COVID-19: Where We Are and Where We Are Going

Dr. Ashish Jha of Brown University sees a difficult winter ahead in terms of battling COVID-19, but reasons to hope in the spring.

Dr. Ashish Jha

In mid-November, I had the pleasure of listening to a virtual presentation from Dr. Ashish Jha, Dean of the Brown University School of Public Health, as part of the Massachusetts Association of Health Plans Health Policy Speaker Series. At the time, people were finalizing their Thanksgiving plans while the Coronavirus Pandemic began its fall resurgence.

Dr. Jha expressed deep concern about our present situation. “The virus is in a very bad place,” he said at the beginning of his remarks. In his assessment, there is no doubt that there is more virus in the community today than during the springtime peak, and the current count of 200,000 new cases each day is unacceptable. However, he believes there is a path forward that will bring us to something like pre-pandemic normalcy in the near future, especially with the promise of effective vaccines. As such, he said, our priority must be to save lives during the winter months.

Jha put a great deal of focus on what he called “priorities,” noting that COVID-19 does not care about our priorities are.  In other words, he said, that while he was personally emphatic to our individual needs, the virus does not care that I prioritize seeing some family, but not others.  The virus will spread wherever and whenever it sees fit.

Jha also discussed priorities in the context of the public policy response to the pandemic. He believes maintaining fully operating schools and hospitals should be our sole societal priorities.  Yet, he said, just days before his talk, New York City shut down in-person learning, while continuing to allow people still to dine together indoors. This is, he called “upside-down.“

Jha was, however, not naïve to the fact that shifting our priorities to focus on schools and hospitals is expensive. It means large-scale federal support for restaurants and their workers to survive the winter months.  He recognized this decision is “politically challenging,” as broad economic shutdowns have been unpopular and politicized. But, in his opinion, it is the best way for us to save lives as we await distribution of vaccines.

The more hopeful part of Jha’s presentation centered around the rapid development of vaccines. At the beginning of the pandemic, he admits he hoped for a 50-60% effective vaccine. Now that early data shows two vaccine candidates with 90%+ efficacy, he is extremely hopeful. He also noted that scientific integrity was not compromised through this process, it was just expedited by conducting the typical steps all at once (e.g., simultaneous human and animal studies).

While he said that we must not lose sight of the short-term task at hand (containing the virus during the winter), Jha is hopeful that we could achieve 30% immunity by the end of January, at which point virus-spread tends to naturally slow. By April or May, he hopes anybody who wants to be vaccinated will be. This may sound ambitious, he noted, and distribution nuances as well as vaccine education, will surely slow any rollout; but he saw it as feasible.

In the meantime, he said we must continue to wear masks, get tested, and only see people from our own household.