Interest in public health surges as pandemic rages on Thursday, Oct 29 2020 

By Madelin Shelton — 

Interest in public health majors at the University of Louisville has surged as the COVID-19 pandemic has ravaged the globe. This interest has led to increased numbers of students beginning or advancing their education in public health.

Dr. Craig Blakely, the Dean of the School of Public Health and Information Sciences at U of L, said that undergraduate enrollment numbers at the School of Public Health rose 36% this fall as compared to last fall. Similarly, their graduate numbers went up 20%.

According to U of L News, the undergraduate increase for the School of Public Health and Information Sciences represents “the largest percentage surge for any baccalaureate degree at U of L this year.”

This surge in interest is not limited to U of L. According to the Association of Schools & Programs of Public Health, applications to Schools of Public Health saw a 15% increase between May 2019 and 2020. While the number of applicants has continued to increase steadily since 2016, the jump from 2019 to 2020 is especially significant.

Blakely said there were two factors he thought was contributing to such a spike besides the coronavirus.

“People are much more aware of what public health is. It’s about trying to create conditions under which people can be healthy.”

Blakely went on to say that with this newfound understanding of public health and the circumstances we now see with the COVID-19 pandemic, people believe that there will be plenty of jobs in this field.

This belief is seen in practice now, as U of L students have joined the effort against COVID-19 by becoming contact tracers to help slow the spread of the virus.

“It’s a great time to be in public health,” Blakely said. “There’s a lot going on.”

File Graphic // The Louisville Cardinal

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Are Ohio Valley States Ready To Reopen? Analysis Finds More Coronavirus Testing Needed Friday, May 8 2020 

An analysis by Harvard scientists and NPR finds that most states —  including Kentucky and Ohio — are not testing enough residents for coronavirus in order to meet recommended benchmarks to safely begin to reopen their economies. 

That analysis by Harvard’s Global Health Institute found that West Virginia is roughly meeting the minimum targets for coronavirus testing, while Kentucky and Ohio lag behind the recommended testing levels. Data on Kentucky and Ohio also show other indications that more testing is needed.

For example, the Harvard/NPR analysis of a week’s worth of Kentucky’s testing found that Kentucky averaged 1,229 tests per day — far lower than the estimated minimum needed by May 15 in order to begin to safely relax some of the business closures and social distancing safeguards in place. 

The Harvard scientists also recommend that the ratio of coronavirus tests that return a positive result be 10% or lower, something the World Health Organization also recommends. For the testing done during the week of April 29 through May 5, the ratio of positive tests in Kentucky was nearly 17%, far exceeding the recommended limit. 

From NPR and the HGHI

Similarly, Ohio averaged 5,717 tests per day, again far lower than the minimum the Harvard team estimated would be required by May 15.

From NPR and the HGHI.

However, both those states are ramping up testing capacity rapidly as they approach a phased-in reopening of some businesses and services. An analysis by member station WFPL of more recent testing data from Kentucky shows a far lower ratio of positive results, an indicator that the state is making progress.  

Dr. Tom Tsai is an assistant professor at the Harvard Chan School of Public Health and the Global Health Institute. He’s also a surgeon at Brigham and Women’s Hospital in Boston. 

In an interview with the ReSource’s Becca Schimmel, Tsai explained some of the public health benchmarks for safely reopening state economies, and talked about how an increase in testing and contact tracing can help overcome some of the challenges of resuming work life during the pandemic. 

Dr. Tom Tsai: The thresholds we look at in terms of whether a state is ready to reopen are several-fold. One is to make sure their test positive rate is below 10%. That’s a useful premise, because we know that in South Korea, their test positive rate was 2 to 3%, Germany was 6 to 8%. And anything above 10% suggests that you’re under-testing the population. So the test positive rate is a helpful metric to consider. 

The second is the number of tests that you’re doing as a per capita basis for the country. And that’s largely driven through a complex relation of issues, but including the burden of cases in your state, but also the strategy of why you’re testing. Then the most important thing is whether the actual number of cases is decreasing with time and the number of hospitalizations is decreasing with time.

Courtesy of HGHI

Dr. Thomas Tsai of the Harvard Global Health Institute.

Just looking quickly at some of the numbers for Kentucky and Ohio, I think they’re, you know, in a position where they are past the peak of where the cases are, and are in a plateau stage and even starting to see some of the cases decline, which is good news. 

The overall message, though, is more important than the thresholds for reopening, that this is not an on-off switch, but really a dial. And that the states need to really consider having very clear metrics on what success or failure looks like, and understanding that in the next weeks to months, based on the testing data, if the number of positive cases is actually increasing, then we may have to dial-up social distancing, again, in order to make sure that we’re not inadvertently creating a resurgence of cases by lifting social distancing too early.”

