Is COVID over? Public Health Expert Talks Masks, Vaccines | opinion
At the beginning of the COVID-19 pandemic, Dr. Angela Dunn, the state epidemiologist, on the voice of the Utah medical community, who frequently spoke with the governor and other heads of state at press conferences.
As Deseret News put it in a profile of her earlier this year:
“While many raved about her succinct and jargon-free media briefings … Dunn also faced many naysayers and even threats. But through it all, she continued to emphasize information about politics.”
Dunn, who is now executive director of the Salt Lake County Department of Health, may no longer be a daily presence on television screens, but she remains an influential voice in the state’s response to the pandemic.
This week, the Deseret News/KSL editorial board sat down with Dunn to review the current status of the pandemic and the outlook for the future. Here is an edited and condensed transcript of that discussion.
Q: We just passed that milestone of 1 million deaths in the US. What is your perspective when you hear this number?
Thin: It is definitely tragic, especially given effective vaccinations and the fact that the majority of these deaths occur in people who are not up to date on their COVID vaccine. I wonder what we could have done better or what we need to do differently in the future in relation to everything vaccine related.
Q: Where have we lost public trust or how could we have built it differently?
Thin: It goes back before COVID. Public health relies heavily on data. We think if someone disagrees with us, we can just give them more data and change their mind. … We have people who have been anti-vaccination for a lot longer than COVID, and we’ve only ever shown them the dates. And COVID is an acute example of how public health needs to move beyond data to build trust with individuals and get to the personal level of what’s really going on: why do people distrust government in general and how can public health change from the separate elected officials? machine to show that we really are part of the greater well-being?
Q: Are we in another wave of COVID-19 right now, and how do we know when people are doing unreported home testing?
Thin: I finally got COVID; It’s been two weeks since I finally tested negative. … Numerically, our cases are rising and our test-independent leading indicators are rising — that’s our sewage monitoring and people seeking treatment for a COVID-like illness. These leading indicators are definitely rising, but not to the extent of the delta or omicron flares. It’s a slow, very mild increase, and what’s good for us in Utah is that our hospital admissions are still going down, and that’s really good news.
My son and I had a very minor illness… and we want that; this is what we have been striving for for the past two years. … And we’re here to keep you up to date on your vaccinations. But unfortunately, the flip side of this coin is that fewer than 50% of Salt Lake County residents are up to date on their vaccines, which is not enough to prevent a further increase.
Q: Does updating your vaccines provide protection against the new omicron subvariants we are seeing in other countries?
Thin: Vaccinations still protect against serious illnesses. You can still get infected, but we find that it still protects very well before you need to be hospitalized or seek medical attention. So while the vaccines against Delta aren’t as effective as they were – we’re not seeing the 98% protection rate now – it’s still in the 80’s, and even in the 70’s it’s great. … So we’re still in good shape against the new omicron variants. But people need to catch up and get their boosters when they’re eligible.
Q: Do immunity and vaccination really protect us from contagion and disease?
Thin: To prevent a new surge, we all need to be up to date on our vaccines. Even if you still get COVID, you will not be hospitalized and you will not pass it on to anyone else who might be hospitalized. We really need to continue the message that it will protect you from serious illnesses. So does the flu vaccine; it protects us from being hospitalized and dying.
Q: Are we back to normal now in keeping our vaccinations up to date?
Thin: I think we’re almost there. It is still a pandemic because it is still spreading in different countries around the world. But we in the US are in a better place than we were six or three months ago. The pandemic is not over yet, but we are in a different phase largely due to our vaccinations and our natural immunity to the Omicron wave. … Keeping your vaccinations up to date allows you to make the personal choice to go about your normal life as it suits you and protects you largely from serious illnesses. So…all the big mandates, the closing of restaurants and bars, things like that…we’re past that point because we have vaccinations that are so effective.
Q: As we look ahead to the next few months of July 4th, graduations, big summer events, what worries you about social gatherings?
Thin: There’s a lot of talk about a summer wave, but I’m most worried about fall. We haven’t come through a fall without a huge climb. … We have to get through autumn 2022 without feeling like we have to close the schools again. … The approaching summer is definitely worrying given the dwindling immunity of many people. For those of us under 50 who are yet to get a second boost, our immunity to our boost is also waning, so this summer could be the perfect storm to see that increase in cases.
My biggest concern is our hospital capacity. At the moment our intensive care units are quite full, but not with COVID patients. Our COVID patients currently occupy about 2% to 3% of all our ICU beds…yet ICUs are still about 80% to 90% occupied. … Even a tiny increase due to COVID could again overwhelm our hospitals.
Q: Looking back on the pandemic, what lessons have we learned?
Thin: It is very clear that as this pandemic begins, public health and elected officials need to work more closely together in the run-up to a pandemic and especially in times of crisis. … Seeing you as a partner in pursuing common priorities and common goals will be beneficial going forward. But this is much bigger than public health. The divided country was divided before the pandemic, but we braced ourselves for a perfect storm. … And unfortunately, public health will have to bear most of the negative impact of this in terms of confidence.
Q: Are you concerned about the loss of respect for public health in this highly politicized climate?
Thin: Absolutely. You can see that on all levels. … In a way, public health could have made things better, but we always can, whatever the crisis. But in a way, it feels like public health is a scapegoat. … A lot of misinformation and different things have been said by the federal government against the CDC or the state government against public health.
Q: What missteps has Utah made during the pandemic?
Thin: Everyone had their best interests at heart, but… it sometimes felt like it was definitely public health versus economics and public health versus politics, rather than “we’re all on the same team.” We don’t want to crash the economy, nor do we want people to die needlessly. Had we been able to be more coherent, we could have given the public a clearer answer as to what we did and didn’t know, and a way forward. I don’t think that’s unique to Utah. … What we really took away from this is the need to continuously work with people outside the health sector, because health touches everything.
Q: Do masks work? Were they helpful in protecting us from COVID-19?
Thin: (she pauses) Yes, definitely. … I hesitated because at the beginning I wasn’t actually a believer in masks. I thought there was no way. You’ll touch your face and it’s a false sense of security and it’s just not worth it. But then the data showed that masks definitely help when you reach a certain level of illness in your community where the person next to you at the grocery store is more likely to have COVID than not. … It won’t prevent it 100%, but it will reduce it.
Q: Were social distancing and surface disinfection effective strategies against COVID-19?
Thin: What I think was accomplished by social distancing was fewer people gathering so you had less chance of coming into contact with COVID. Knowing that COVID is in the air… the molecule can hang in the air longer, but it has limited the number of people we have been in contact with.
It turns out that COVID… doesn’t really live long on surfaces, but certainly hangs in the air longer, so you’d better avoid coming into contact with people who are sick and also wearing a mask than you are wiping your purchases.
Q: Do cloth masks protect us less effectively than N-95 masks against COVID-19 infection?
Thin: When we had Alpha it wasn’t as transmissible as Omicron so a cloth mask did a good job of preventing spread because you had to have a lot of droplets to get infected. But with Omicron, it’s much more transmissible, so fewer droplets could infect someone, so you needed a better mask. … If you want to protect yourself with a mask now in the pandemic, it is important that you get a respirator with a really high filter capacity.
Q: What’s the most important thing people need to know for the future?
Thin: It’s okay if you get COVID and are mostly vaccinated. … Feeling good at the end is a luxury, but it shouldn’t be. We should all be up to date on our vaccines and those who cannot get vaccinated or who are more susceptible should take comfort in the fact that the vast majority of people around them are vaccinated – we just aren’t yet so far.