Dean's COVID-19 Commentary

Good news continues for the pandemic in Colorado. Last week’s hospitalization count was 184, a substantial drop from the five-week plateau in the low 300s. Last week, the COVID-19 Modeling Group released an updated report. The projections indicate that the epidemic curve should continue dropping into mid-October. This drop is projected even after accounting for the additional mixing from the opening of schools. The modeling team is reluctant to project beyond mid-October because of the substantial uncertainty around future variants that may drive the pandemic. At this time, there is no variant of concern circulating elsewhere that might reignite Colorado’s epidemic. The BA.2.75 Omicron subvariant is being monitored but a BA.2.75 case has not yet been reported in Colorado.  

This lull coincides with the start of classes at the Colorado School of Public Health—today. Last year, as we returned to campus, the Delta variant had already started to drive up the epidemic curve. Circumstances are more favorable this year and I am hopeful that the lull will extend—beyond October. But, quoting whomever, “Predictions are difficult, particularly about the future.”

I have commented previously on my worries about Russia’s nuclear weapons saber rattling. The last few weeks have brought concern about a different sort of nuclear catastrophe involving Ukraine’s Zaporizhzhia Nuclear Power Station, the largest in Europe and among the largest in the world. Although now held by Russia, Ukraine continues to operate the plant. Last week, the plant was shelled with counterclaims as to which country carried out the shelling. The plant was also disconnected from Ukraine’s electric grid for a time, raising concern about an upset because of a lack of back-up power. And remember, the Chernobyl nuclear power station, which experienced the 1986 core meltdown, is located in Ukraine. As a precaution, potassium iodide is being distributed in the surrounding communities for ingestion should radiation be released. Potassium iodide blocks the uptake of radioactive iodine into the thyroid, where it can cause cancer. There was a sharp rise in thyroid cancer among youth and young adults following the Chernobyl disaster. There were an estimated 4,000 cases of thyroid cancer, mostly in children and adolescents, and nine known deaths in children. 

One of the most enduring and frequent consequences of the Chernobyl disaster has been the stigmatization of those exposed, in part because of fear that radiation has caused lasting genetic damage that will be passed on to children. A trio study involving whole genome sequencing of children and their parents did not find evidence of transgenerational impact from germline mutations. A similar study is planned among the atomic bomb survivors in Hiroshima and Nagasaki. Still, literature concerning the consequences of the Chernobyl disaster has repetitively documented its consequences for mental health and wellbeing stemming from a multiplicity of factors, including dislocation and loss of employment. Prior to joining the Colorado School of Public Health, I reviewed the relevant literature through 2014 in a project supported by Green Cross Switzerland. This review and focus groups carried out with Kiev International Institute of Sociology (KIIS) confirmed the persistence of mental health challenges among the survivors. Ukraine, in particular, and the world more generally do not need another nuclear disaster. 

To date, there have been five major disasters involving nuclear power plants: Kyshtym in the Urals; Windscale in the United Kingdom; Three Mile Island in Pennsylvania; Chernobyl in Ukraine; and Fukushima in Japan. Risk models over the decades predict that such disasters are very low probability, albeit with high impact, but these five demonstrate that they do occur. The disasters involved design flaws and the impossibility of fail-safe mechanisms that can anticipate all human follies. And mistakes made by operators are not independent events, but they can pile on to produce catastrophe as with Chernobyl. There are various already available accounts of each disaster; a new book, Atoms and Ashes: A Global History of Nuclear Disasters, by Serhii Plokhy describes the five disasters for those wanting to read more. 

The Kyshtym disaster, kept secret by the Soviet Union when it happened in 1957, contaminated villages along the Techa River. About 40 years later, I led a group for the U.S. Department of Energy to the region, which houses the Mayak nuclear complex, to establish a collaborative research program with Soviet scientists: the Joint Coordinating Committee for Radiation Effects Research (JCCRER). Studies of the exposed population and of workers were initiated, but I understand that this collaborative program has now been ended. The other disasters were also followed by research initiatives with highly controversial findings reported for the Windscale disaster.  

I write this just before leaving for a meeting in New Mexico, a state broadly impacted by nuclear weapons and nuclear power. An extraordinary photographer and artist, Patrick Nagatani, captured this impact in his book Nuclear Enchantment. We were colleagues while I was at the University of New Mexico and I benefited from several personal and passionate introductions to his work. Take a look at his work. 

Please hope that stupidity does not lead to disaster. And welcome to new students—you will have much to do in your careers.

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