Dean's COVID-19 Commentary

Once again, starting with the ever briefer Colorado COVID-19 update: no change.

Now, on to reminiscing on March 13, 2023, three years after COVID-19 abruptly transformed the way that we live. On Friday, March 13, 2020, Chancellor Elliman sent out a communication that began “We write to inform you of critical steps being taken now to protect the health of the CU Anschutz community.” The Chancellor announced that effective Monday, March 16, education would transition to remote and non-critical employees would also work remotely. This announcement came as case numbers were mounting in Colorado and followed the World Health Organization’s tardy declaration of a pandemic on March 11. We retreated to our homes, worried about our safety and the future, and stockpiled food and toilet paper.   

I wrote the first of over 140 commentaries on the pandemic that week. In the first, entitled “Lessons Learned Already: COVID-19,” my comments addressed the persistent challenge and adverse public health consequences of misinformation and the need to implement established approaches for epidemic control. Revisiting the commentary, here are some sentences that still resonate:

• “When public health works, it is in the background and overlooked. When challenged by epidemics or other disasters, it is in the foreground with expectations of controlling and ending problems. Explaining what public health is can be difficult, as the two words—public health—capture an extraordinary scope of activities.”
   
• “Sadly, there is much to learn from the handling of this pandemic. Our ‘post-truth’ world slowed the needed national response as the epidemic was dismissed as a ‘hoax’, politicized, and trivialized, while the threat was undeniably growing.”
   
• “Epidemics do end, but this one will have lasting impact—memories and fears, losses of jobs and savings, and more. Some will wonder, for example, what team might have come out on top of ‘March Madness’? Others will remember losses of family and friends.”

Three years later, the pandemic may be ending (for now) and we have largely resumed living as though COVID-19 no longer poses a threat. One sign of the decline of the pandemic is the winding down of the Coronavirus Resource Center at Johns Hopkins, a remarkable global resource for data on the pandemic. Lauren Gardner, a Hopkins faculty member in the Whiting School of Engineering, launched the website and received the 2022 Lasker-Bloomberg Public Service Award for this key tool for pandemic control. Three years ago, I did not anticipate the arrival of effective vaccines within a year of the pandemic’s start. My most optimistic, albeit naïve, guess was at least two years. I was wrong and at the one year mark I received my first vaccine dose. The emotional and liberating moment of receiving the first shot will not be forgotten.  

But unfortunately, the shadow of misinformation tarnishes our most effective public health tool—vaccination—for controlling COVID-19. It has also extended to masks, most recently with the furor resulting from the misinterpreted Cochrane review. That article incited so much controversy that Cochrane’s editor-in-chief stepped forward to clarify its summary of the review’s findings and to address misinterpretations of the article. Brett Stephens, the New York Times editorialist, based his widely cited February 21 editorial, “The Mask Mandates Did Nothing. Will Any Lessons Be Learned?,” on the Cochrane review. In a “conversation” with fellow columnist Gail Collins, he backtracks a bit, but clings to criticism of mask mandates. A lesson learned but already well known in 2020—the media does wrongfully represent scientific evidence, particularly if that evidence is not sharply presented by scientists. The consequences may be damaging.

At the three-year mark, consider the following multiple choice responses to the question of the origin of SARS-CoV-2: 1) it originated naturally; 2) it was leaked from the Wuhan Institute of Virology; 3) its origin is currently uncertain; and 4) its origin will never be known with certainty. Finding an answer to this important question has not been helped by a spate of recent activities, including the leaked report from the Department of Energy, which concludes with “low confidence” that the virus originated in a lab leak in China, and also the first hearings of the House Select Subcommittee on the Coronavirus pandemic. The Department of Energy report is not presently available so the basis for its finding is unknown. I am in agreement with one conclusion from the House hearing: “Knowing the origin of COVID-19 is fundamental to helping predict and prevent future pandemics.” David Wallace-Wells provided a thoughtful overview of this three-year-old story in the New York Times. Michael Worobey at the University of Arizona has an informative commentary in the Los Angeles Times. Those wanting to learn more about the hearing of the House Select Subcommittee should see the press release on their website. 

One additional (almost) three-year anniversary: the collaborative series on COVID-19 assembled by the collaboration of the Denver Museum of Nature and Science with the Colorado School of Public Health. Today’s noon session is entitled "COVID-19 Looking Back and Looking Forward." A recording and a summary will be available.  

Returning to a few recent topics, the East Palestine, Ohio, train derailment remains in the news as politics persist and the people of East Palestine remain understandably worried and frustrated. Would it be helpful for President Biden to visit the clean-up? Air monitoring results from the Texas A&M Superfund Program and Carnegie Mellon University confirm EPA’s conclusion that levels of specific chemicals were below risk thresholds for acceptability. These findings, however, offer no reassurance concerning long-term risk or the potential consequences of water contamination, one worry of the residents. 

I started my previous commentary while in Hiroshima for a meeting of the Board of Councilors for the Radiation Effects Research Foundation. En route, I started Malcolm Gladwell’s The Bomber Mafia, a book about airborne warfare strategies during World War II. I was drawn to read the book by its chapters on the bombing of Tokyo with napalm, an invention by my college organic chemistry professor, Louis Fieser. Napalm worked to ignite anything it touched whether buildings or people. The photo of nine-year-old Phan Thi Kim Phuc, a napalm victim in Vietnam, cannot be forgotten. Napalm “worked” in the bombing of Tokyo, killing perhaps 100,000, presumably mostly civilians. This death toll, while lower than the casualty count for Hiroshima and Nagasaki, speaks to the horror of the weapons that we use against the military and civilians. Russia is following this same strategy of indiscriminate targeting of civilians in Ukraine.

Ending more cheerily, three years on we can be optimistic about the course of the pandemic and there are small hints of spring in Colorado.

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