Dean's COVID-19 Commentary

The Colorado COVID-19 update in brief: hospitalizations are once again at a plateau, albeit lower than July’s levels, and test positivity and case numbers are trending downwards. Last week’s COVID-19 hospitalization count was 187, lower than 195 the prior week, and close to 184 for the last week of August. Nationally, the epidemic curve continues downward, and globally, a variant of concern that will interrupt the current lull has yet to emerge. Epidemic influenza has not arrived.

The lull offers a time to build resiliency. We need to be prepared for the next rise in the COVID-19 epidemic curve and for the next pandemic when another threatening infectious agent emerges. There is much that could be done, but I am not confident that the many needs surfaced by the COVID-19 pandemic will be addressed. As one example, I previously wrote about the report from the National Academies committee that I chaired, on the topic of providing respiratory protection for the nation, including the general public and workers not currently covered by the Occupational Safety and Health Administration (OSHA). The report received little attention when released and follow-up dissemination activities have not gained traction. Yet, the nation and the states did poorly in providing respiratory protection devices to many high-risk worker groups and to the U.S. population as SARS-CoV-2 arrived in 2020. We still lack devices that can be used by all segments of the population—children, the elderly, and people with facial hair, for example.

Children are back in schools. Have we taken steps to reduce transmission of airborne infection in schools? Potential measures include assuring that the heating, ventilating, and air-conditioning (HVAC) units in schools are functioning optimally; adding filtration of small particles; and possibly using ultraviolet-C radiation. Assuring that HVAC systems are functioning is critical and increasing air exchange is beneficial. Enhancing air quality in schools is central in the White House plan for a safe start of the school year. Funds are available in the American Recovery Act for that purpose, but much of the money remains unspent.

Through the Environmental Health Matters Initiative of the National Academies, I am co-chair (with Linsey Marr from Virginia Tech) of a committee organizing a series of workshops on managing the building environment to reduce transmission of airborne pathogens. The first workshop, held last month, covered general advances in knowledge on the topic since the start of the COVID-19 pandemic. The second on September 14 will address schools—reviewing advances in scientific understanding, offering four case studies from school systems, and considering barriers to implementation measures that we know are effective. Register here.

I frequently comment on the intersection of politics and public health. A recent New York Times poll provides insights into the ever-changing context set by political leanings around the pandemic. In the August poll, the gulf between “liberals” and “conservatives” around pandemic-related issues had narrowed, compared with March, on such topics as the perception of the personal risk of COVID-19 and views on in-person K-12 instruction. Additional findings from the survey address views of the handling of the pandemic by the two political parties. Last week, I wrote about the happenings around the elected board at Sarasota General Hospital. Someone brought this story concerning politics and public health and health care in Montana to my attention. Read it with concern. 

The Colorado School of Public Health community has read several books together on racism and health equity: Caste: The Origins of Our Discontents by Isabel Wilkerson and The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together by Heather McGhee. As I mentioned last week, Linda Villarosa, author of Under the Skin: The Hidden Toll of Racism on American Lives and the Health of Our Nation, will be making a presentation on the CU Anschutz campus tomorrow, Tuesday, September 13. I just finished the book and urge you to listen to Villarosa’s presentation, which will be available in an in-person format. Like the books read last year, Under the Skin uses a blend of storytelling and data to address the persistent power of racism in driving health disparities affecting Black people. Hear the author and then read the book.

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