Dean's COVID-19 Commentary

The weather forecast no longer shows looming snowstorms and subfreezing temperatures. As I write, in Colorado’s ever-changing weather, we just had a storm with thunder and hail. Colorado’s epidemic may also be changing, after weeks of rising cases and hospitalizations. This week, the epidemic curve stalled with hospitalization counts in the low 600s. The plateau is good news and perhaps a consequence of rising immunity among middle-aged Coloradans who dominate hospital admissions. The stall comes two weeks after the state’s COVID-19 Dial “devolved” and many counties reduced or eliminated policy measures for transmission control. This is the time when we would expect to see the consequences of these policy changes. Fortunately, the epidemic curve is not going up. The bad news is that the current plateau in the low 600s is far higher than previous lows of about 300 in mid-March and 130 in July 2020. The epidemic curve is not projected to return to prior lows until sometime in August.

The global gap in vaccination and the horrific news from India are ever more worrisome. India and the countries of South America are now the leaders in new cases and death rates are highest among countries of Eastern Europe and Latin America. The stories from India include people turned away at hospital doors, a lack of oxygen, and open funeral pyres. This reality is far more troubling than what happened at the pandemic’s start as hospital capacity was reached in Italy and New York City. Beyond immediate lockdown measures, the fix for India is vaccination, but the country has lagged in spite of its vaccine production capacity. The United States is assisting India with materials for vaccine production and will be sharing 60 million doses of the AstraZeneca vaccine with other countries. As noted by Peter Hotez, this is the time for vaccine diplomacy.  

This year’s (virtual) convocation speaker, Chris Beyrer at the Johns Hopkins Bloomberg School of Public Health, has been a strong voice on the pandemic and human rights. Chris came on the faculty as I began my 14-year stay as chair of the school’s Department of Epidemiology. In the ensuing three decades, he founded the Center for Public Health and Human Rights, served as the President of the International AIDS Society, and has championed health rights for many overlooked populations. Now, he is co-chair of the International AIDS Society-Lancet Commission on Health and Human Rights. Chris is lead author on a recent commentary in The Lancet that sets out the human rights case for equitable access to COVID-19 vaccines: “As of March 21, 2021, 78% of 447 million deployed doses of COVID-19 vaccines were in only 10 countries.” And this is only one facet of global health inequities; the Commission’s report will be out in 2022, no doubt finding that there is much work to be done.  

The United States is fortunate to have an adequate vaccine supply, but too many Americans intend to reject vaccination. Vaccine hesitancy remains a favorite media topic. The necessity of achieving the highest rate of vaccination possible is clear and, as vaccination rates have slowed in the United States, the causes of hesitancy are a topic of discussion. The persisting intersection of politics and vaccine hesitancy remains particularly troubling. I am weary of media stories that offer personal explanations for not being vaccinated: the pandemic is a hoax; vaccines change DNA; not proven to work; and more. Opinions should be respected; however, the evidence on vaccine efficacy and safety is solid. Perhaps these stories should be followed by disclaimers that provide the scientific evidence for the efficacy and safety of vaccines.   

Last week, the three universities housing the Colorado School of Public Health—the University of Northern Colorado, Colorado State University, and the University of Colorado—all announced a return to a more usual on-campus experience with a policy of mandatory vaccination against SARS-CoV-2 for students, staff, and faculty. For the school, we are starting to plan for a return that reflects the “new normal,” seeking to retain some online and hybrid options. For example, I anticipate continued use of webinars that reach widely and can be recorded. Still, staring at a computer screen is not equivalent to being captivated by an in-person presentation delivered by an accomplished speaker. Of course, it is far easier to drop off an uninformative webinar than to exit an auditorium in front of a speaker.  

Enjoy spring and look forward to our fall return to campuses.   

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