Schimmel: Do you think that if social distancing policies end and then need to be put back in place, that people will want to follow those guidelines again after they’ve had them dialed back?

Dr. Tsai: There’s definitely a social distancing fatigue that we’re already seeing in lots of space, especially as the weather is getting nicer and people are more likely to leave their homes. That’s why it’s so crucial to get the policy right now, because in some ways, once the floodgates open, in terms of trying to return to normal, it’s gonna be very hard to reinstitute social distancing measures that have been placed over the last several weeks, to months.

Schimmel: What are the risks to the states if they open without meeting those benchmarks?

Dr. Tsai: Well, we’re in a lockdown now, nationally, because we didn’t have the right testing capacity over the last several months, and we want to make sure as we consider reopening that we can stay open. And that means having enough information on testing. But testing is only one piece of the puzzle. Moving forward will likely involve really thoughtful and aggressive contact tracing to make sure we’re testing everybody who’s been exposed to a contact. It also may mean that we need to do workplace surveillance.

Schimmel: Aren’t there concerns about violating HIPAA and personal privacy when taking employee temperatures that some have been implementing in workplaces?

Dr. Tsai: I think it’s important to frame it in the right way, that this isn’t meant to be an obtrusive way of monitoring. This is really to help people have the right and best information for their own safety. And, you know, we think about you know, when you’re driving a car, right, everybody wears a seatbelt. We follow the rules of the road, we follow traffic lights, we stop at stop signs. And those aren’t invasions of your autonomy or privacy, but that’s basically following the rules of the road and making sure that it’s safe for everybody on the road, safe for society. I think some of these strategies — wearing masks and public being screened for temperatures —  can be viewed in the same way. They’re not affronts to your personal liberty. It’s making sure that everybody including yourself is safe from COVID-19.

This interview was edited for length and clarity.

Study Finds Coal Closures Saved Thousands Of Lives Wednesday, Jan 8 2020 

A new study finds the closure of coal-fired power plants and transition to natural gas generation across the United States over a decade saved an estimated 26,610 lives due to a reduction in air pollution, with about a fifth of those avoided deaths in the Ohio Valley.

The coal-rich Ohio Valley states received outsized health benefits from the shift from coal to gas. The analysis found about 5,300 deaths were avoided in West Virginia, Kentucky and Ohio.

The study, published Monday in the Journal Nature Sustainability, examined the impact of the closure of 334 coal-fired units between 2005 and 2016. During that same time period, 612 new natural-gas-fired units were brought online.

The analysis found that when coal plants closed, air pollution including particulate matter, ozone and other toxic substances decreased in nearby communities, reducing deaths from respiratory diseases, stroke and heart disease.

“We see that on average, across the country, the mortality rate, the number of people dying in a given population size goes down by about one percent when a unit shuts down,” said Jennifer Burney, an associate professor at the University of California San Diego’s School of Global Policy and Strategy and author of the study.

For decades, coal produced and burned in the Ohio Valley played an outsized role for much of the United States. The decline of coal has profoundly changed many communities as employment in the mining and coal generation sectors declined, but Burney said her research shows coal’s decline also has tangible benefits in lives saved.

“It’s really interesting that this is also where you see these really high beneficial impacts,” she said. “People have not died that might have if those plants have been kept on.”

The study also found the closure of coal plants benefited the country’s agricultural sector. Less air pollution allowed more sunlight to reach the earth’s surface, which the analysis extrapolates resulted in saving an estimated 570 million bushels of corn, soybeans and wheat grown near closed coal-fired generators.

In addition, Burney’s analysis estimated air pollution from coal plants also masked some of the warming in the atmosphere.

“It’s like taking off your hat in the sun. You feel the full heat that’s there and that’s what’s happening right now as the air is getting cleaner,” she said. “We’re now seeing the full extent of warming that’s already present, but had been kind of hidden from us by pollution.”

While the public health benefits of decommissioning coal plants are significant, Burney cautioned that does not mean natural gas generators come without similar risks.

“[Natural gas] produces a little bit less carbon dioxide than coal, but it’s still spewing a bunch of carbon dioxide in the air,” she said. “And from an air pollution perspective, just like with coal, when you burn natural gas, you get carbon dioxide but you also get a set of other pollutants that are produced —  it’s just a different mix from coal.”

She said more study is needed to determine what kinds of impacts turning on a natural gas plant may have on both communities and crop yields.