Dean's Update
August 20, 2021 - Aron Sousa, MD
Friends,
I happened to talk to leaders at several of the state’s hospital systems this week. And while COVID-19 has not been a major problem in our hospitals for a couple of months, adequate staffing has been a struggle. They each have hundreds of openings for people in nursing and allied health professions – the folks who make a hospital run. And if some of the stories about salaries for travel staffing are true, I completely understand why some professionals are leaving to work in COVID hot spots.
Welcome to the start of endemic COVID-19. I think this is going to be our world for quite a while. The delta variant is so contagious that it can move through the unvaccinated half of our population without being disturbed by pockets of vaccinated folks. A person with old COVID-19 might spread the disease to a couple of people, but one person with delta spreads it to five to eight people. And, the delta virus has mutated to bind quickly and effectively to the mucosa of our nose and replicate before the immune system of some vaccinated people ramps up. Most often there is no infection in vaccinated people, but sometimes this leads to relatively brief vaccine breakthrough infections that can be transmitted to others, including to more susceptible unvaccinated people. That is why masking helps.
This week, the feds have begun planning for a booster shot for people who are eight months past their completion of an mRNA vaccine sequence. The Advisory Committee on Immunization Practices (ACIP) has already recommended that immunosuppressed people get a third shot.
In an important study out of the UK this week, it looks like the Pfizer vaccine is working well against the delta variant with 88% effectiveness against symptomatic disease compared to 93% effectiveness against the alpha variant. At the same time, there is a new CDC report suggesting that while vaccine effectiveness in New York against hospitalization has remained stable at 92-95%, age-adjusted effectiveness against infection has dropped from about 91% in May to about 80% at the end of July. That’s a bit of a mixed message.
A lot has been changing over the course of these studies. Economies opened, mask mandates lifted, the more transmissible delta variant became prevalent in the US and Europe, and time passed since people were vaccinated. Each of these complicates the studies, decreases the apparent or real effectiveness of vaccines, and makes it difficult to interpret the data.
Even after we are all vaccinated or have gotten sick, or both, COVID-19 will be with us. We have all lived with four known, endemic, human coronaviruses for our entire lives. Mostly they cause the common cold or a flu-like illness. Every now and then, even those four can be more serious. In fact, in early 2020, before COVID-19 reached the US, one of my relatives with a chronic illness was briefly hospitalized with coronavirus HKU1 RPP, a coronavirus discovered in 2005 but which already had a worldwide distribution.
We just need to hold tight, get vaccinated, stay vaccinated, and keep the unvaccinated as safe as possible. Or at least, we need to keep the unvaccinated from all getting sick at once and overrunning our short-staffed hospitals. The more people are vaccinated, the faster we get to that endemic state. The more we wear masks and are careful around each other, the safer the unvaccinated will be, and then our hospitals and medical system will be able to care for those who need them.
This week, I get to announce a couple of people making happy transitions within CHM. Last week, I briefly noted that Debra Furr-Holden, PhD, received a $6 million grant aimed at boosting adult vaccination including COVID-19 across five geographic areas. This is a lot of work on top of an already huge project load…and an impending grandchild!!! For all these reasons, Debra is stepping away from the role as director of the Division of Public Health on August 31. Under her leadership the division has had remarkable growth and success in scholarship, hiring, funding, faculty development, and, in particular, impact. Her leadership in the community, state, and nation is so much broader than her work as director. She will continue as associate dean for public health integration for CHM, so we get to continue her leadership in the college. I appreciate all of her incredible work for the division and look forward to watching her now that she is set free from some of her administrative work.
Wayne McCullough, PhD, who has been doing a great job as the director of our Master of Public Health degree program, is stepping into the division’s leadership as interim director. Under Wayne’s leadership, the MPH has entered the CEPH accreditation pathway, which has been a long-term goal of the college. He will continue in his role in the MPH, but we are adding an associate director to help him manage his new load. Dr. McCullough joined the college from the Business/Academic collaborative and Office for Health Equity and Inclusion at the UM Health System. In the course of his career, he has conducted hundreds of millions of dollars in research in many parts of the world for businesses in the technology industry. His current research interests are focused on the impact of communication on underserved communities and population health. Please welcome Wayne as he steps into the interim role on September 1.
My deepest appreciation to them both.
On Sunday, 190 new students embark on their journeys into the medical profession at the college’s 2021 Matriculation and White Coat Ceremony. Tune in to watch the livestream at 3 pm or join us masked and in person at DeVos Performance Hall in Grand Rapids.
Wear your mask, get vaccinated, do not go to work or school if you are sick, and get tested if you have a cold.
Serving the people with you,
Aron
Aron Sousa, MD
Interim Dean