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Epidemiologists share lessons they’ve learned from the coronavirus pandemic.
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This is the Virus Briefing, your comprehensive guide to the latest news and expert analysis on the coronavirus pandemic and other outbreaks. Sign up here to get this newsletter in your inbox.
Welcome to the inaugural Wednesday edition of the Virus Briefing, previously the Coronavirus Briefing. I’m your host, and I’ll be here every week. (On Mondays and Fridays, we’ll catch you up with the latest headlines.)
Our new focus reflects the fact that the world is facing more than one outbreak: most certainly the ongoing coronavirus pandemic, but also monkeypox, as well as the resurgence of polio, of West Nile, and of other pathogens.
A few weeks ago, fresh off a Covid infection and waiting in a long line for my monkeypox vaccine, I was struck by how the U.S. seemed to be repeating its mistakes.
Friends of mine who had become infected with monkeypox were confused by guidance from the government, and were scrambling for treatment. Testing was practically nonexistent. Case records were almost certainly an undercount. The vaccine rollout was fumbled. Surveillance was uneven.
So for today’s inaugural newsletter, I wanted to understand some of the lessons that we learned from the coronavirus pandemic, as we move forward and face new threats.
Top public health officials are also trying to learn from their mistakes. Today Dr. Rochelle Walensky, the director of the C.D.C., delivered a sweeping rebuke of her agency’s handling of the coronavirus pandemic, saying it had failed to respond quickly enough and needed to be overhauled.
“For 75 years, C.D.C. and public health have been preparing for Covid-19, and in our big moment, our performance did not reliably meet expectations,” Dr. Walensky said, in a startling acknowledgment of the agency’s failings.
To explore other lessons from the pandemic, I reached out to more than 50 epidemiologists, and asked them for their takeaways — big and small.
I heard a lot of soul searching about the profession of epidemiology and its limitations, especially when it comes to communicating with the public.
(The C.D.C., in an internal review released today, concluded that its public guidance has been “confusing and overwhelming.”)
“Since the pandemic, I realized we scientists often take the understanding of science for granted,” said Yanmin Zhu, an epidemiologist and instructor in medicine at Harvard Medical School. “In addition to producing scientific evidence, it is equally important for us to disseminate the scientific results to the policymakers and the public, as well as understand how science is comprehended from their perspectives.”
There was also a lot of reflection about how the perceived need for certainty affects public health messaging.
“When they — we — get something wrong, we need to do our best to correct the record,” said Noelle Cocoros, a research scientist at the Harvard Pilgrim Health Care Institute.
Many epidemiologists said they learned a hard lesson about how people would respond to steps taken by the government — even if those actions benefit their health, and the health of their communities.
“The lesson that comes to the top of mind is the combination of misinformation and politicization of public health interventions,” said Claire Leiser, a Ph.D. student in the department of epidemiology at the University of Washington. “I was surprised by the extreme resistance to masking and vaccinations. Now I appreciate the impact of the political climate on public health in a way that I didn’t before the Covid-19 pandemic.”
New and creative ways to inform and nudge the public will be critical to our ability to respond to future pandemics, many experts argued.
“The greatest lesson I learned was that we Americans must stop privileging our own humanity over Africans,” said Ramya Kumar, a Ph.D. student in the department of epidemiology at the University of Washington. “It is South Africa’s highly developed virology surveillance systems that alerted the world to new Covid-19 variants — only to be met with racist cartoons and travel bans.”
“The world has placed Africans at the back of the line to receive vaccines, or in the case of H.I.V., antiretroviral treatment,” Kumar added. “Isolated health solutions that are designed to maximally benefit the U.S. and other high-income countries do not work and never will.”
Another common refrain recognized the fragility of the systems we have in place to protect us from the next outbreak.
“Public health infrastructure has been decimated,” said Bill Miller, a professor of epidemiology at The Ohio State University College of Public Health. “We were woefully unprepared for a pandemic. We remain so. State and local governments have cut public health budgets for decades.”
“We need to infuse more thinking and creativity into the health departments,” he added. “But how to do this when many state governments are taking away health department authority, rather than expanding it, is a particularly difficult question.”
There were also plenty of personal takeaways too.
“I learned that, despite having a Ph.D. in epidemiology, I cannot convince my brothers to get vaccinated,” said Jennifer Yourkavitch, an epidemiologist and program director at Results for Development, a health and education nonprofit organization. “I learned that parents will not live forever.”
With so many viruses to worry about, how can we possibly keep track of them all?
One route: The toilet. My colleagues Aliza Aufrichtig and Emily Anthes reported that a scrappy team of New York City scientists, public health experts and plumbers is embracing wastewater surveillance as the future of disease tracking.
(Their eye-grabbing story features photographs and video by Jonah Markowitz.)
People who are infected with the coronavirus and other diseases shed the pathogen in their stool. By measuring and sequencing the viral material present in sewage, scientists can determine whether or not cases are rising in a particular area and which variants are circulating.
People excrete viruses even if they never seek testing or treatment. So wastewater surveillance has become a critical tool for keeping tabs on outbreaks. The Sewer Coronavirus Alert Network has already begun tracking the monkeypox virus in wastewater. And last week, New York City officials announced that polio had been detected in the city’s sewage.
Coronavirus:
The Marshall Islands in the Pacific, which were almost completely spared from the pandemic, are confronting an outbreak.
Jill Biden tested positive for the coronavirus on Monday.
U.S. prosecutors are struggle to catch up to a tidal wave of pandemic fraud.
Time magazine reports that many schools have not updated their ventilation systems, which help prevent the spread of the coronavirus.
Polio:
Public health officials have a clear message for parents worried about the polio found in wastewater in New York City: If your children are vaccinated, they are safe.
Did you text your mom recently asking if you had been vaccinated against polio? So did we.
Monkeypox:
In Europe, unequal vaccine access is giving some people coronavirus flashbacks.
A possible case of a person passing monkeypox to their dog was reported in France, The Washington Post reports.
Other virus news:
The West Nile virus had been detected in two New York City residents, as well as in a “record number” of infected mosquitoes throughout the city.
Seven years after the Zika epidemic began, families in Brazil are struggling to care for children with the aftereffects of the virus.
A new Langya virus was detected in dozens of people in eastern China, but the pathogen does not spread easily among people, and is not lethal, Nature reports.
I recently asked readers for lessons they will apply to future pandemics, things they would have done differently, and advice they have for future generations. More than 600 of you responded. Thanks to everyone who wrote in.
“Trust in science. Please, I beg you, trust in science, and do not under any circumstances discount what people who have spent their entire lives learning how to fight these diseases have to say. This is not political, diseases never will be, so please have a grain of common sense and decency; protect yourself, and by extension those around you.” — William Roberts, Powder Springs, Ga.
“People you love are going to suffer mental illness under these awful circumstances. They will let you down in spectacular ways, but you have to forgive them or you lose twice.” — Lenna Pierce, Brooklyn, N.Y.
“I wouldn’t have tried as hard to convince friends and family to comply with public health measures. They were never going to listen to anything I had to say; all I accomplished was losing relationships.” — Jess, Pittsburgh, Pa.
“I would not have wiped down groceries … we were so ignorant of this virus back then.” — Julie Schumann, Quad Cities, Ill.
“Listen to public health officials. Elevate them and do not make a pandemic a political issue. A pandemic is an apolitical animal. Be humble and submit to public health measures. Do not be a vector. Isolate and enjoy your solitude.” — Usha Srinivasan, Bel Air, Md.
Thanks for reading. I’ll be back next Wednesday — Jonathan
Email your thoughts to virusbriefing@nytimes.com.
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