Dean's COVID-19 Commentary

By the numbers, COVID-19 remains quiet in Colorado. The Colorado Department of Public Health and Environment now reports weekly hospitalizations for COVID-19 on Wednesdays. The current figure of 135 is among the lowest over the two years of the pandemic. Case numbers are flat and test positivity is low at 3.3% although it has trended upwards in recent days. The BA.2 variant remains concerning because of its transmissibility, but it is not more virulent than BA.1.

The reports from the United Kingdom’s Health Security Agency (formerly Public Health England) have been the single most useful source of information on variants. They capture not only what is happening in the United Kingdom but also provide up-to-date background information on variants. The latest report provides information on the recombinant variants, combining the Delta and BA.1 genomes. Another variant combines BA.1 and BA.2 genetic information. By contrast with the Health Security Agency, the information offered by the Centers for Disease Control and Prevention is not as up-to-date nor as comprehensive. Information is available from CDC on genomic sequencing of SARS-CoV-2 by state and for the nation. 

This genomic surveillance is one component of what is needed during this lull and the possible “endemic” period to come. The current phase of the pandemic is most likely to be interrupted by the coincidence of a new variant and waning immunity, which will set the stage for a resurgence. Careful and comprehensive surveillance is critical so that a warning can be offered with time to respond, likely with vaccination and potentially a return to some nonpharmaceutical interventions.  

Should we consider calling for a fourth shot, at least for the most susceptible? The Biden Administration has announced plans to offer a second booster shot to persons aged 50 and up. A New York Times article reviews the pros and cons of doing so and the information gaps that introduce substantial uncertainty. Quoting Peter Hotez at the Baylor College of Medicine, who states the obvious: “We are going to have to make this decision on the basis of incomplete information.” When asked the inevitable question, “What will you do?”, I will reply that I am going to get a second booster. My logic reflects an assessment that the potential gain for protection, albeit to an unknown degree, far outweighs risks, which appear to be minimal. 

Saturday, the NCAR fire erupted on the east side of Boulder, threatening nearby neighborhoods and leading to the evacuation of 8,000 homes. It follows the December 30 Marshall fire by three months. Do these fires signal the arrival of a year-round fire season? Climate change scenarios predict an ever longer and more severe fire season, a prediction that is matched by reality. The most recent report from the Intergovernmental Panel on Climate Change (IPCC) reports on projected impacts for North America, including wildfires. It affirms what Coloradans have experienced over the last decade. For a quick overview of climate change and Colorado’s climate, take a look at this website from the NOAA National Centers for Environmental Information. 

Yes, in public health, we can never stop worrying—unfortunately.

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

P.S. Mark your calendars for Steffanie Strathdee’s visit to the school as the 2022 Hamman Lecturer Next Monday, April 4, at 4 p.m. Steffanie will talk about her 2016 experience when she and colleagues were credited with saving her husband’s life from a superbug infection using bacteriophages, and her book, The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug.

The lecture will be a hybrid event, but for those joining in person, the event will be held in the Elliman Conference Room in the new Health Sciences building. Steffanie will be signing books following the lecture, and a limited number of books will be available for attendees. I hope you’ll join us.