Dean's COVID-19 Commentary

The news this week on the pandemic can be easily summarized: vaccines and variants—encouraging and discouraging. The Food and Drug Administration granted Emergency Use Authorization for the Johnson and Johnson vaccine on Friday. The immediately available supply (4 million doses) is not large, but the company is slated to provide 100 million doses by the end of June. Recall that only one dose is needed with this vaccine. Supply of the Pfizer and Moderna vaccines will also increase over the month of March. Reflecting the change in vaccine supply, Colorado has again revised its plan for vaccine distribution, adding a fourth phase to 1B, the current phase. Workers involved in higher education have been added to the new phase of 1B.4, which covers those in higher education whose work involves “close contact with many people.” Those involved in PreK-12 and childcare workers are covered in phase 1.B2. We may move rapidly through the four phases of 1.B, particularly if vaccine hesitancy is high. As I wrote last week, the route to herd immunity is through vaccination.  

New variants of the SARS-CoV-2 virus have emerged over the last few months. Consequences of the variants of concern include increased transmissibility, increased virulence and decreased vaccine responsiveness. To date, 41,000 mutations have been reported, some gaining advantage by increasing transmissibility and, perhaps in the future, by being vaccine resistant. Last week, further variants were reported that may have originated in the United States, the so-called California and New York variants. While these new variants are worrisome, the epidemic curve is declining across the United States, primarily reflecting the policy measures taken over the last several months to combat the winter peak. Fortunately, the mRNA technology supports rapid changes in vaccines to contend with variants that may be less responsive to vaccines in use.  

Changing the subject, the pandemic’s toll reaches beyond disease and death to our economy, harming so many sectors that are integral to our world, like restaurants and the performing arts. Jazz clubs are one of the sad victims of the pandemic. Ever been to a jazz club? If so, you will recall being tightly packed, perhaps sharing a table with strangers, and, if fortunate, being close to the musicians. I started going to jazz clubs in the 1960s, the first time to Paul’s Mall in Boston to hear the Muddy Waters Blues Band at its peak. Since then I have been to many, sometimes while traveling—the Tokyo Blue Note, Ethiojazz in Addis Ababa, the Black Cat in Geneva, and Le Caveau de la Huchette in Paris. At the invitation of Alfredo Morabia, the editor of the American Journal of Public Health, I wrote about the connections between jazz and public health a few years ago.  

The pandemic has hit jazz clubs hard. Closures include several storied clubs: Birdland and the Jazz Standard in New York City, Blues Alley in Washington, DC, and the Blue Whale in Los Angeles. Here in Denver, El Chapultepec closed after 87 years, a decision driven by the pandemic and other factors. Close to our condominium in Denver, I regret not having heard music in El Chapultepec before it closed. Jack Kerouac and his entourage frequented the bar in the early 1950s, but a claimed appearance in Kerouac’s famed On the Road is only rumor. Clubs in Denver—Dazzle and Nocturne—seem to be hanging on, now offering limited live performances and streaming.   

One challenge of live music venues, extending beyond jazz clubs, is the generation of aerosols by wind instruments. Shelly Miller at CU Boulder and faculty-member John Volckens at CSU are studying the generation of aerosols during musical performances. Not surprisingly, wind instruments are potent generators of aerosols. Unfortunately, the return to live performances likely will be slow and cautious to minimize risk for audiences and performers alike. Another reason for all to be vaccinated.  

In the face of a declining epidemic, economic stress, and COVID fatigue, restrictions are being relaxed across the country, including Colorado. The nation’s public health leaders wisely urge caution as we manage the difficult dance between needed reopening and maintaining control of the pandemic. For now, my guidance is to be vaccinated when it is your turn, and with whatever vaccine is offered, and to continue with the measures that protect you and others: face coverings, distancing, and hand hygiene. We all know the drill.  

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

P.S. Our school recently launched a ColoradoSPH Spotify account that features podcasts and a growing collection of faculty and staff playlists, including a playlist of some of my jazz favorites.