In Colorado, the “tripledemic” continues. Hospital capacity is strained. COVID-19 hospitalizations seem to be slowly ebbing downwards with the count dropping from 440 to 399 to 395 over the last three weeks. Test positivity has turned the corner as well. The statistics are encouraging for respiratory syncytial virus (RSV) as well; those hospitalizations are declining. Surveillance data suggest that influenza may also start to retreat. These downturns are encouraging, but they are starting from high peaks.
 
This week there were more COVID-19 follies. In Florida, Governor DeSantis is moving aggressively to undermine COVID-19 vaccines. Last week, he announced a three-pronged approach: 1) he established the Public Health Integrity Committee led by Florida’s Surgeon General, Dr. Joseph Ladapo; 2) he petitioned for the formation of a statewide grand jury to investigate crimes and wrongdoing against Floridians involving vaccines; and 3) he called for further surveillance of sudden deaths of people who received COVID-19 vaccines in Florida. Previously a supporter of vaccination, political positioning with the Republican right-wing base is his presumed motive. Cynical undermining of public health measures has real consequences—a lesson that we have learned repeatedly during the pandemic. Ladapo will lead the Public Health Integrity Committee; recall that his Florida appointment was controversial and clouded by the rejection of widely accepted and evidence-affirmed approaches for managing the COVID-19 pandemic.
 
Governor DeSantis and Surgeon General Ladapo should read a recently released working paper by Yale economists showing excess mortality among registered Republicans in Florida and Ohio. This study linked 2017 voter registrations in the two states to mortality data for 2018-2021. Using 2019 for comparison, the researchers provide estimates of excess death for Republicans and Democrats during the pandemic years. A striking difference in higher excess mortality among Republicans emerges in 2021 when vaccines for COVID-19 became available. The excess death rate among Republicans was 76% higher than the excess among Democrats.
 
Desantis and Ladapo might also read last week’s Morbidity and Mortality Weekly Report (MMWR) providing the findings of a case-control study of bivalent vaccine efficacy among persons 65 years of age and older. After all, Florida has a large population of elderly persons. The new MMWR documents a high level of bivalent vaccine effectiveness during fall 2022 when BA.5 or BQ1./BQ1.1 were predominant. Compared with unvaccinated persons, the vaccine’s effectiveness against COVID-19 hospitalization was 84%. Compared to those who received two or more monovalent vaccine doses (two or more months before illness onset), the bivalent booster was 73% effective. These findings affirm that the bivalent booster is effective against currently circulating variants and support the “get your booster” message.

Unfortunately, Coloradans are not responding to this message; only 23.4% have completed the primary vaccine series and received an Omicron dose. Explanations for the low uptake rate are lacking, stalling our ability to lead effective interventions and increase booster vaccinations.
 
Dr. Anthony Fauci retires at month’s end from the National Institutes of Health after a 54-year stay. He has been a clear and logical voice on many public health issues, including the three years of the COVID-19 pandemic. Read his recent New York Times commentary. Here is the last paragraph:

 
I hope that we continue to hear his voice and heed his advice.

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