Dean's COVID-19 Commentary

I start with two numbers: the first—268 Coloradans hospitalized on July 1 with COVID-19 and the second—408 in hospital on August 6, a 50% increase. In Colorado across the summer, the epidemic curve has moved from declining—to stable—to clearly rising. With schools reopening, the timing of the surge is troubling. The July 28 modeling report did not anticipate such a rapid surge. The modeling estimated the effective reproductive number as 1.1, an estimate that projects a slow, steady rise, but not the current precipitous uptick. The pandemic continues to surprise, as this surge comes as vaccination rates are increasing. The curve’s quick rise likely continues to reflect the impact of the Delta variant and a too rapid return to past mixing and behavior patterns. The large number of summer tourists probably affects some areas, particularly mountain resort communities, as well.  

On the CU Anschutz Medical Campus, we just returned to an indoor mask mandate, complementing the requirement that all faculty, staff, and students be vaccinated, except for those with specific religious or medical exemptions. This reinstituted mask mandate is sensible, particularly as we have learned about the potential for people with breakthrough infection to transmit SARS-CoV-2. Many jurisdictions have instituted mask requirements following the recent change in the CDC guidelines. Of course, inevitably and unnecessarily, political ping-pong is being played with masks once again. 

The fingerprint of politics is smeared across the pandemic’s latest rise, as it has been from the start. I finished reading Nightmare Scenario: Inside the Trump Administration’s Response to the Pandemic that Changed History by Abutaleb and Paletta. You may not want to read a 430-page account of the toxic interactions that led to a public health disaster and you probably remember some of the highlights: hydroxychloroquine, bleach, the prevarication of Dr. Deborah Birx, the anti-science antics of Dr. Scott Atlas, and the dissing of the Centers for Disease Control and Prevention. One encouraging story: the alliance of four key physicians in the administration—Drs. Fauci, Birx, Redfield and Hahn—to continue to voice truth to the public, to support each other, and to take a “last stand” if needed.  

Politics must explain the antics of Governor Ron DeSantis in Florida. Even as hospitalizations and deaths have doubled over the last two weeks in the state, the governor continues to issue orders that countermand basic public health measures. Executive Order 21-175 blocks school districts from mandating use of masks by students, with the potential penalty of loss of state funds. The order falsely draws on “science” in its justification, for example: “Whereas, forcing children to wear masks could inhibit breathing, lead to the collection of dangerous impurities including bacteria, parasites, fungi and other contaminants, and adversely affect communications in the classroom and student performance.” I concur that communications can be affected, but “dangerous impurities”? Of concern from the broader public health perspective is the Governor’s insistence on a parental right to decide if their children will wear masks. Extended to childhood vaccinations, requiring immunization for school enrollment would be threatened. The Governor does not grasp (perhaps) that public health involves actions by the public to benefit everyone.  

Some governors are learning. Arkansas Governor Asa Hutchinson now regrets signing into law a bill banning state and local mask mandates. He acknowledges that the course of the pandemic has shifted in his state and that mask mandates might be needed for schools. The pandemic is ever-changing and our responses need to change accordingly and not be fixed by dogma. 

Hoping for another surprise with Colorado’s epidemic curve—a downturn by the opening of the Colorado School of Public Health on August 23. 




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

P.S. Saturday’s national news had the teaser that Denver’s air quality was among the worst in the world. Smoke from the Dixie Fire in Northern California has reached Colorado, driving levels of small particles into the unhealthy range above the National Ambient Air Quality Standard. The haze and limited visibility are the result and a reminder of the consequences of climate change.