Dean's COVID-19 Commentary

March 5 marked the one-year anniversary of Colorado’s first case of COVID-19, soon followed by the first death on March 13. This is the toll in Colorado over the year since then: 435,000 identified cases; an overall total, including symptomatic and asymptomatic, of perhaps 1.3 million; 24,000 hospitalizations; and 5,984 deaths. On March 5, 2020, I was hosting an event for our school’s Advisory Board and donors; on March 5, 2021, I attended the Governor’s remembrance event—"A Year Later: We Honor and Reflect.” The Governor’s remarks were somber and reflective of the loss of many Coloradans. He listed them—grandparents, parents, brothers and sisters, sons and daughters, friends, and more, as we all know. 

Don’t forget this anniversary. There will be more anniversaries to come.

The first anniversary that I am eager to celebrate, hopefully within the next few years, will be the pandemic’s official end. Reflecting at the one-year mark, I could not have anticipated today’s pandemic status in Colorado: three highly effective vaccines available through Emergency Use Authorization; an increasingly abundant vaccine supply; and the possibility that the epidemic could be sufficiently controlled by mid- to late-summer to transition towards normalcy.  

This good news comes with caution. The Colorado Modeling Group estimates that about 20% of the population is presently immune through having been infected with SARS-CoV-2 or through vaccination, far short of the needed prevalence of 70-80%. The B.1.1.7 variant with its increased transmissibility and virulence is circulating in Colorado with 189 isolates to date and the possibility remains that an increase in its frequency will bring an upturn in the epidemic curve. Also worrisome is that Coloradans will relax behaviors that have helped sustain the downward trajectory of the epidemic curve. But the good news at the moment: the epidemic curve continues its decline, albeit more slowly over the last few weeks.  

Over the next few months, Colorado and other states will transition towards “normalcy,” likely not that of 2019. There are multiple steps, multiple decisions, and multiple points of risk in the face of uncertainties. For example, when should mask mandates be ended and when should people make a personal decision to stop wearing a mask? The evidence is abundant on the benefits of masks in reducing transmission, most recently confirmed in a nationwide study by the Centers for Disease Control and Prevention. 

Regretfully, we may learn soon about what happens when mask mandates are ended too soon. Inexplicably (in my opinion), the governors of both Texas and Mississippi have ended their state mandates. Last week, Governor Abbott in Texas issued Executive Order GA-34 ending the mask mandate and opening businesses 100%. Governor Reeves in Mississippi took a similar step. These decisions were taken when about 8% of the population of each state had been fully vaccinated, hardly approaching the level for herd immunity.  

And, while I am venting, there was a mask burning at Idaho’s Capitol on Saturday (reminiscent of book burning?) and there was Saturday night’s riot on University Hill in Boulder. The former was symbolic but harmless, while the latter was risky as a superspreading event and more—police were attacked and some injured. On 9News, a student lamented that “the right to party” had been trampled by the university and Boulder County. We should all be outraged by this event, which follows poor CU Boulder student behavior in the fall. Quoting Jeff Zayach, Boulder County’s executive public health director, “The videos from the party last night are shocking and disturbing, especially considering Governor Polis had just mourned the nearly 6,000 people that died in the last year with COVID in Colorado. To see this kind of blatant activity, clearly in violation of the orders from the state, with no regard for masks and social distancing is unacceptable.” As a public health academician, as a member of the CU faculty, as the father of an alumnus, and as a Boulder resident, I agree.    

It is not yet time to pretend that it is 2019. We can look forward to that return. It will not be instantaneous but will come slowly and progressively as the state approaches herd immunity. Be patient, and quoting Yogi Berra, “It ain’t over till it’s over.”  

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