier, however. The Pew Research Center recently released findings of a poll involving 19 countries that inquired about views of threats including climate change and the spread of misinformation. Seventy-five percent saw climate change as a top threat with misinformation close behind at 70%. For reference, the spread of infectious diseases was viewed as a top threat by 61%. There was substantial and potentially informative variation in responses across the 19 countries.  

What is the solution and can spreading misinformation be punished? Last week, the California legislature approved a bill that would punish physicians for spreading misinformation about COVID-19 vaccinations and treatments. Still unsigned by Governor Newsom, the spread of such misinformation would be designated as “unprofessional conduct” and handled as such by the Medical Board of California. State Senator Richard Pan, a pediatrician and a Democrat, is a co-author. He has been a strong voice in California against vaccine misinformation. Proposed actions in some states would support physicians whose opinions and practices are not supported by evidence. In Colorado, HB 22-1015 (Off-label Use of Approved Drugs to Treat COVID-19) did not advance in the last legislative session.

I was alerted to troubling happenings at Sarasota General Hospital by my son-in-law. The nine-member hospital board is elected, and three of the four successful candidates in a recent election ran on the “Health Freedom Slate.” The Health Freedom Slate involves “medical freedom”—perhaps freedom from evidence-based care? One of the new board members, a physician, has used ivermectin and hydroxychloroquine to treat patients. This is a frightening threat to providing the most effective treatments for COVID-19. Consider the consequences of the spread of this tactic to other aspects of medical care.  

Bad news continues on some public health fronts. For many, the Labor Day weekend saw extremely high temperatures with California now under a “heat dome” for almost a week, and today’s forecast is for a record high in Denver. And risks remain at Ukraine’s Zaporizhzhia nuclear plant. 

Mark your calendar and RSVP for a talk on September 13 at 9:00 a.m. by Linda Villarosa, author of Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation. 

Stay well and get your COVID-19 booster and flu shot. 

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