Dean's COVID-19 Commentary

The COVID-19 pandemic has changed education quickly, leaving an imprint that will last. In spring, the Colorado School of Public Health quickly pivoted to remote education and continued in that mode at the CU Anschutz campus in the fall. Regrettably, with little reason to anticipate an end to the pandemic in the next few months, leadership of both the CU Anschutz and UNC programs has decided to continue with remote education again in the coming spring semester.

We have learned that we can teach well using remote approaches. The school has taken steps to provide training to faculty and consultation with an instructional designer for all courses. But the warmth and depth that comes with personal interactions lessens. Certainly, and by definition, "body language" is lost when conversing with small talking heads in a square. We can maintain the school's learning community without being together physically, and we are committed to continued improvement. 
  
The pandemic has proven to be an effective platform for teaching public health. Lori Crane and I are co-teaching a one-credit course based around the pandemic. The course "teaches itself" as the pandemic plays out. With today's remote instruction, Lori and I can invite those involved with the pandemic and ask them to "drop in" to the class to speak with students. For example, Rachel Herlihy, the State Epidemiologist, joined the session on surveillance for 15 minutes and walked students through the website of the Colorado Department of Public Health and Environment. 

The pandemic also brings powerful evidence on the health and economic inequities of its consequences, creating a data platform for students and faculty to learn and teach about the social determinants of health. My causal diagram has structural racism and engrained economic inequality as root causes. For Colorado, the Black/African American and Latinx populations have had much higher rates of infection throughout the pandemic in comparison with non-Hispanic whites (see figure below). This figure will be central when Lori and I turn to the inequities of the pandemic. Beyond seeking explanations, we need to seek solutions. 




I am distressed, but not surprised, by the explosion of SARS-CoV-2 infections on college campuses. Across the summer, the age distribution shifted with the highest incidence moving to 20-29 year olds, likely reflecting insufficient social distancing and mask wearing. With many colleges and universities back in session for a month or more, the shift to younger ages continues. A New York Times survey shows a disturbing and worsening picture with more than 130,000 campus-related cases since the pandemic's start. 

Institutions of higher education tried to prepare for the fall semester, but underestimated the challenges, particularly those posed by undergraduates. One of my favorite demonstrations of not understanding the challenges of reopening campuses comes from the University of Illinois, which used modeling to project what might happen on reopening the campus. The epidemic projections proved to be underestimates because the modelers failed to include scenarios in which students did not isolate, even if infected — which happened in actuality. 

Here in Colorado, case rates are rising sharply among college-aged young adults. The University of Colorado attempted to prepare for the return of students with a testing program and surveillance, but the students' insufficient adherence to use of masks and other measures has led to an outbreak across the university. At the Boulder campus, a rising epidemic curve led to a two-week closure of in-person instruction starting last week. The campus dashboard provides details. The Boulder County Health Department had to respond with a Public Health Order affecting university students that is intended to end the outbreak. 

Have we (the collective) missed an opportunity for education? Did institutions of higher education take sufficient steps to assure that returning students understood their responsibilities and the consequences of not adhering to infection control measures? Did students understand that their behaviors would place others at risk for COVID-19, even if their own risks were minimal? The outbreaks on campuses across the country suggest a failure to inform and educate. Time to start anew?